PREVALENCE AND DEGREE OF RETINAL VASCULATURE ALTERATIONS IN ADULTS BORN PRETERM WITH VERY LOW BIRTH WEIGHT: A Birth Cohort Study.

Abstract

To assess the prevalence and degree of retinal vascular abnormalities in retinopathy of prematurity-treatment naïve adults born preterm with very low birth weight (VLBW; birth weight <1500 g). Both eyes of 64 VLBW participants and 81 term-born controls from the Finnish birth cohort were examined at mean age of 38 years. Macular developmental arrest and foveal avascular zone were assessed from optical coherence tomography and angiography (optical coherence tomography angiography) images, and persistent avascular retina from Optos widefield images and analyzed with co-effect of perinatal and cardiovascular factors. The foveal avascular zone of VLBW eyes was smaller ( P < 0.001) than that of control eyes and showed a strong association with macular developmental arrest (odds ratios 13.90, P < 0.001). All eyes had normal visual acuity. Foveal avascular zone size below the fifth control percentile was recorded in 57% and totally vascularized fovea in 14% of the VLBW eyes. Twenty-three percent of the VLBW eyes had persistent avascular retina, and this was associated with macular developmental arrest (odds ratios 3.39, P = 0.029) and hypertension (odds ratios 3.96, P = 0.008). Regressed retinopathy of prematurity-like retinal features were recorded in 20% of the VLBW eyes. Uncomplicated persistent avascular retina and small, or even absent, foveal avascular zone are frequently seen as a natural course of retinal vascularization in adults born preterm with VLBW.