Grating visual acuity in eyes with retinal residua of retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group
V. Dobson, G. E. Quinn, R. A. Saunders, R. Spencer, B. R. Davis, J. Risser and E. A. Palmer
Department of Ophthalmology, University of Arizona, Tucson, USA.
OBJECTIVES: To compare grating visual acuity of eyes with varying severity
of retinal residua of retinopathy of prematurity to grating visual acuity
of eyes that did not have acute-phase retinopathy of prematurity, showed no
ocular abnormalities on follow-up, and were from patients who passed
neurodevelopmental screening questions. DESIGN: Monocular grating visual
acuity was measured by means of the Teller acuity card procedure when
children reached 1, 2, 3 1/2, and 4 1/2 years of age. PATIENTS: A total of
1398 children with birth weights less than 1251 g whose acute-phase
retinopathy of prematurity was documented as part of the Multicenter
Cryotherapy for Retinopathy of Prematurity Study and who participated in
follow-up visual acuity testing. RESULTS: Eyes with no or mild residua of
retinopathy of prematurity showed a mean visual acuity similar to that of
the comparison group. Eyes in a subgroup with abnormally straightened
temporal retinal vessels showed a mean visual acuity approximately 1 octave
below that of the comparison group. Mean visual acuity scores from eyes
with macular heterotopia ranged from 1 octave (at 1 year) to more than 2
octaves (at 4 1/2 years) below the mean visual acuity of the comparison
group. Mean visual acuity scores for the few eyes in the retinal fold or
partial detachment group that had quantifiable visual acuity were well
below the means for the comparison group. CONCLUSIONS: Acute-phase
retinopathy of prematurity that regresses without retinal residua produces
no deficit in grating visual acuity between 1 and 4 1/2 years of age. In
contrast, eyes with macular heterotopia show a visual acuity deficit, and
the deficit is greater at older than at younger ages. Eyes with retinal
fold or partial detachment that have measurable visual acuity show large
visual acuity deficits at all ages.
