RETINAL ARTERIOVENOUS MALFORMATION IN GRADE III AND IV RETINOPATHY OF PREMATURITY

The authors report the results of the study of retinal vessels in the patients with grade III and IV cicatrical retinopathy of prematurity with the use of spectral optical coherent tomography. A total of 29 children (40 eyes) at the age varying from 6 months to 12 years with this condition were available for the observation. Seventeen of them (21 eyes) were under the age of 6 years and the remaining 12 ones (19 eyes) were older that that. The spectral optical coherent tomography was employed to estimate the depth distribution and the diameter of the first-order retinal vessels. These vessels were found in the ganglion cell layer only in eight of the 40 (20%) eyes. In 12 (30%) eyes they were localized in the nerve fiber layer and in 20 (50%) ones outside the retina. In other words, "physiological" location of the vessels in the ganglion cell layer was documented only in 20% of cases. The study revealed the relationship between the degree of displacement of the retinal vascular bed and the presence of the extraretinal tissue. Another finding of interest was a tendency toward the thinning of the retina in the eyes with the extraretinal localization of the vessels (p < 0.01). We failed to observe correlation of the gestational age and body weight at the time of birth with the localization of the retinal vessels (p > 0.05). It is concluded that localization of the retinal vessels may be used as a reliable criterion permitting to elucidate preclinical negative dynamics in the patients with cicatrical retinopathy of prematurity. At the same time, it is a risk factor of the development of late complications, such as tractional retinoschisis, retinal detachment and tear. The study revealed a tendency toward decreasing vessel diameter and increasing arteriovenous index. These findings suggest the impaired blood supply to the retinal vasculature in the cases of retinopathy of prematurity compared with the age-matched healthy full-term children. This disorder may be a cause of development of dystrophic processes in the retina.

retinopathy of prematurity, spectral optical coherent tomography, retinal vessels, calibrometry, extraretinal growth