Fluorangiographic Study of Retinal and Choroideal Vasculature in a Preterm Population

Abstract

Purpose: : To evaluate retinal and choroidal development in type I retinopathy of prematurity (ROP) using fundus photographs and fluorescein angiograph (FA).

Methods: : Since Dec 2004, 55 inborn babies underwent treatment for ROP at Catholic University Hospital in Rome. Conventional laser photoablation was administered until Sept 09. Thereafter one eye was randomized to receive an intravitreal injection of 0.5mg of bevacizumab in a 0.02 ml BS solution; the fellow eye received conventional laser photoablation. Fundus photographs and fluorescein angiography (FA) using RetCam (Clarity, Pleasanton, CA) were performed before treatment and up to 5 years of age under general anaesthesia. FA's of the entire population were retrospectively examined to determine the presence of retinal and choroidal abnormalities.

Results: : 34 babies (67 eyes) were considered type 1 ROP. Among these babies, 49 eyes (25 babies) had favourable structural results. 18 eyes (9 babies) progressed to stage 5. Abnormal central choroidal filling and other posterior pole abnormalities are a common and sometimes longlasting finding in type 1 ROP both in conventional and injected eyes. Furthermore all eyes treated with bevacizumab were noted to have peripheral retinal abnormalities including large avascular areas, abnormal vessel branching, and shunts) Such lesions were rare in the laser treated eyes (all p<0.01 when bevacizumab and laser compared for each).

Conclusions: : When type 1 ROP eyes are treated with bevacizumab, there appear to be more serious retinal and choroidal abnormalities on FAs at follow-up. This is likely to have long lasting implications for visual function of the child.

Keywords: retinopathy of prematurity • choroid