Zone II stage 2 retinopathy of prematurity without plus disease: long-term follow-up and predictors of persistent avascular retina.

Abstract

Purpose: To evaluate peripheral vascular and retinal findings in school-aged children with spontaneously regressed zone II, stage 2 retinopathy of prematurity (ROP) without plus disease, and to investigate risk factors for persistent avascular retina (PAR).

Methods: The medical records of patients born at Cukurova University Hospital from 2015 to 2018 were reviewed retrospectively to identify those with spontaneous regression of zone II, stage 2 ROP, who had been followed until zone III vascularization in the neonatal period. Patients were subsequently contacted for detailed clinical examination at school age. Fluorescein angiography (FA) was performed those whose last ROP examination had shown PAR and those whose last ROP examination had shown complete vascularization (CV) but with subsequent (school age) suspicion for vascular abnormalities. All patients were classified as having PAR or CV. Maternal, prenatal, and neonatal risk factors for PAR were assessed.

Results: Of 50 patients, 32 were classified as CV and 18 as PAR. The PAR group had a significantly longer duration of systemic antibiotic therapy (P = 0.032), but there was no significant association between antibiotic duration and PAR on univariate logistic regression analysis. Multivariable logistic regression analysis showed that the risk of PAR was higher in patients in whom zone II stage 2 ROP was diagnosed at ≥37 weeks' PMA (OR = 17.458, P = 0.008) and in those with later discharge (OR = 1.427, P = 0.035). FA showed abnormal vascular branching without leakage, and the peripheral retina had no holes, tears, or detachment.

Conclusions: Zone III PAR and abnormal peripheral vascular findings may be observed after spontaneous regression of zone II, stage 2 ROP; however, no vascular leakage, retinal holes, tears, or detachments were identified in our cohort.