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ME Hartnett, DW Rodier, HW Thompson; Vision after Surgery for Stages 4 and 5 Retinopathy of Prematurity as Measured by Teller Acuity Cards and the New Light Perception-Projection Scale . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1251.
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Purpose: To determine the correlation between vision scores measured by Teller Acuity Cards (TAC) and a new Light Perception-Projection Scale (LP scale) in infants who had had treatment for threshold disease and were referred for management of stages 4 and 5 ROP, and to test whether vitreoretinal surgery to prevent or repair stage 5 ROP improved visual function as measured with these two methods. Methods: Infants managed with observation or retinal detachment repair underwent visual acuity testing using TAC and the LP scale. The LP scale is easy to administer and measures the detection of light in different fields of view under light or dark illumination. The correlation between the methods was determined. Eyes with reattached retinas and those with persistently detached retinas were grouped as to 1) stage at first visit and 2) worst stage that developed. In each group, visual function measured by TAC and the LP scale was compared in patients with attached and persistently detached retinas. Results: Thirty-five eyes of 19 infants were tested. The scores obtained with the LP scale and TAC were highly correlated (r=-0.91; p<0.0001; n=35). Both TAC and LP scale scores were significantly better in eyes with attached retinas, compared to eyes with persistently detached retinas, when the ROP stage at first visit was 4a (p=0.0005; ANOVA) or 4b (p=0.03). LP scale scores were also significantly better in eyes with retinal attachment, compared to eyes with persistently detached retinas, when the ROP stage at the first visit was stage 5 (p=0.01). In eyes with stage 5 as the worst stage, successful retinal reattachment was associated with significantly better TAC scores (p=0.015) and LP scale scores (p=0.004), compared to similar eyes with persistent retinal detachment. Conclusion: The LP scale may be clinically useful in testing visual function in low vision infants, because it correlates with TAC scores, is easy to administer, and may measure lower visual function than TAC. Although prevention of Stage 5 ROP is the goal in ROP management, surgical reattachment of the retina in some cases of stage 5 ROP may be beneficial to visual function.
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