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M. P. Rabinowitz, J. E. Grunwald, K. A. Karp, G. E. Quinn, G.-S. Ying, M. D. Mills; Does Retinal Vessel Diameter Measured Between 31 and 34 Weeks Post-Conceptional Age Predict Progression to Severe Retinopathy?. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3089.
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To assess the predictive value of early retinal vascular diameter measurements for the development of severe retinopathy of prematurity (ROP) in high-risk preterm infants.
39 infants, 78 eyes at risk for development of ROP were enrolled in this study. All infants had birth weight ≤1251g and gestational age <30 weeks. Digital fundus imaging was performed using a Nidek NM200D non-contact camera at exam between 31 and 34 weeks post-conceptional age (PCA). Subjects were followed-up every 1-2 weeks, as clinically indicated, until retinal vasculature matured, regressed, or was treated. Fundus photographs taken at 31-34 weeks PCA were masked and assessed using VesselMap semi-automated software. The 3 highest-quality photos from each eye were analyzed, and mean vessel diameters were measured for the major superior and inferior temporal arteries (STA and ITA) and veins (STV and ITV). Poor image quality did not allow vessel measurement in 24% of photographs. One or more vessels could not be measured in 19% of eyes. Mean vessel diameters from eyes that developed severe, treatment-requiring ROP were compared to those that did not require treatment.
9 patients, 18 eyes developed severe ROP requiring treatment. Average PCA at worst stage was 35.4 weeks. 18 patients, 36 eyes developed less severe ROP not requiring treatment. Average PCA at worst stage was 35.6 weeks. 12 patients, 24 eyes did not develop ROP. Eyes that developed severe ROP requiring treatment showed significantly increased vascular diameters compared to eyes that did not require treatment (table).Multivariate analysis adjusted by birth weight, gestational age, and chronologic age showed similar results.
Retinal vascular diameters early in the course of ROP evaluation are significantly larger in eyes that progress to severe ROP than in those that develop less severe or no ROP. At 31-34 weeks PCA retinal vessel diameters may help identify high-risk infants that are more likely to require treatment.
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