Structural and functional ophthalmological follow-up of a preterm population: report at six years of age

Abstract

Purpose : The aim of the study was to analyse structural and functional ophthalmological outcomes at six years of age in a population of children born with ≤32 weeks of gestational age (GA) and/or ≤1000grams of birth weight (BW) at the A. Gemelli University Hospital in Rome.

Methods : Per protocol, all preterm babies screened for acute ROP (following ICROP criteria) undergo at six year of age a full ophthalmologic and orthoptic examination. Different neurodevelopmental aspects were assessed By means of the Wechsler Intelligence Scale for Children (WISC) . A standard score below 79 was considered below average. Recently wide-field fundus retinography and oral ultra wide-field fluorescein angiography (UWFFA, OPTOS Inc USA) and OCT and OCT-A (Carl Zeiss, D) imaging were introduced in the protocol. Peripheral retinal vascular features highlighted by UWFFA were classified by three different graders and correlated with to clinical parameters such as BW, GA and acute ROP severity. Peripheral avascular retina (PAR) was also observed and classified form 1 to 3 based on its extent. Foveal Avascular Zone (FAZ) was observed with both OCT-A and UWFFA and correlated with visual acuity (VA).

Results : 45 preterm infants, 28.5% of the preterm population screened for ROP from January 2013 untill December 2014 were examined at a mean age of 6 years and 5 months. 72 eyes were previously diagnosed by various ROP stages. Mean age at examination was 6.14 years. 13 babies showed various degree of neurological disabilities and 17 various form of strabismus. ETDRS LogMar visual acuity ranged from 2 to 0. Peripheral retinal vasculature showed at WFFA a dichotomous pattern in 67% (n=55, shunting pattern in 21% (n=17) and finger-like pattern in 12% (n=10). One eye only showed a light leakage at the junction between vascular and avascular retina. PAR was present in 63% (n=29). FAZ was absent on 28,5% (n=24) of the OCTA images with a good accordance with WFFA images. No significant correlation was found with VA.

Conclusions : Dichotomous branching pattern and PAR are common peripheral vascular features in our population. These findings suggest the importance of a long term follow up in preterm children, especially those with specific peripheral vascular retinal features.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.