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Development of grating acuity in infants with regressed stage 3 retinopathy of prematurity
1Department of Psychology, University of Pittsburgh, PA 15260.
Insights
Infants with regressed retinopathy of prematurity (ROP) may experience delayed visual acuity development. This delay is primarily linked to co-occurring central nervous system abnormalities, not ROP itself.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Regressed Stage 3 ROP, despite lacking lasting retinal or optic nerve damage, may impact visual development.
- Understanding visual acuity trajectories in infants with regressed ROP is crucial for early intervention.
Purpose of the Study:
- To assess grating acuity development in infants with regressed Stage 3 retinopathy of prematurity (ROP).
- To compare visual development between infants with regressed ROP and healthy preterm controls.
- To identify factors contributing to any observed delays in visual acuity.
Main Methods:
- The acuity card procedure was employed to measure grating acuity.
- Seventeen infants with regressed Stage 3 ROP were compared to 28 healthy preterm infants and 28 matched controls.
- Visual acuity was tested at multiple age points from birth to 18 months.
Main Results:
- Infants with regressed ROP demonstrated delayed grating acuity development until 2 years of age.
- Significant differences were noted at 3-5 and 10-12 months, but not at other tested ages.
- Post hoc analysis revealed that central nervous system abnormalities (periventricular leukomalacia or severe intraventricular hemorrhage) accounted for the acuity delay.
Conclusions:
- Regressed Stage 3 ROP alone does not appear to cause lasting visual acuity deficits.
- Co-existing central nervous system abnormalities are the primary drivers of delayed visual development in this cohort.
- Infants with regressed ROP without CNS issues show visual development comparable to preterm peers.
Abstract:
The acuity card procedure was used to measure grating acuity in 17 infants with regressed Stage 3 retinopathy of prematurity (ROP) who had no lasting anatomic changes in the retina or optic nerve. Results were compared with those of 28 healthy preterm infants and 28 infants matched by birth weight and gestational age who did not have Stage 3 ROP. Infants in the ROP group showed delayed grating acuity development until 2 years of age. This difference among groups was significant at the 3-5- and 10-12-month test ages but not at the 0-1-, 8-9-, and 16-18-month test ages. Post hoc analyses indicated that the delay in acuity development shown by the ROP group was due to the poor acuity scores of the infants in that group who had central nervous system abnormalities of periventricular leukomalacia or severe (Grade III or IV) intraventricular hemorrhage. When the data of these infants were removed from the analysis, the ROP group showed acuity development similar to that of both the healthy preterm group and the group of infants with matched birth weights and gestational ages who did not have Stage 3 ROP.