Grating Acuity Outcomes in Children with Retinopathy of Prematurity from a Public University Hospital in Brazil

Abstract

Purpose : The purpose of this longitudinal study was to evaluate grating visual acuity (GA) and its deficit (GAD) in children with retinopathy of prematurity.

Methods : Preterm children with retinopathy of prematurity (ROP) and normal neuro psychomotor development had their GA (logMAR) assessed by sweep-VEP in at least three consecutive visits. ROP cases were classified into 2 categories: laser- treated or spontaneously regressed ROP. GAD (logMAR) was calculated by subtracting acuity thresholds from mean visual acuity value using age norms from our own laboratory. Deficits were assigned as mild (from 0.11 to 0.39 logMAR), moderate (0.40 to 0.80 logMAR or severe (>0.80 logMAR). Mann-Whitney test was used to compare initial and final GA. The rate of maturation was calculated as the slope of the best-fit line relating to logMAR GA to age in log months.

Results : A group of 25 children (16 females; birthweight: 1073.2±321.8g; gestational age:27.9±2.8 weeks), 21 laser-treated and 4 spontaneously regressed ROP, aged from 0.23 to 11.77 months (mean±SD=3.34±2.48; median=3.02) was evaluated. The interval between the first and the last visit ranged from 4-120 months (mean±SD=31±28; median=24). Only mild GAD was observed in 4 children (11%, 3 treated and 1 regressed ROP) in the first visit (0.13±0.02), and in 6 (16%, all treated) in the last visit (0.21±0.11) with the remaining within normal limits. Overall, the final GA (0.23±0.16) was significantly better (p=<0.001) when compared to the initial one (0.77±0.21). Mean GA maturation rate was 0.43 logMAR/log months in children with ROP showing slower maturation rates when compared to normative data (0.58logMAR/log months) and were comparable between in laser-treated ROP and spontaneously regressed ROP (0.45 e 0.40, respectively).

Conclusions : In this small cohort of patients, the benign visual prognosis was confirmed for both laser-treated ROP or spontaneously-regressed ROP, with the vast majority of cases showing normal GA or mild GADs. The maturation rate and grating acuity deficit can be useful in the evaluation of these pediatric patients.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.