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Visual acuity in infants after vitrectomy for severe retinopathy of prematurity
G E Quinn1, V Dobson, C C Barr
1Division of Pediatric Ophthalmology, Children's Hospital of Philadelphia, PA 19104.
Insights
Infants with total retinal detachment due to retinopathy of prematurity (ROP) showed poor visual outcomes after vitrectomy or no surgery. Preventing ROP-related retinal detachment is crucial for better vision in premature infants.
Area of Science:
- Ophthalmology
- Neonatology
- Retinal Surgery
Background:
- Retinopathy of prematurity (ROP) is a leading cause of vision loss in premature infants.
- Total retinal detachment is a severe complication of ROP, often leading to poor visual prognosis.
- The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) provided data on ROP management.
Purpose of the Study:
- To report visual acuity outcomes in infants with ROP-induced total retinal detachment.
- To compare outcomes between infants undergoing vitrectomy and those not receiving surgical intervention.
- To evaluate the effectiveness of current interventions for ROP-related retinal detachment.
Main Methods:
- A case series analysis of 98 infants (129 eyes) who developed total retinal detachment from ROP during the CRYO-ROP trial.
- Assessment of monocular grating acuity at 1 year using acuity cards.
- Comparison of visual outcomes in 53 infants (71 eyes) postvitrectomy versus 45 infants (58 eyes) without retinal reattachment surgery.
Main Results:
- Only one infant (two eyes) demonstrated pattern vision at the lowest measurable threshold after vitrectomy.
- No other eyes, whether vitrectomized or not, showed evidence of pattern vision.
- The majority of infants experienced very poor visual outcomes, regardless of surgical intervention.
Conclusions:
- Surgical reattachment procedures for ROP-induced total retinal detachment yield poor visual results.
- Preventative strategies to avoid ROP and subsequent retinal detachment are paramount.
- Further research into effective treatments for ROP-related retinal detachment is warranted.
Abstract:
During the course of the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP), 98 infants (129 eyes) from the randomized segment of the trial developed total retinal detachment from retinopathy of prematurity (ROP) before the 1-year examination. The authors report as a case series the results of acuity card assessment of monocular grating acuity at 1 year in 53 infants (71 eyes) postvitrectomy and in 45 infants (58 eyes) who had retinal detachments but who did not undergo retinal reattachment surgery. The decision to undertake and the surgical technique used for a retinal reattachment procedure was not part of the randomized CRYO-ROP trial. Two eyes of one infant had pattern vision at the lowest measurable threshold after vitrectomy. None of the remaining eyes that had undergone vitrectomy and none of the eyes that did not undergo vitrectomy showed evidence of pattern vision. The relatively poor visual outcomes in this case series suggest that efforts are well-spent in attempting to prevent retinal detachment in ROP.