Macular edema in Asian Indian premature infants with retinopathy of prematurity: Impact on visual acuity and refractive status after 1‑year.
Date
2015-05
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Abstract
Purpose: To report the impact of transient, self‑resolving, untreated “macular edema” detected
on spectral domain optical coherence tomography in Asian Indian premature infants with
retinopathy of prematurity (ROP) on visual acuity (VA) and refraction at 1‑year of corrected age.
Materials and Methods: Visual acuity and refraction of 11 infants with bilateral macular edema (Group A)
was compared with gestational age‑matched 16 infants with ROP without edema (Group B) and 17 preterms
infants without ROP and without edema (Group C) at 3, 6, 9 and 12 months of corrected age using Teller
Acuity Cards and cycloplegic retinoscopy. Sub‑group analysis of the previously described pattern A
and B macular edema was performed. Results: Visual acuity was lower in infants with macular edema
compared with the other two control groups throughout the study period, but statistically significant only
at 3 months. Visual improvement in these infants was highest between the 3rd and 6th month and plateaued
by the end of the 1st year with acuity comparable to the other two groups. The edema cohort was more
hyperopic compared to the other two groups between 3 and 12 months of age. Pattern A edema had worse
VA compared to pattern B, although not statistically significant. Conclusion: Macular edema, although
transient, caused reduced VA as early as 3 months of corrected age in Asian Indian premature infants
weighing <2000 g at birth. The higher hyperopia in these infants is possibly due to visual disturbances
caused at a critical time of fovealization. We hypothesize a recovery and feedback mechanism based on the
principles of active emmetropization to explain our findings.
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Keywords
Emmetropization, hand‑held, macular edema, retinopathy of prematurity, spectral‑domain optical coherence tomography, visual acuity
Citation
Vinekar Anand, Mangalesh Shwetha, Jayadev Chaitra, Bauer Noel, Munusamy Sivakumar, Kemmanu Vasudha, Kurian Mathew, Mahendradas Padmamalini, Avadhani Kavitha, Shetty Bhujang. Macular edema in Asian Indian premature infants with retinopathy of prematurity: Impact on visual acuity and refractive status after 1‑year. Indian Journal of Ophthalmology. 2015 May; 63(5): 432-437.