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Robert Gunzenhauser, Tamara L Lenis, David Sarraf, Simon SM Fung, Stacy L Pineles, Irena A Tsui; Comparison of structural and visual outcomes in laser-treated vs. untreated eyes with retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6526.
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© ARVO (1962-2015); The Authors (2016-present)
Retinopathy of prematurity (ROP) is associated with decreased foveal avascular zone (FAZ) area and myopia. This study uses optical coherence tomography (OCT) and OCT angiography (OCTA) to test the hypothesis that structural differences may be associated with different visual outcomes in untreated vs. laser-treated ROP eyes.
This is a retrospective study of children with a history of ROP born before 34 weeks gestational age (GA). Birth weight (BW), GA, ROP treatment status, and other clinical parameters were recorded. Subjects underwent anterior segment OCT (AS-OCT) and posterior segment OCT/OCTA (Optovue). Structural outcomes were temporal anterior chamber angle (ACA), angle opening distance (AOD), trabecular-iris space area (TISA), FAZ, and foveal vessel density and thickness at the superficial and deep capillary plexuses (SCP, DCP). Visual outcomes included LogMAR best corrected visual acuity (BCVA) and refractive error in spherical equivalent.
65 eyes of 33 subjects were included (n=38 laser-treated, n=27 untreated). Median follow up was 10.0 yrs (range: 4.4–16.0) and 6.4 yrs (4.6 –14.6) in the treated and untreated groups, respectively. Untreated subjects had a significantly greater GA (p=0.002) and BW (p=0.002) vs. treated subjects. Treated eyes had smaller FAZ (p=0.021) and greater foveal thickness (p=0.001) vs. untreated eyes. Despite these differences, foveal vessel density and BCVA were similar between the groups. For eyes scanned at multiple time points (n=7 laser-treated, n=6 untreated), there was no significant difference between the groups with regard to changes in FAZ size, or foveal vessel density at the SCP or DCP, over time. However, laser-treated eyes were significantly more myopic (-3.4 D vs. +0.8 D, p<0.010) vs. untreated eyes. Anterior segment analysis of a subset (n=24) revealed that treated eyes had more narrow ACA (p<0.001), smaller AOD (p<0.001), and smaller TISA (p<0.001) compared with untreated eyes.
Although laser treated eyes had smaller FAZ area and thicker fovea, there was no significant difference in final vision between treated and untreated eyes with ROP. However, treated eyes were significantly more myopic and had a more crowded anterior segment on AS-OCT.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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