The Development of Retinal Function and Refractive Error in Children With Retinopathy of Prematurity.

Abstract

The purpose of this study was to test the hypothesis that retinopathy of prematurity (ROP) prolongs development of rod-mediated thresholds for detection of stimuli at 10degrees but not 30degrees eccentricity. In addition, to evaluate the thresholds at each site for an association with visual acuity (VA) and spherical equivalent (SE). We estimated rod-mediated dark-adapted thresholds (DATs) for the detection of 2degree diameter, 50ms, blue (λ < 510nm) flashes at 10degrees and 30degrees eccentric in former preterm subjects (n = 111), stratified by ROP severity: None (n = 32), Mild (n = 66), and Severe (n = 13). We also tested Term-born (n = 28) controls. To determine the age at half-maximal sensitivity (Agehalf) for each group and eccentricity, we fit DATs to logistic growth curves. We obtained VA and SE for Preterm subjects and evaluated the course of threshold development at 10degrees and 30degrees for significant association with VA and SE predicted at age 10 years. DAT development at 10degrees was significantly delayed in ROP (Mild and Severe); ROP did not significantly alter DAT development at 30degrees. At age 10years, among Preterm subjects, both VA and SE were significantly associated with group (None,Mild, and Severe). SE was predicted by the course of DAT development at 30degrees. VA was not associated with the course of DAT development at 10degrees. At 10degrees, ROP-whether mild or severe-is associated with significant delays in DAT development, evidence that the late-maturing central retina is vulnerable to ROP. The association of 30degree threshold and myopia are evidence that more peripheral retina is important to refractive development.