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September 1995

Grating Visual Acuity in Eyes With Retinal Residua of Retinopathy of Prematurity

Author Affiliations

From the Departments of Ophthalmology and Psychology, University of Arizona, Tucson (Dr Dobson); Division of Pediatric Ophthalmology, Children's Hospital of Philadelphia and Scheie Eye Institute, University of Pennsylvania, Philadelphia (Dr Quinn); Storm Eye Institute, Medical University of South Carolina, Charleston (Dr Saunders); Texas Retina Associates and University of Texas Southwestern Medical Center, Dallas (Dr Spencer); School of Public Health, University of Texas Health Science Center at Houston (Drs Davis and Risser); and Casey Eye Institute, Oregon Health Sciences University, Portland (Dr Palmer).; Dr Dobson receives royalties for the Teller acuity cards.

Arch Ophthalmol. 1995;113(9):1172-1177. doi:10.1001/archopht.1995.01100090098029

Objectives: To compare grating visual acuity of eyes with varying severity of retinal residua of retinopathy of prematurity to grating vasual acuity of eyes that did not have acute-phase retinopaty of prematurity, showed no ocular abnormalities on follow-up, and were from patients who passed neurodevelopmental screening questions.

Design:  Monocular grating visual acuity was measured by means of the Teller acuity card procedure when children reached 1, 2, 3½, and 4½ years of age.

Patients:  A total of 1398 children with birth weights less than 1251 g whose acute-phase retinopathy of prematurity was documented as part of the Multicenter Cryotherapy for Retinopathy of Prematurity Study and who participated in follow-up visual acuity testing.

Results:  Eyes with no or mild residua of retinopathy of prematurity showed a mean visual acuity similar to that of the comparison group. Eyes in a subgroup with abnormally straightened temporal retinal vessels showed a mean visual acuity approximately 1 octave below that of the comparison group. Mean visual acuity scores from eyes with macular heterotopia ranged from 1 octave (at 1 year) to more than 2 octaves (at 4½ years) below the mean visual acuity of the comparison group. Mean visual acuity scores for the few eyes in the retinal fold or partial detachment group that had quantifiable visual acuity were well below the means for the comparison group.

Conclusions:  Acute-phase retinopathy of prematurity that regresses without retinal residua produces no deficit in grating visual acuity between 1 and 4½ years of age. In contrast, eyes with macular heterotopia show a visual acuity deficit, and the deficit is greater at older than at younger ages. Eyes with retinal fold or partial detachment that have measurable visual acuity show large visual acuity deficits at all ages.