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Incomplete peripheral retinal vascularisation in retinopathy of prematurity: is it the consequence of changing oxygen
Sigal Zmujack Yehiam1, Samantha K Simkin1, Rasha Al-Taie1,2
1Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Insights
Incomplete peripheral avascular retina (IPAR) affects 12.8% of premature infants screened for retinopathy of prematurity (ROP). Higher oxygen saturation targets did not increase IPAR prevalence, suggesting other risk factors are more significant.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) screening is crucial for premature infants.
- Incomplete peripheral avascular retina (IPAR) is a potential complication.
- Understanding IPAR's prevalence and risk factors is essential for optimal infant eye care.
Purpose of the Study:
- To determine the prevalence and risk factors of IPAR in infants screened for ROP.
- To investigate the association between IPAR and oxygen saturation (SpO2) targets.
- To identify potential risk factors for avascular retina development.
Main Methods:
- Retrospective review of retinal images from premature infants screened for ROP.
- Comparison of IPAR prevalence before and after an increase in SpO2 targets.
- Exclusion of infants with concurrent ocular pathology or ROP treatment.
Main Results:
- 12.8% of infants (62/486) exhibited IPAR at final ROP screening.
- A higher prevalence of IPAR was observed in infants born before 2015 (Group 1) compared to after (Group 2) (p=0.043).
- Increased SpO2 targets were not associated with a higher prevalence of IPAR.
Conclusions:
- IPAR occurs in 12.8% of ROP-screened infants.
- Higher SpO2 targets did not elevate IPAR prevalence.
- Low gestational age and low birth weight are suspected risk factors for avascular retina.
Background:
We wish to determine the prevalence and risk factors of incomplete peripheral avascular retina (IPAR) in children screened for retinopathy of prematurity (ROP) and its association with oxygen saturation (SpO2) targets.
Methods:
A retrospective review of retinal images of premature infants born and screened for ROP in Auckland Region, New Zealand, between January 2013 and December 2017 was conducted. Images were reviewed to determine if avascular retina was present at their final ROP screening. The prevalence of peripheral avascular retina was compared among infants born prior to (Group 1) and after (Group 2) 2015 when the SpO2 target was increased. Infants with any concurrent ocular pathology or who had received ROP treatment were excluded.
Results:
In total, 62 (12.8%) of the total of 486 infants (247 in Group 1; 239 in Group 2) were found to have IPAR at their last ROP screening. Group 1 had more statistically significant infants with IPAR compared to Group 2 (39/247 infants and 23/239 infants respectively; p = 0.043).
Conclusions:
Incomplete peripheral retinal vascularisation occurred at a prevalence of 12.8% in infants at risk of ROP. Higher SpO2 targets did not increase the prevalence of incomplete peripheral retinal vascularisation. Low gestational age and low birth weight are likely risk factors for the development of avascular retina. Further research into the risk factors associated with incomplete peripheral retinal vascularisation and the associated long-term outcomes is needed.
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