Commentary - Journal of Clinical Ophthalmology (2021) New Insights in Ophthalmology
Commentary on long-term macular vascular density measured by OCT-A in children with retinopathy of prematurity
Ana Rita Carreira*, João Cardoso, Diogo Lopes, Tomás Loureiro, Audrey Sampaio, Teresa Fonseca, Ana Vide-Escada, Nuno Campos
Ophthalmology Department of Hospital Garcia de Orta, E.P.E, Almada, Portugal
- Corresponding Author:
- Dr. Ana Rita Carreira
Ophthalmology Department of Hospital Garcia de Orta
E.P.E, Avenida Torrado da Silva
E-mail: [email protected]
Accepted date: 08 February, 2021
Citation:Carreira AR, Cardoso J, Lopes D, et al. Commentary on long-term macular vascular density measured by OCT-A in children with retinopathy of prematurity. J Clin Ophthalmol 2020;5(S2):353-354.
About the Study
Laser photocoagulation is one of the therapeutical options for the treatment of Retinopathy of Prematurity (ROP) [1-3]. Although generally considered a safe procedure, it may be associated with an increased risk of cataract development and myopia [2,4,5]. Recent studies with optical coherence tomography angiography (OCT-A) in former preterm children with history of ROP have additionally demonstrated changes in macular morphologic and vascular parameters [6-11]. However, since there are few publications on this topic, we still do not know the long-term impact of laser treatment on macular parameters and vasculature in addition to the effects of the disease [6-11]. Our study aimed to assess long-term superficial vascular density measured by OCT-A in former preterm children with history of ROP with and without need of laser treatment.
We enrolled a population of former premature children with a birth weight (BW) <1500 gr and/or gestational age (GA) <32 weeks that developed stage 2 or 3 ROP and kept follow-up at our department for more than 10 years. Children were divided in 2 groups according to laser requirement and underwent a complete ophthalmologic evaluation, including best corrected visual acuity (BCVA) assessment and OCT-A (Zeiss Cirrus HD-OCT 5000 with Angioplex 6 × 6 mm). Cases of high myopia (≥ -6.00 D) were excluded.
Fifteen eyes of children with history of stage 3 plus ROP, of whom 7 had involvement of zone 1, were included in Group 1 (Laser-requiring ROP) and 19 in Group 2 (Non-treated ROP), with a mean age of 14.80 ± 2.30 and 15.50 ± 1.50 years (p=0.57), respectively. Group 2 included 13 eyes of children with history of stage 2 ROP and 6 of stage 3 ROP, none of which with plus disease or involvement of zone 1. Group 1 had lower mean GA and BW than Group 2 (25.40 ± 0.80 vs 26.80 ± 1.40 weeks, p<0.001; 638.00 ± 112.00 vs 885.00 ± 99.00 gr, p<0.001, respectively). BCVA was lower in Group 1 (0.08 ± 0.04 logMAR vs 0.04 ± 0.07 logMAR, p=0.03). Group 1 had also lower vascular parameters, especially central and internal vascular density (9.15 ± 2.75 vs 10.52 ± 0.86 mm-1, p=0.05; 13.74 ± 1.00 vs 15.86 ± 0.64 mm-1, p=0.05; respectively). There were differences in morphological parameters between groups as well, particularly in mean macular thickness, which was higher in Group 1 (300.50 ± 10.50 vs 281.11 ± 2.50 μm, p=0.05), and in avascular zone circularity, lower in Group 1 (0.58 ± 0.06 vs 0.76 ± 0.02, p<0.001). BCVA was correlated with macular internal, external and total vascular density and flow (p<0.05). No correlation was found between BCVA and morphological parameters (p>0.05). GA and BW were both correlated with BCVA (p<0.001).
Our paper demonstrated that children with Laser-requiring ROP have a decrease of long-term BCVA, which was at least partially associated with a decrease in superficial macular vascular density and flow. Nevertheless, degree of prematurity was greater in children who underwent laser treatment, which might have influenced our results.
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