Classification of Fluorescein Angiographic Findings in Threshold and Prethreshold Rop

Abstract

Purpose: : to evaluate fluorescein angiographic findings in threshold and prethreshold ROP and to define the timing of treatment and the abnormal retinal areas inside the ridge to treat.

Methods: : starting from Dec‘04 RETCAM digital fluorescein angiography (Massie Lab., Pleasanton, CA) became available for ROP screening in the neonatal intensive care unit at the Catholic University Hospital in Rome. Until July ‘07 199 inborn preterm with gestational age (GA) 32 wks and/or a birth weight (BW) 1500gr were screened for ROP. The mean BW was 1187.9 gr. (range 350-2420gr.) and the mean GA was 29.3 wks (range 24-35wks). ROP was diagnosed in 81 babies (mean BW 922.8gr, GA 27.6wks). 38 eyes (19 babies) type1 ROP were treated at pre-threshold level. 13 eyes (7 babies), classified as type 2, reached "classical" threshold" were also treated. Digital fluorescein angiography was performed before treatment.

Results: : fluorescein showed a variable arm to eye transit time; common features for all ROP were good visualization of junction between vascular and avascular retina, also due to intense dye leakage. We also observed abnormal vessels branching and capillaries formation near the ridge. Naked shunts, large capillary free formation and areas of hypo perfusion with significant dye leakage inside vascularised retina were observed. Teleangectasia, cotton wools and macular abnormalities were found in some cases.

Conclusions: : Fluorescein angiographic findings in ROP are necessary to guide a successful laser treatment.

Keywords: retinopathy of prematurity • retina