Abstract

DO.18.09

Macular assessment in premature infants with retinopathy of prematurity

Spasovska K., Schneider N., Ab Ghani S., Elflein H., Oberacher-Velten I., Lorenz B.
Department of Paediatric Ophthalmology, Strabismology and Opthalmolgenetics, Universitätsklinikum, Regensburg
Support: Bay. Landesstiftung; Bay. Sparkassenstiftung; DFG (DFG LO 457/4)

Objective: To measure the distance between optic nerve and fovea (ODF), to classify the macular development in premature infants with retinopathy of prematurity (ROP) and to measure the temporal retinal vessels angle (TVA) in order to examine an eventual correlation between these two issues compared to normal infants.
Methods: The study comprised 55 premature infants diagnosed with ROP(GA 23-32 wks) selected from infants undergoing screening for ROP using a telematical approach with the RetCam 120¹, examined according to the German National Guidelines² and ROP staging followed the revised ICROP³. ODF and TVA were assessed as described previously^4,5. Macular development was classified according to Isenberg⁶. Digital images were analysed with Adobe Photoshop 7.0.
Results: In 90 eyes with acute ROP(44 left,46 right) the ODF was 155±14 pixels(4.65±0.45mm) and mean TVA 82.7°±8.2. The highest stage of macular development was stage 3 detected in 4.44% (4/90) of the eyes, stage 2 was found in 17.78% (16/90), stage 1 in 77.78%(70/90) and no stage 0. The results showed negative correlation (Pearson r=-0,63) between ODF and TVA in patients with stage 3 ROP. ODF was not significantly changed in ROP stage 1 and 2 in contrast to stage 3 where mean ODF was 161±20 pixels(4.83±0.6mm).
Conclusions: Macular measurements at screening may provide important information on ROP, macular displacement and maturation in infants with ROP. Mean TVA in acute ROP was not significantly changed compared with normal infants⁷ (82.7°±8.2 vs.85.5°±7.04). Compared to ODF in normal infants4(4.4±0.4mm) an increase in ODF of 9.77% was found in ROP stage3 (4.4 vs.4.83mm in stage3).Considering a physiological increasing ODF of 11% from infancy to adulthood in healthy individuals (4.4 vs.4.9mm in adults) 8 one might expect a further increase in macular displacement in eyes with acute ROP underlining the importance of long-term ophthalmological follow-up in prematures.
¹Elflein.H,Lorenz, B.in Teleophtalmology.NY.Springer 2006:109-112
²Ophthalmologe 1999, 96:257
³Arch Ophthalmol 2005, 123:991
⁴IOVS. 2006 47:4683-6.
⁵BJO 2006; 90:702-4
⁶AJO 1986 101:74-80
⁷DOG Berlin2006 6dog309 8Opt Vis Sci.1992 69:369-77

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