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Nimesh Patel, Kenneth Fan, Hasenin Al-khersan, Nicolas Yannuzzi, Dhariana Acon, Catherin Negron, Audina M Berrocal; Persistent Tunica Vasculosa Lentis as an Independent Risk Factor for Treatment in Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2187.
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© ARVO (1962-2015); The Authors (2016-present)
Tunica vasculosa lentis (TVL) is the vascular network that supplies the lens during fetal development and regresses by term. In pre-term neonates, TVL may persist and be found on clinical exam. The purpose of this study was to assess whether persistent TVL on neonatal screening exams may predict a higher rate of treatment in retinopathy of prematurity (ROP).
This was a retrospective 1:1 case-matched series form a single tertiary care center. All patients seen from 2000 to 2019 for ROP screening were included. Those noted to have TVL on exam were matched 1:1 based on birth weight and gestational age at birth with ROP patients without TVL. Data collected at each exam included age, weight, examination findings, and treatment status. Outcomes included rate of treatment with laser or intravitreal bevacizumab, plus disease, zone 1, and stage 2 or 3 ROP. Paired t-test was used to compare baseline demographics and characteristics between the two groups. McNemar’s test was used to determine characteristics correlating with ROP severity and treatment.
Overall, 196 patients were included in the study, of which 98 were patients with TVL (group 1) and 98 were case matched controls (group 2). In group 1, TVL was found in 80.6% of patients at the first visit at an average post-conception age of 32.3 weeks. Between group 1 and group 2, there was no statistical difference in average birth weight (722.6g and 721.6g, p=0.84) or gestational age at birth (25.8 vs 25.8 weeks, p=0.56). There was no statistical difference in incidence of ROP (80.6% to 73.47%, p=0.07). The average post-conception age at treatment was 36.8 weeks and 37.6 weeks, respectively.There was an increased rate of treatment in group 1 vs group 2 (31.6% vs 11.2%, p=0.0003, odds ratio of 1.88). Group 1 also had an increased rate of zone 1 disease (15.3 % vs 1.02% p= 0.002, odds ratio of 7.5). Lastly, group 1 had a higher absolute rate of plus disease, however, this was not statistically significant (27.55% vs 17.35%, P=0.09)
The present study suggests that persistent tunica vasculosa lentis is a significant independent risk factor for retinopathy of prematurity requiring treatment.
This is a 2020 ARVO Annual Meeting abstract.
External photo with persistent tunica vasculosa lentis
Fluorescein angiography showing filling of the persistent tunica vasulosa lentis and leakage
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