Abstract
Purpose :
To review the prevalence, clinical features, and treatment outcomes of adolescent and adult patients with previously regressed ROP who develop late onset exudation and vasoproliferative changes.
Methods :
After Emory University Institutional Review Board approval, retrospective review of all patients older than 10 years with a diagnosis of ROP evaluated at the Emory Eye Center, Atlanta, GA from (2000 to 2018) was performed. Patients with new subretinal yellow exudates or worsening fibrovascular proliferation were included.
Results :
Of 138 patients greater than the age of 10 with ROP, 5 (3.6%) developed late-onset exudative and/or fibrotic changes in the posterior segment (eg. Figure 1). Two patients were male and 3 were female. Three patients had ROP treatment as a neonate. Treatments included peripheral laser ablation in 3, scleral buckle in 2, and pars plana vitrectomy in 2. Baseline clinical features are in Table 1. Management strategies included 1 with observation, 3 with serial anti-VEGF injections, 2 with vitrectomy and 1 with cryotherapy. With mean follow-up of 4.8 years (range of 1 month to 7 years), outcomes were 2 with resolution of exudation/proliferation without recovery to baseline vision, and 3 with progressive tractional changes and severe loss of vision, including 1 with phthisis.
Conclusions :
Late onset exudation and fibrovascular proliferation in adults with ROP can occur with previously regressed ROP. Three of 5 cases in our series were severe and refractory to all forms of treatment including serial anti-VEGF, vitrectomy, and cryotherapy. One case had exudation and proliferation in the form of a retinal reactive astrocytic tumor. In contrast to current guidelines, our findings highlight the need for continued monitoring with regular fundus examination in adolescents and adults with regressed ROP. Further studies need to be conducted in order to clarify the precise etiology of these manifestations.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.