The evaluation of ocular findings in prematures who had retinopathy of prematurity that regressed without treatment and in prematures who had no retinopathy of prematurity

Purpose: Retrospective evaluation of long term refractive outcome, anterior and posterior segment findings of preterm infants with spontaneus regression retinopathy of prematurity and without retinopathy of prematurity (ROP). Materials and Methods: The data of 112 eyes of 56 patients between the ages of 5-10 years who had a premature birth between August 2009 and December 2014 and who were followed up at the Department of Ophthalmology of Uludağ University Medical Faculty were examined retrospectively. Patients were divided into two groups with ROP who spontaneus regressed on average 45 weeks or more were as group 1 and group 2 without ROP. Refraction, best corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), macular, peripapillary retinal nerve fiber thickness (RNFL) and choroidal thickness were evaluated in all cases. Biomicroscopic anterior and posterior segment examinations and strabismus were recorded. Results: All of the cases with spontaneus regression were mild PR (stage 1 or stage 2 without "plus" disease). The groups were statistically similar in terms of birth week (DH), birth weight (DA), final examination age and number of cases. Spherical equivalent (SE), myopic, hypermetropic and astigmatic refractive error, ametropia, amblyopia ratio, IOP and AL were also found to be statistically similar in patients with spontaneous regressed ROP and those without ROP. The mean BCVA of the groups was similar and was 0.98 ± 0.07 in group 1 and 0.98 ± 0.05 in group 2 (p = 0.716). Strabismus rates were 10.3% in group 1 and 14.8% in group 2. There was no statistical difference between these values (p = 0.70) and esotropia was the dominant type. There was no statistically significant difference between central foveal (246,09±26,45; 231,19±17,84) and central macular thickness (281,43±19,28; 274,63±15,25) in group 1 and group 2. Central fovea and central macules were thicker in group 1 (p = 0.001; p = 0.042). A statistically significant negative correlation was found between gestational age and birth weight and central foveal and central macular thickness. The nasal RNFL thickness of the patients in group 1 was found to be statistically significantly thinner (p = 0.006) than those in group 2, whereas the temporal RNFL thicknesses were statistically significantly thicker (p = 0.001). The mean subfoveal and nasal choroidal thickness of the patients in group 1 was found to be statistically slim (p = 0.019; p = 0.017). No significant relationship was found between RNFL and choroidal thickness at birth week and birth weight. There was no statistically significant relationship between macular, RNFL and choroidal thickness and BCVA. Discussion and Conclusion: There was no significant visual impairment in the premature cases with and without PR who with spontaneus regression retinopathy of prematurity. Permanent effects on macular, RNFL and choroidal parameters evaluated by OCT were observed in patients with spontaneus regression retinopathy of prematurity. However, there was no correlation with visual acuity. Prospective studies with large numbers of patients are needed to better understand the clinical significance of structural changes and their relationship with visual acuity. Keywords: Prematurity, retinopathy of prematurity, refractive state, optical coherence tomography, macula, retinal nerve fiber thickness, choroidal thickness