Purchase this article with an account.
EF Hall, N Oden, C Cole, C Barr, DL PhelpsSTOP-ROP Multicenter Study Group; Prethreshold and Threshold ROP: Distribution of Quadrants of Posterior Pole Dilation and Tortuosity . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1235.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Background: Posterior pole vascular dilation and tortuosity (D/T) are critical findings in the classification, treatment, and prognosis of retinopathy of prematurity (ROP). Investigators have recognized a spectrum of D/T severity. During the Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity multicenter trial (STOP-ROP), we collected prospective data on the distribution of quadrants of D/T observed and ROP outcomes. Purpose: Describe the distribution of quadrants of posterior pole vascular D/T observed at prethreshold (PT) and threshold (TH) ROP and their prognostic significance. Methods: Study-certified ophthalmologists using standard photographs, recorded D/T by retinal quadrants in 649 infants with PT ROP. Observations were recorded at enrollment and again at study outcome, defined as progression to STOP-ROP TH, or resolution (ROP in zone III for at least two successive weekly examinations or full retinal vascularization). During STOP-ROP, the conventional definition for TH was used in zone II. In zone I the definition used was the presence of plus disease ROP, or any stage 3 disease, even without plus disease. Plus disease required 2 or more quadrants of D/T. Results: The distribution of quadrants of D/T at PT, TH zone II, and TH zone I are shown in the Table. Of 736 eyes at PT in zone II with known outcomes, 430 resolved without reaching TH. Resolution rates generally decreased as the number of quadrants(Q) of D/T seen at PT increased: [71% resolved for 0Q(n=260), 39% for 1Q(n=12), 62% for 2Q(n=51), 47% for 3Q(n=7), and 41% for 4Q(n=100)]. In the 293 zone I PT eyes with known outcomes, 157 resolved and initial Q of D/T were: 54% regression for 0Q (n=285) and 38% for 1Q (n=8). Overall, 80% of eyes at TH had 4 quadrants of D/T. Conclusions: D/T in the posterior pole most frequently affects either 0 or 4 quadrants, although 1, 2 or 3 quadrant involvement may be observed. Resolution of PT ROP without progression to TH is common (41%) even with 4 quadrants D/T in zone II PT eyes. Table View OriginalDownload SlideView OriginalDownload Slide
This PDF is available to Subscribers Only