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Structural features of macular eyes of preschoolers born preterm: analysis by optical coherence tomography, and indirect ophthalmoscopy

PURPOSE: Compare the retinal structure of the macula and fovea among premature infants with retinopathy of prematurity (ROP) stages II and III post treatment, premature infants with ROP stages II and III with spontaneous regression and premature infants without ROP, through optical coherence tomography (OCT) and binocular indirect ophthalmoscopy (BIO) examinations. METHODS: Cross-sectional observational and not-blinded study. There were included premature infants born between 06/1992 and 06/2006 and examined between 06/2009 and 12/2010; gestational age less than or equal to 32 weeks and birth weight less than or equal to 1,599 g; with a minimum of three visits during the selection period; without retinopathy of prematurity, or with the diagnosis of ROP stages II or III in at least one eye with spontaneous regression or after ROP treatment; maximum of six months of chronological age for the first examination at the service; minimal chronological age of four years old in the reassessment period. There were excluded premature infants who did not attend or did not have clinical conditions for the reassessment examination. The premature infants were divided into three groups: G1 - with ROP post-treatment; G2 - with ROP post-spontaneous regression; and G3 - without ROP. The exams performed were BIO and OCT. RESULTS: Twenty-four premature infants (48 eyes) presented the criteria required for the research, chronological age ranging from 5 to 6 years. At BIO, there was a statistically significant difference for the presence of alterations in the retina of premature infants from group G1. However these changes corresponded to the cicatricial lesions left by the ROP treatment, without visible impairment to the macular region. At OCT there were statistically significant differences for the greatest foveal thickness between premature infants from groups G1 and G2. Considering the left eye, there was no statistically significant difference related to the thickness of the fovea between G1 and G3. There was no difference among the three groups studied in relation to the changes of the retinal layers at OCT. CONCLUSION: Premature infants with ROP post-treatment showed foveal thickness greater than premature infants with ROP post-spontaneous regression; and foveal thickness similar to premature infants without ROP in relation to assessment of the left eye. Regarding the changes of the retinal layers detected at OCT, the three groups were similar, without expression of difference for the treated group in this study.

Retinopathy of prematurity; Macula lutea; Tomography, optical coherence; Ophthalmoscopy; Child, preschool


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