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The Development of Retinal Function and Refractive Error in Children With Retinopathy of Prematurity
Hanna De Bruyn1, Ronald M Hansen1,2, James D Akula1,2
1Ophthalmology Department, Boston Children's Hospital, Boston, Massachusetts, United States.
Insights
Retinopathy of prematurity (ROP) delays rod-mediated vision development in the central retina but not the peripheral retina. This ROP-induced delay is linked to visual acuity and refractive error in preterm infants.
Area of Science:
- Ophthalmology
- Developmental Biology
- Retinal Physiology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Understanding the long-term visual consequences of ROP is crucial for timely intervention.
- Rod-mediated vision development is a key indicator of retinal maturation.
Purpose of the Study:
- To investigate if ROP prolongs the development of rod-mediated visual thresholds at 10 and 30 degrees eccentricity.
- To assess the association between these visual thresholds and visual acuity (VA) and spherical equivalent (SE) in preterm infants.
Main Methods:
- Rod-mediated dark-adapted thresholds (DATs) were measured at 10 and 30 degrees eccentricity in preterm infants with varying ROP severity and term-born controls.
- DAT development was modeled using logistic growth curves to determine age at half-maximal sensitivity.
- Visual acuity (VA) and spherical equivalent (SE) were assessed and correlated with DAT development at age 10 years.
Main Results:
- ROP was associated with significantly delayed DAT development at 10 degrees eccentricity.
- No significant alteration in DAT development was observed at 30 degrees eccentricity due to ROP.
- At age 10 years, VA and SE were significantly associated with ROP severity, with SE linked to 30-degree DAT development.
Conclusions:
- Mild to severe ROP significantly delays rod-mediated visual development in the central retina (10 degrees).
- This suggests the central retina's late maturation is vulnerable to ROP.
- The association between peripheral retinal thresholds (30 degrees) and myopia indicates the periphery's role in refractive development.
Purpose:
The purpose of this study was to test the hypothesis that retinopathy of prematurity (ROP) prolongs development of rod-mediated thresholds for detection of stimuli at 10 degrees but not 30 degrees eccentricity. In addition, to evaluate the thresholds at each site for an association with visual acuity (VA) and spherical equivalent (SE).
Methods:
We estimated rod-mediated dark-adapted thresholds (DATs) for the detection of 2 degree diameter, 50 ms, blue (λ < 510 nm) flashes at 10 degrees and 30 degrees eccentric in former preterm subjects (n = 111), stratified by ROP severity: None (n = 32), Mild (n = 66), and Severe (n = 13). We also tested Term-born (n = 28) controls. To determine the age at half-maximal sensitivity (Agehalf) for each group and eccentricity, we fit DATs to logistic growth curves. We obtained VA and SE for Preterm subjects and evaluated the course of threshold development at 10 degrees and 30 degrees for significant association with VA and SE predicted at age 10 years.
Results:
DAT development at 10 degrees was significantly delayed in ROP (Mild and Severe); ROP did not significantly alter DAT development at 30 degrees. At age 10 years, among Preterm subjects, both VA and SE were significantly associated with group (None,Mild, and Severe). SE was predicted by the course of DAT development at 30 degrees. VA was not associated with the course of DAT development at 10 degrees.
Conclusions:
At 10 degrees, ROP-whether mild or severe-is associated with significant delays in DAT development, evidence that the late-maturing central retina is vulnerable to ROP. The association of 30 degree threshold and myopia are evidence that more peripheral retina is important to refractive development.
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