Refractive and visual outcomes of macular edema of prematurity at 9 months, 2 years, and 5 years of age.

Objective: Determine visual and refractive outcomes of cystoid macular edema (CME) in preterm infants at risk for retinopathy of prematurity (ROP).

Design: Prospective, observational cohort study.

Participants: Premature infants eligible for ROP screening from 2 tertiary hospitals.

Methods: Participants underwent awake handheld spectral domain optical coherence tomography (SD-OCT) imaging during their ROP exams. A single, masked pediatric ophthalmologist performed eye examinations, including cycloplegic streak retinoscopy, at 9 months, 2 years, and 5 years of age.

Results: Among 94 preterm infants (175 eyes), birth weight was 1 018.09 ± 290.16 g and gestational age 28.38 ± 2.87 weeks. Thirty-two infants (34%) developed CME (mean maximum central foveal thickness 300 ± 350 µm) as newborns. No differences were found between those with versus those without CME in high myopia, mild myopia, mild hyperopia, and high hyperopia at 9 months (p = 1.00; n = 65), 2 years (p = 1.00; n = 47), and 5 years (p = 1.00; n = 31). Mean spherical equivalents (1.89 ± 2.19 vs 1.73 ± 1.15, 1.77 ± 1.92 vs 0.99 ± 1.48, and 1.28 ± 0.74 vs 0.41 ± 1.59 at 9 months, 2 years, and 5 years, respectively; p = 0.87-1.00), visual acuity (p = 0.14-1.00), astigmatism (p = 0.71-1.00), and strabismus (p = 1.00) also did not correlate with a history of CME at any time point.

Conclusions: We identified no associations between CME in premature newborns screened for ROP and visual acuity or refractive error at 9 months, 2 years, or 5 years of age.