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Alan Alba-Orozco, Luvia Rodriguez Quiñones, Hugo Sepulveda, Virgilio Morales-Canton, Maria Ana Martinez-Castellanos; Fluorescein Angiography Differences Between Retinopathy of Prematurity and Retinopathy Induced by Oxygen in Preterm Newborns. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5924.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the differences found in fluorescein angiography in preterm newborns between retinopathy of prematurity (ROP) and induced by high doses of oxygen.
Retrospective case series. We included 3 premature babies older than 32 weeks gestation with birthweight grater than 1250 grams and high oxygen dependence (90-95% oxygen blood saturation. Fundus photographs and Fluorescein angiography (FA) were obtained using a wide-field digital pediatric imaging system (RetCam II) and were compared between the 2 groups.
We observed a preserved pattern of vascular flow up to the equatorial retina with normal branching of the blood vessels, followed by a tortuous hyperfluorescent demarcation line without leakage and a hypofluorescent area which corresponds to the avascular zone in infants without ROP. Moreover, the findings in patients with ROP, especially in early stages (1 and 2), were a hyperfluorescent demarcation line or ridge in the midperiphery with leakage, associated with hyperfluorescent points in the macular zone without a specific pattern.
We detected in both groups a hypofluorescent area in the periphery corresponding to the avascular zone, with a demarcation line in the transition to the vascularized retina. The major difference observed, was the capillary leakage in that region. This could be due to the immaturity of the blood vessels caused by the absence of pericytes on the vascular wall, understanding that these cells are the main supporting component. Therefore, the retinal vascular development depends of certain state of physiological hypoxia, which can be disrupted by this kind of therapy, so we could easily confuse these two entities clinically, especially at early stages. In this situation, FA is a useful diagnostic tool to make a correct diagnosis.
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