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Assessment of Macular Structural Changes and Visual Function in Retinopathy of Prematurity
Amanda Ely1, Victoria Nguyen2, Allen Kunselman3
1Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Insights
Laser treatment for retinopathy of prematurity (ROP) in children leads to poorer visual acuity and contrast sensitivity, along with increased central retinal thickness. These findings suggest lasting macular abnormalities after ROP laser treatment.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Pediatric Eye Care
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Macular structure and function are critical for visual acuity.
- Understanding the long-term ocular effects of ROP and its treatment is essential for patient management.
Purpose of the Study:
- To evaluate macular structure and function in children with a history of laser-treated ROP.
- To compare outcomes between laser-treated ROP, untreated ROP, immature retinas, and full-term controls.
Main Methods:
- Prospective observational cohort study including 4 groups: laser-treated ROP, untreated ROP, immature retina, and full-term controls.
- Assessed foveal function using logarithm of the minimum angle of resolution (logMAR) visual acuity and contrast sensitivity (CS).
- Evaluated retinal morphology via central retinal thickness (CRT) measurements using optical coherence tomography.
Main Results:
- Laser-treated eyes exhibited significantly worse logMAR visual acuity and CS compared to untreated and control eyes.
- Central retinal thickness was significantly greater in laser-treated eyes compared to all other groups.
- A negative correlation was observed between logMAR visual acuity and CRT in laser-treated eyes.
Conclusions:
- Laser treatment for ROP is associated with abnormal macular structure and function.
- These abnormalities may result from the severity of ROP, the laser treatment itself, or a combination of both.
- Further research is warranted to elucidate the specific contributions of ROP severity and laser intervention to long-term visual outcomes.
Purpose:
To assess macular structure and function in retinopathy of prematurity (ROP).
Methods:
This was a prospective observational cohort study performed on children with laser-treated ROP (n = 32 eyes of 17 children, age 9.12 ± 2.60 years) and untreated ROP (n = 22 eyes of 12 children, age 10.40 ± 2.76 years), or premature children meeting ROP screening criteria but without ROP (immature retina) (n = 10 eyes of 6 children, age 9.00 ± 2.00 years), and full-term control patients (n = 42 eyes of 21 children, age 11.67 ± 2.87 years) comparing foveal function (logarithm of the minimum angle of resolution [logMAR] visual acuity, contrast sensitivity [CS]) and retinal morphology (central retinal thickness [CRT]). Linear mixed models were fit, followed by post-hoc comparisons using the Tukey-Kramer method.
Results:
Visual acuity of laser-treated eyes (0.26 logMAR, 95% CI: 0.19 to 0.33) was significantly worse than that of untreated (0.06 logMAR, 95% CI: -0.02 to 0.165, P = .004) and control (-0.02 logMAR, 95% CI: -0.08 to 0.05, P < .001) eyes, but not different from immature retina eyes (0.11 logMAR, 95% CI: -0.01 to 0.22, P = .12). CS in treated eyes (1.56 log units, 95% CI: 1.48 to 1.63) was significantly worse than normal eyes (1.69 log units, 95% CI: 1.62 to 1.76, P = .05), but not different from either untreated (1.66 log units, 95% CI: 1.56 to 1.75, P = .35), or immature retina (1.65 log units, 95% CI: 1.51 to 1.78, P = .63) eyes. CRT of laser-treated eyes (330.98 µm, 95% CI: 318.18 to 343.79) was significantly greater than untreated (290.32 µm, 95% CI: 276.32 to 304.32, P < .001), immature (298.39 µm, 95% CI: 280.29 to 316.50, P = .02), and control (272.07 µm, 95% CI: 260.96 to 283.19, P < .001) eyes. In lasered-treated eyes there was a statistically significant negative correlation between logMAR and CRT (correlation = -0.39, 95% CI: -0.75 to -0.03, P = .03).
Conclusions:
Laser-treated eyes had abnormal macular structure and function compared to untreated eyes and normal control eyes. Further studies are needed to determine whether these abnormalities are attributable to increased severity of ROP in laser-treated patients, the effect of laser treatment, or both.
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