Fluorescein Angiography Findings in Treatment-Naive Premature Infants with Retinal Vascular Immaturity and Persistent Avascular Retina

ABSTRACT

Purpose

To evaluate the fluorescein angiography (FA) findings in eyes with spontaneously regressed retinopathy of prematurity (ROP).

Methods

Fluorescein angiography images of 162 eyes of 81 treatment-naive infants who underwent FA due to retinal vascular immaturity and persistent avascular retina (PAR) despite exceeding postmenstrual age of 60 weeks were analyzed retrospectively. Disc diameter (DD), optic disc-to-fovea distance (FD), the length of temporal retinal vascularization (LTRV), and the length of measurable temporal avascular retina distance (LMTAR), were quantitatively measured.

Results

The mean gestational age and FA imaging age were 29.39 ± 3.13 and 86.51 ± 24.80 weeks postmenstrual, respectively. The mean ratios of LTRV/FD and LMTAR /DD were 4.47 ± 0.36 and 2.21 ± 1.01, respectively. Pigmentary changes were detected in the peripheral retina in 21% of the eyes. There was at least one angiographic finding in 88% of the eyes, but these findings were usually mild. Based on the FA findings, laser photocoagulation was performed to the peripheral avascular retina in ten eyes of five patients

Conclusion

Even in larger preterm infants and without severe retinopathy and anti-VEGF treatment, PAR and peripheral pigmentary changes may be detected, and mild angiographic vascular activity may continue. These findings may lead to late-onset retinal pathologies that may threaten vision. In eyes with PAR, follow-up with FA and prophylactic laser application may be applicable. Further investigation is required for this topic.

KEYWORDS:

• Fluorescein angiography
• persistent avascular retina
• retinal vascularization
• retinopathy of prematurity
• spontaneously regressed retinopathy

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Patient Consent

Written informed consent was obtained from legal guardians of all infants prior to ROP examination and fluorescein angiography. Written informed consent was obtained from legal guardians of all infants prior to fluorescein angiography imaging for analyzing and publishing the data or photographs for any publication.

Data Availability Statement

We have full access to the data and take responsibility for the integrity of the data and data analysis. All data generated or analyzed during this study are included in this published article (and its supplementary information files).

Additional information

Funding

No support or funding was received from any institution or organization for the study.