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Tiffany Ann Chen, Cassie Ludwig, Darius M Moshfeghi; Peripapillary Pigmentation and Optic Disc Morphology in Newborns with Treatment-Warranted Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5537.
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Little is known about the changes in peripapillary area and optic disc morphology during the progression of treatment-warranted retinopathy of prematurity (TW-ROP). We performed a retrospective, case-control study to better understand the differences in peripapillary pigmentation and optic disc area between the first and last screening exams for infants at risk for ROP.
All premature newborns screened for ROP as part of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) initiative between December 1, 2005 and December 30, 2015 were reviewed. Two control newborns without TW-ROP were matched by gestational age to each TW-ROP newborn identified. For the first and last ROP screening exams, mean gray value (MGV), peripapillary pigmentation area (PPA), integrated density (ID), optic disc area (ODA), and cup-to-disc area (CDA) were measured from fundus photos using ImageJ. Statistical analyses were performed using SAS software with p < 0.05 indicating statistical significance.
Of 843 screened newborns, 37 had TW-ROP with an average gestational age of 25 weeks. As expected, TW-ROP babies had significantly lower birth-weights than non-TW-ROP babies (691.3 g vs. 770.2 g, p = 0.014). No significant differences in sex or multiplicity were observed. From first to last screening exams, the MGV in TW-ROP babies decreased by 4.68 units (p<0.0001) vs. 2.65 units in non-TW-ROP babies (p=0.0699), PPA increased by 0.1 mm2 (p=0.0707) vs. decreased by 0.17 mm2 (p=0.0047), and ID increased by 25.13 units*mm2 (p=0.1734) vs. decreased by 44.06 units*mm2 (p=0.0021). A 1:2 case:control matched analysis showed statistically significant differences in PPA and ID from first to last screening exams between TW-ROP and non-TW-ROP babies (PPA p= 0.0118 and ID p=0.0155). There was no difference in ODA or CDA from first to last screening exams between the two groups.
Our results showed no difference in the ODA, but a significant difference in PPA and ID from first to last ROP screening exams between TW-ROP and non-TW-ROP newborns. The decrease in MGV from first to last ROP exam was greater in TW-ROP babies, indicating that peripapillary pigmentation became darker to a greater degree in TW-ROP as compared to non-TW-ROP newborns. The clinical significance of these results remains to be determined.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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