Late Retinal Detachments in Retinopathy of Prematurity

This study aimed to investigate the presenting characteristics and outcomes of ROP patients with late retinal detachment (RD).

A retrospective chart review was performed for patients with ROP who presented with a late RD, occurring at least 2 years after initial ROP diagnosis. Demographic information, visual outcomes, and RD characteristics were obtained.

A total of 38 patients with a history of ROP who presented with a late RD were included (57.9% males). The median birth weight was 851.5 g and median gestational age at birth was 26.5 weeks. The median age at presentation for RD was 19 years. More than half of the RDs were diagnosed incidentally on routine examination, and 51.7% had macula-off RD. Fifty percent of patients had a rhegmatogenous RD, 35.3% had tractional RD, and 14.7% had combined rhegmatogenous and tractional RD. The majority of patients (78%) underwent surgical intervention for RD repair with either combined pars plana vitrectomy and scleral buckle (46.9%), scleral buckle alone (34.4%), or pars plana vitrectomy alone (18.7%), and 22% were observed due to guarded prognosis. The median logMAR vision was 1.8 at presentation and 1.18 at final follow-up. Redetachment occurred in 23.6% of patients, of whom 88.9% had additional surgery.

Late RDs can develop in the setting of ROP and usually occur in young adulthood. More than one half of patients were found asymptomatically on routine examination and had macula-off RD. Many required complex surgery with silicone oil. Long-term follow-up for ROP patients may be indicated to monitor for progressive traction and retinal breaks.