Retinal vascular speed <0.5 disc diameter per week as an early sign of retinopathy of prematurity requiring treatment

• Published in: European journal of ophthalmology Vol. 28; no. 4; p. 441
• Main Authors: Solans Pérez de Larraya, Ana M, Ortega Molina, José M, Fernández, José Uberos, Escudero Gómez, Júlia, Salgado Miranda, Andrés D, Chaves Samaniego, Maria J, García Serrano, José L
• Format: Journal Article
• Language: English
• Published: United States 01.07.2018
• Subjects: Blood Flow Velocity - physiology; Female; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Premature; Male; Ophthalmoscopy - methods; Retinal Vessels - diagnostic imaging; Retinal Vessels - physiopathology; Retinopathy of Prematurity - diagnosis; Retinopathy of Prematurity - physiopathology; Retinopathy of Prematurity - therapy; Retrospective Studies; ROC Curve; treatment of retinopathy of prematurity; Retinopathy of prematurity; temporal retinal vascularisation
• ISSN: 1724-6016
• DOI: 10.1177/1120672118761328

To analyse the speed of temporal retinal vascularisation in preterm infants included in the screening programme for retinopathy of prematurity. A total of 185 premature infants were studied retrospectively between 2000 and 2017 in San Cecilio University Hospital of Granada, Spain. The method of binocular indirect ophthalmoscopy with indentation was used for the examination. The horizontal disc diameter was used as a unit of length. Speed of temporal retinal vascularisation (disc diameter/week) was calculated as the ratio between the extent of temporal retinal vascularisation (disc diameter) and the time in weeks. The weekly temporal retinal vascularisation (0-1.25 disc diameter/week, confidence interval) was significantly higher in no retinopathy of prematurity (0.73 ± 0.22 disc diameter/week) than in stage 1 retinopathy of prematurity (0.58 ± 0.22 disc diameter/week). It was also higher in stage 1 than in stages 2 (0.46 ± 0.14 disc diameter/week) and 3 of retinopathy of prematurity (0.36 ± 0.18 disc diameter/week). The rate of temporal retinal vascularisation (disc diameter/week) decreases when retinopathy of prematurity stage increases. The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.79-0.91) for retinopathy of prematurity requiring treatment versus not requiring treatment. The best discriminative cut-off point was a speed of retinal vascularisation <0.5 disc diameter/week, with a sensitivity and a specificity of 84.8% and 77%, respectively. The rate of temporal retinal vascularisation is a quantifiable observation that can help to alert a clinician that treatment of retinopathy of prematurity may be required. However, before becoming a new standard of care for treatment, it requires careful documentation, with agreement between several ophthalmologists.