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Cassie Ann Ludwig, Margaret Greven, Darius M Moshfeghi; Posterior Segment Predictors of Treatment-Warranted Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6298.
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© ARVO (1962-2015); The Authors (2016-present)
The Stanford University Network for the Diagnosis of Retinopathy of Prematurity (SUNDROP) initiative—an ongoing telemedicine-based community initiative for in-hospital screening of high-risk infants for treatment-warranted ROP (TW-ROP)—has been shown to be a safe, reliable, and cost-effective supplement to the efforts of ROP specialists. We utilized data collected in the SUNDROP initiative to determine whether posterior segment characteristics differ in newborns meeting threshold criteria for ROP treatment. We hypothesized that peripapillary atrophy and fundus pigmentation might differ in newborns with TW-ROP and non-TW-ROP.
A retrospective case control study. Participants included premature newborns requiring ROP screening at six neonatal intensive care units from December 1, 2005, to November 30, 2011 who underwent retinal ablative therapy and untreated controls within the same cohort matched for date of first exam. We reviewed fundus photographs from newborns enrolled in a telemedicine ROP screening protocol who developed TW-ROP compared to a control cohort to grade fundus pigmentation and peripapillary atrophy. We used McNemar’s chi-squared statistic for matched data to assess the relationship between peripapillary atrophy and fundus pigmentation in newborns with TW-ROP and with non-TW-ROP.
When compared to 31 subjects with non-TW-ROP, 31 infants with TW-ROP were more likely to have peripapillary atrophy (McNemar’s chi-squared, p=0.0113). As previously reported, there was also an increase in presence of a light fundus in those with TW-ROP as compared to those with non-TW-ROP (McNemar’s chi-squared, p=0.0500). There was no difference between cases and controls in gestational age at the time of the first screening, gender, or multiplicity. However, there was a statistically significant difference between cases and controls in birth weight and gestational age at birth.
This study demonstrates a difference in the posterior segment exam with wide-field digital imaging of newborns with TW-ROP as compared to those with non-TW-ROP. Peripapillary atrophy and lightly pigmented fundi may help to predict need of retinal ablative therapy in newborns with ROP.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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