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Functional and microvascular sequelae of type 1 retinopathy of prematurity: insights from OCT-A and microperimetry
Barbaros Hayrettin Unlu1, Ozlem Ural Fatihoglu2, Ayse Bozkurt Oflaz3
1Menemen State Hospital, Department of Ophthalmology, Izmir, Turkey.
Insights
Laser photocoagulation for retinopathy of prematurity impacts long-term visual function and fixation stability in children. Treatment affects macular vascular development, highlighting the need for ongoing follow-up.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Retinal Imaging
Background:
- Evaluates long-term outcomes of laser photocoagulation (LP) for retinopathy of prematurity (ROP) in school-aged children.
- Assesses macular integrity, retinal sensitivity, fixation stability, and microvascular parameters.
Purpose of the Study:
- To assess the long-term structural, functional, and microvascular effects of LP treatment for ROP in children.
- To compare outcomes in children treated for ROP, preterm infants without ROP, and full-term controls.
Main Methods:
- Retrospective cross-sectional study of children aged 10-15.
- Ophthalmologic examinations including microperimetry and OCT-A.
- Comparison of fixation stability, foveal avascular zone (FAZ) area, and vascular density (VD) across three groups.
Main Results:
- Laser-treated infants showed significantly more eccentric fixation compared to preterm and term-born children (p<0.019).
- Smaller FAZ areas and higher VD were observed in laser-treated infants (p<0.001).
- Negative correlation found between fixation instability and FAZ size (p<0.016), linking fixation behavior to microvascular integrity.
Conclusions:
- ROP diagnosis and treatment significantly impact long-term visual function, fixation, and macular vascular development.
- Emphasizes the necessity of long-term follow-up for preterm infants post-ROP treatment.
- Further research is needed to explore the relationship between fixation stability and retinal microvasculature.
Background:
This study evaluated the long-term structural, functional, and microvascular outcomes in school-aged children with a history of laser photocoagulation (LP) therapy for the treatment of type 1 retinopathy of prematurity (ROP). The macular integrity, retinal sensitivity, fixation stability, and microvascular parameters were assessed using microperimetry and optical coherence tomography angiography (OCT-A).
Methods:
This retrospective cross-sectional study included children aged 10-15 who underwent detailed ophthalmologic examinations. Participants were divided into three groups: (1) children who had received LP for the treatment of ROP in infancy, (2) prematurely born infants without any ROP diagnosis, and (3) full-term controls. Statistical analysis was conducted to compare fixation stability, foveal avascular zone (FAZ) area, and vascular density (VD).
Results:
A significant difference was found in fixation stability among the groups, demonstrating more stable fixation in term-born children compared to preterm groups and significantly eccentric fixation in laser-treated infants (p = 0.019 and p < 0.001, respectively). Furthermore, FAZ areas were substantially smaller, and VD values were higher in laser-treated infants (p < 0.001 for both). A negative correlation was identified between fixation instability and FAZ size (p = 0.016 and p = 0.015), suggesting a relationship between fixation behaviour and foveal microvascular integrity.
Conclusion:
The diagnosis and treatment of ROP can significantly affect long-term visual functions, fixation behaviours, and macular vascular development. These findings emphasise the importance of long-term follow-up for preterm infants and the need for further studies to investigate the relationship between fixation stability and retinal microvasculature.
