Sequential vascular changes followed by angiography in spontaneously regressed retinopathy of prematurity in infants born greater than 32 weeks gestation and birthweight greater than 1250g with high oxygen dependance

Abstract

Purpose: To describe retinal abnormalities assessed by fluorescein angiography (FA) in eyes of bigger and mature preterm infants exposed to high oxygen saturation and developed retinopathy of prematurity (ROP).

Methods: A retrospective, nonrandomized, case series. We included three patients (6 eyes) diagnosed with retinopathy of prematurity and oxygen saturation rate over 95% measured with a pulse oximeter. Fundus photographs and FA were obtained every two weeks using a wide-field digital pediatric imaging system until the resolution from the disease. (RetCam II Clarity)

Results: Fluorescein angiography showed incomplete vascularization of peripheral retina with a tortuous demarcation line with a ridge in some areas, all eyes showed capillary free areas in all ready vascularized retina, vessels in the posterior pole showed parietal hyperfluorescence near the foveal avascular zone. Some vessels showed microaneurism-like lesions. Once the oxygen was regulated the disease showed involution with growth of a normal capillary pattern all the way to the ora serrata.

Conclusions: The high oxygenation in preterm infants is a factor for the generation of oxygen toxicity retinopathy, decreased oxygenation parameters can cause regression of retinopathy and subsequent vascularization of the peripheral retina. Further studies are needed to confirm this hypothesis.

Keywords: 706 retinopathy of prematurity • 635 oxygen • 688 retina