September 1996

Partial Retinal Detachment at 3 Months After Threshold Retinopathy of PrematurityLong-term Structural and Functional Outcome

Author Affiliations

From the Department of Ophthalmology, Children's National Medical Center, and the George Washington University School of Medicine and Health Sciences, Washington, DC (Dr Gilbert); Division of Pediatric Ophthalmology, Children's Hospital of Philadelphia and Scheie Eye Institute, University of Pennsylvania, Philadelphia (Dr Quinn); Departments of Ophthalmology and Psychology, University of Arizona, Tucson (Dr Dobson); Department of Ophthalmology, Children's Hospital of Buffalo, University of Buffalo, Buffalo, NY (Dr Reynolds); University of Texas Health Science Center at Houston, School of Public Health (Dr Hardy); and the Casey Eye Institute, Oregon Health Sciences University, Portland (Dr Palmer).

Arch Ophthalmol. 1996;114(9):1085-1091. doi:10.1001/archopht.1996.01100140287005

Objective:  To investigate the structural and functional outcome at age 4½ years of eyes that had partial retinal detachment (RD) at 3 months after the occurrence of threshold retinopathy of prematurity; these eyes were involved in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study.

Methods:  Of the 531 eyes in the randomized portion of the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study, 61 had partial RD at the 3-month examination. The extent of retinal involvement was recorded, and the presence of a foveal detachment was noted. At the examination conducted at age 4½ years, the fundus structure was graded into cicatricial retinopathy of prematurity outcome categories by study ophthalmologists, and the visual acuity was measured by masked examiners using the Teller Acuity Card procedure and the crowded HOTV recognition acuity test.

Results:  Of the 61 eyes, 7 eyes continued to have partial RD at age 4½ years. Of the remaining eyes, 20 eyes had structural outcomes classified as favorable in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study, and 27 eyes had unfavorable structural outcomes. Data were un-recordable for 3 eyes and missing for 4 eyes. No difference in outcome was found for eyes with partial RD at 3 months that had undergone cryotherapy vs eyes that had served as controls. Only 6 eyes had a visual acuity better than 20/200. When partial RDs did not involve the fovea at 3 months, structural and functional outcomes at 4½ years were better than when RDs involved the fovea. The best predictor of outcome was the extent of RD at 3 months.

Conclusions:  Partial RD present 3 months after threshold retinopathy of prematurity is unstable anatomically, and the visual outcome is generally poor. Structure and function at 4½ years are related to the extent of RD and the involvement of the fovea at 3 months.