Optical coherence tomography findings in stage 4A retinopathy of prematurity: a theory for visual variability.

Abstract

To report macular anatomic abnormalities in eyes with stage 4A retinopathy of prematurity (ROP) that may account for poor visual outcome despite an ophthalmoscopically normal-appearing posterior pole. Retrospective case series. Nine patients (14 eyes). Nine patients (14 eyes) diagnosed with stage 4A retinal detachments were imaged with optical coherence tomography (OCT) before repair by lens-sparing pars plana vitrectomy. One patient (2 eyes) 2 years after successful lens-sparing vitrectomy for stage 4A detachment with reduced visual acuity underwent fluorescein angiography, fundus photography, and imaging with OCT. Optical coherence tomography findings. Preoperative OCT confirmed absence of macular involvement in 12 of 14 eyes. Two eyes demonstrated diffuse intraretinal posterior pole changes. Both eyes of a 2-year-old infant demonstrated a lack of normal foveal architecture on OCT scanning and an absent foveal avascular zone on angiography. Anatomic macular abnormalities--not immediately apparent ophthalmoscopically--may explain the variability in visual outcome after lens-sparing vitrectomy for stage 4A ROP.