Evolution of Zone 1 ROP by Ultrasonography – Implications for Early Surgical Intervention

Abstract

Abstract: : Purpose: We have previously investigated the use of 10 MHz and 20 MHz ultrasound (US) for detection of all stages of retinopathy of prematurity (ROP). We now show by 20 MHz ultrasound the evolution of zone 1 ROP Methods: A 26 week gestation neonate was examined at 7 weeks post–delivery at cribside with a 20 MHz US system (Quantel Medical). The exam was performed through closed eyelids by placing the probe in a fluid–filled latex sleeve allowing optimal placement of the probe's focal zone. Exams were performed over a 5 week period. Results: Initial US examination OU revealed a flat retina with a translucent tangential membrane in both eyes, not detectable by ophthalmoscopy, at the anterior margins of the zone 1 ROP. Four weeks later, an additional tangential cyclitic membrane just posterior to the lens along with vitreous hemorrhage was noted. One week later, hemorrhagic organization and centripital contraction of both membranes was seen causing circumferential traction and a funnel retinal detachment. A vitrectomy was then performed. Conclusions: 20 MHz ultrasound is an accurate method for following the course of stage 1 ROP and provide clinical information that may be of value in the earlier surgical intervention for zone 1 ROP.

Keywords: retinopathy of prematurity • imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)