Abstract
Purpose: :
to correlate fluorescein angiographic (FA) macular findings and early and long term visual outcomes in a preterm population underwent to laser photocoagulation for ROP threshold.
Methods: :
from March ’05 until Dec ‘08 288 inborn preterm were screened for ROP(BW 1200.8 ; EG 29.4). ROP was diagnosed in 113 babies (mean BW924.7, GA 27.7wks). 36 eyes (18 babies) type1 ROP were treated at pre-threshold level. 30 eyes (15 babies), classified as type 2, reached "classical" threshold" were also treated. Digital FA was performed before treatment in all the babies. 11 babies progressed to RD despite laser treatment. 20 babies with good laser outcome have been followed up by FA only/and visual tests evaluation (reaction to light, fixation, tracking, reaction to coloured or B/W stimuli, staring at distance, acuity according to Durand and visual fields) and autorefractometry in cicloplegia at 6 months , 1 year and 3 year. 6 babies were lost at follow-up, 4 of them died.
Results: :
FA macular abnormalities in severe ROP can be classified as follow: absence of FAZ (foveal avascular zone) in 14 babies (70%), hyperfluorescence lesions (exudative leakage) in 11babies (55%) and hypofluorescent lesions. 4 babies died before any functional evaluation. Visual evaluation was performed at 6 and 12 months. All babies showed reaction to light and were able to fix; 46,6% showed a complete tracking, 36,6% a partial one and 16,6% have no tracking skill; 73,3% showed reaction to coloured stimuli, 13,3% to black/white, 13,3% didn’t show any response; mean staring at distance was 1,28 mt (range 0,2-3 mt); only 4 babies on 15 (26,7%) had a normal visual acuity; visual field was normal in 26,7% babies, reduced or without response in 73,3%. At autorefractometry we found that 9 eyes on the total 21 was myopic, 9 hyperopic and all 21 eyes had negative (62%) or positive (38%) astigmatism.
Conclusions: :
Although this study is limited by the population size it is possible to hypothesize a correlation between FA findings and visual functional outcomes in severe ROP
Keywords: retinopathy of prematurity • retina