Characteristics of Spontaneously Regressed Retinopathy of Prematurity at Termination of Acute Retinal Screening Examinations Using a Novel Grading System

Abstract

Purpose: To characterize and compare residual retinal changes of spontaneously regressing retinopathy of prematurity (ROP) at termination of acute-phase retinal screening examinations.

Methods: A retrospective chart review of 521 infants screened for ROP from 2016 to 2019 was performed. Data were collected on patients with at least stage 1 ROP, but who were not treated. The primary outcome measure was presence of residual fibrotic retinal tissue at termination of acute ROP screening examinations. Secondary outcomes included: type of residual fibrotic retinal tissue, persistent avascular retina, vitreous hemorrhage, and retinal detachment. A novel grading system was used to categorize findings. Comparisons between groups were made using Fisher exact tests.

Results: A total of 255 eyes met inclusion criteria. A total of 206 of 255 eyes (81%) showed persistent avascular retina, whereas 57 of 255 eyes (22%) showed residual fibrotic retinal tissue at termination of acute screening. All eyes with previous stage 3 ROP showed residual fibrotic retinal tissue (8 of 8 eyes, 100%). Eyes whose highest stage of ROP was stage 2 showed more residual fibrotic retinal tissue at termination of acute screening (40 of 73 eyes, 55%) compared to eyes whose highest stage was stage 1 (9 of 174, 5%) (P < .0001). Stage 3 eyes were excluded from this comparison due to the small sample size. One eye had vitreous hemorrhage at post-menstrual age 44 1/7 weeks. No eyes had retinal detachment.

Conclusions: Despite meeting at least one of the criteria for termination of acute ROP screening, residual fibrotic retinal tissue and persistent avascular retina are common after spontaneous regression of ROP. Further investigation into the long-term clinical significance of these residual changes is warranted. [J Pediatr Ophthalmol Strabismus. 2023;60(5):359-364.].