Factors influencing the timing of complete retinal vascularization in infants screened for retinopathy of prematurity.

Abstract

Background: Premature infants screened for retinopathy of prematurity (ROP) reach complete retinal vascularization at various postmenstrual ages (PMAs). The purpose of this study was to evaluate the factors that affect the age at which the infant eyes reach retinal vascular maturity.

Methods: We reviewed patients screened for ROP at our institution between December 13, 2007, and December 30, 2020. Data extracted included demographics, gestational age (GA) and birth weight (BW), ROP examinations, age and weight at retinal maturity, surgical procedures, ventilation status, antibiotic treatment, positive blood cultures, blood transfusions, and central line placement.

Results: A total of 1,971 patients were analyzed. The mean GA at birth was 28 weeks, and the mean BW was 1,096 g. Mean PMA for retinal maturity was 44.90 weeks. Mean PMA at retinal maturity was higher for infants born at an earlier GA (P < 0.0001). Additionally, infants who underwent nonocular surgery reached retinal maturity at significantly high PMA (P < 0.0001). Infants with stage 1 ROP or greater had a significantly longer time from birth to retinal maturity (P < 0.0001) and those with stage 2 or 3 disease reached retinal maturity at even older chronological ages (P < 0.0001). Chronological age at retinal maturity was also higher for children with positive blood cultures or who received transfusions ≥5 units (P < 0.0001).

Conclusions: Postmenstrual age at retinal maturity and chronological age at retinal maturity both vary widely among infants at risk of ROP, and are associated with a variety of ocular and systemic clinical predictors.