Structural changes of the retina in 3rd and 4th degree cicatrical retinopathy of prematurity.
The paper presents the results of the study of structural changes in the fundus of children with 3rd and 4th degree of ROP in cicatrical phase using a spectral-domain optical coherence tomography (SD-OCT). We examined 29 children (40 eyes) aged from 6 months to 7 years. In 12 children (19 eyes), who were followed for 5 years, we revealed a thinning tendency in all areas of the retina. All eyes showed a diffuse increase of optical density in the avascular zone of the retina (hyper-reflectivity) and loss of retinal lamination, which we interpreted as intraretinal fibrosis manifestation. In addition, in 80% of cases focal increase of optical density of neuroepithelium was even observed in the central areas of the retina. An analysis of OCT scans revealed three types of extraretinal tissue and four types of retinal folds depending on the direction and the degree of the traction. Local tractional retinoschisis on the periphery was identified in 25% of cases. The study showed generalized retinal damages in the 3rd and 4rd degrees of ROP. We demonstrated that traction can increase not only in the active, but also in the cicatrical phase. High precision of SD-OCT facilitates early diagnosis and monitoring of degenerative processes in children with ROP. The method may be used to determine the indications to prophylactic measures (e.g. delimiting laser coagulation of the retina) and thereby prevent the development of later vitreoretinal complications, including retinal detachment. Russian Ophthalmological Journal, 2012; 2:30-33.