PURPOSE: 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. DESIGN: Retrospective case series. PARTICIPANTS: Nine patients (14 eyes). METHODS: 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. MAIN OUTCOME MEASURE: Optical coherence tomography findings. RESULTS: 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. CONCLUSIONS: Anatomic macular abnormalities--not immediately apparent ophthalmoscopically--may explain the variability in visual outcome after lens-sparing vitrectomy for stage 4A ROP.
PURPOSE: 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. DESIGN: Retrospective case series. PARTICIPANTS: Nine patients (14 eyes). METHODS: 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. MAIN OUTCOME MEASURE: Optical coherence tomography findings. RESULTS: 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. CONCLUSIONS: Anatomic macular abnormalities--not immediately apparent ophthalmoscopically--may explain the variability in visual outcome after lens-sparing vitrectomy for stage 4A ROP.
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