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Tianyu Liu, Gui-Shuang Ying, Wei Pan, Eli Smith, Agnieshka Baumritter, Graham E Quinn; Asymmetry of retinopathy of prematurity (ROP) border and correlation with ROP severity in the Telemedicine Approaches to Retinopathy of Prematurity (e-ROP) Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2754. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The current International Classification of Retinopathy of Prematurity designates the disease severity by zone, stage, and presence or absence of plus disease based on ophthalmoscopic appearance. Few studies have quantitatively measured the location of the ROP border in relation to the optic disc. We sought to measure the location of the ROP border in a sample of premature infants who developed ROP and determine its association with subsequent development of referral-warranted ROP (RW-ROP) or treated ROP.
Eyes from the e-ROP study were included if they had at least one exam at ≤34 weeks postmenstrual age (PMA) with ROP not meeting RW-ROP criteria, and at least one additional exam at ≥36 weeks PMA. The first image set with ROP not meeting RW-ROP criteria for each eye was selected for grading. The 5-image set was mosaicked, and measurements of the optic disc and ROP border of each image were made by a single grader following a standardized protocol. Measurements were compared among 3 groups of eyes with ROP: (1) eyes undergoing treatment, (2) eyes with RW-ROP but no treatment, and (3) eyes that never developed RW-ROP or received treatment, using analysis of variance and linear trend tests that accounted for the inter-eye correlation.
317 eyes from 217 infants with mean birth weight 755g, mean gestational age 25 weeks, and mean PMA 33 weeks at first exam met study criteria. 237 (74.8%) of the mosaicked images (165 infants) were of sufficient quality for grading. Of the 237 eyes, 29 were treated for ROP, 39 developed RW-ROP but did not receive treatment, and 169 did not develop RW-ROP or receive treatment. Among all eyes, the disc-to-ROP border distance followed a consistent pattern, with nasal < inferior < superior < temporal, and a mean nasal-temporal distance ratio of 0.79 (Table 1). Eyes with RW-ROP or underwent treatment had significantly smaller areas of vascularized retina and shorter disc-to-ROP border distances in nasal and temporal directions (Table 2).
Location at first observation of ROP along the nasal-temporal axis may be an important predictor of developing referral-warranted and treatment-requiring ROP.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Table 1. Mean (standard error) distances in pixels from optic disc center to ROP border
Table 2. Mean (standard error) quantitative measurements of fundus images by ROP severity
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