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Abstract
This preliminary study analyzed the peripheral retinal vascular pattern in children, using ultra-widefield fluorescein angiography, and its association with perinatal conditions. Retrospective review was conducted examining the fluorescein angiographic findings of children with amblyopia (January 2017 to December 2018). We categorized the peripheral vascular patterns into two groups: loop and branching patterns. We investigated differences in these patterns, according to the perinatal condition. Thirty children (9.27 ± 3.41 years old; 47.67% male) were included. An equal number of children had the loop or branching pattern (15:15). The gestational age (GA) in the loop group was significantly shorter than the branching group (32.92 ± 5.62 vs. 36.67 ± 5.63 weeks, p = 0.04). The birth weight of the loop group was significantly lower than the branching group (2.00 ± 1.03 vs. 2.72 ± 0.93 kg, p = 0.03). Gender, age, delivery-type, and visual acuity, were not different between the groups. Lower birth weight and shorter GA were observed in children with the loop pattern. The difference in peripheral retinal vascular patterns, according to birth weight and GA, might be due to the development of immature retinal vessels at birth.
Highlights
This preliminary study analyzed the peripheral retinal vascular pattern in children, using ultrawidefield fluorescein angiography, and its association with perinatal conditions
If there is any local hypoxia at the peripheral retina due to immature vasculogenesis at birth, the increased vascular endothelial growth factor (VEGF) secretion could promote endothelial cell growth, which could contribute to making the farthest vessel
If further vasculogenesis is needed after birth, due to a short gestational age or low birth weight, we thought the possibility of having a loop peripheral vascular pattern might be increased
Summary
This preliminary study analyzed the peripheral retinal vascular pattern in children, using ultrawidefield fluorescein angiography, and its association with perinatal conditions. Interestingly, Singer et al recently reported that the distances from disc to the perfused vascular border were significantly shorter in older subjects (> 60 years) than in younger s ubjects[14] This means peripheral angiographic findings could change with age. Instead of having anterior growth of blood vessels, the direction of blood vessel growth might turn towards or stay where oxygenation is relatively poor We think this is probably the reason why the circumferential vascular pattern (loop pattern) vessels are formed along the edge of the peripheral retina. We conducted a preliminary study about peripheral retinal vascular patterns in children, using ultra-widefield FA, and its association with the perinatal condition. The primary objective of this study was to analyze the peripheral retinal vascular pattern in children, using ultra-widefield FA, and to investigate its association with the perinatal condition. The secondary objective was to analyze peripheral angiographic findings of children (e.g., the presence of capillary telangiectasia, microaneurysm, and vascular leakage in the late phase)
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