Assessment of Macular Structural Changes and Visual Function in Retinopathy of Prematurity

Purpose: To assess macular structure and function in retinopathy of prematurity (ROP). Methods: This was a prospective observational cohort study performed on children with laser-treated ROP (n = 32 eyes of 17 children, age 9.12 ± 2.60 years) and untreated ROP (n = 22 eyes of 12 children, age 10.40 ± 2.76 years), or premature children meeting ROP screening criteria but without ROP (immature retina) (n = 10 eyes of 6 children, age 9.00 ± 2.00 years), and full-term control patients (n = 42 eyes of 21 children, age 11.67 ± 2.87 years) comparing foveal function (logarithm of the minimum angle of resolution [logMAR] visual acuity, contrast sensitivity [CS]) and retinal morphology (central retinal thickness [CRT]). Linear mixed models were fit, followed by post-hoc comparisons using the Tukey-Kramer method. Results: Visual acuity of laser-treated eyes (0.26 logMAR, 95% CI: 0.19 to 0.33) was significantly worse than that of untreated (0.06 logMAR, 95% CI: −0.02 to 0.165, P = .004) and control (−0.02 logMAR, 95% CI: −0.08 to 0.05, P < .001) eyes, but not different from immature retina eyes (0.11 logMAR, 95% CI: −0.01 to 0.22, P = .12). CS in treated eyes (1.56 log units, 95% CI: 1.48 to 1.63) was significantly worse than normal eyes (1.69 log units, 95% CI: 1.62 to 1.76, P = .05), but not different from either untreated (1.66 log units, 95% CI: 1.56 to 1.75, P = .35), or immature retina (1.65 log units, 95% CI: 1.51 to 1.78, P = .63) eyes. CRT of laser-treated eyes (330.98 µm, 95% CI: 318.18 to 343.79) was significantly greater than untreated (290.32 µm, 95% CI: 276.32 to 304.32, P < .001), immature (298.39 µm, 95% CI: 280.29 to 316.50, P = .02), and control (272.07 µm, 95% CI: 260.96 to 283.19, P < .001) eyes. In lasered-treated eyes there was a statistically significant negative correlation between logMAR and CRT (correlation = −0.39, 95% CI: −0.75 to −0.03, P = .03). Conclusions: Laser-treated eyes had abnormal macular structure and function compared to untreated eyes and normal control eyes. Further studies are needed to determine whether these abnormalities are attributable to increased severity of ROP in laser-treated patients, the effect of laser treatment, or both.