Retinal vascular changes in preterm infants: heart and lung diseases and plus disease

J AAPOS. 2017 Dec;21(6):488-491.e1. doi: 10.1016/j.jaapos.2017.08.004. Epub 2017 Nov 22.

Abstract

Purpose: To report the retinal vascular features of preterm infants with congenital heart disease (CHD), lung disease (pulmonary hypertension [PH] and bronchopulmonary dysplasia [BPD]), and ROP with plus disease to determine whether these disease entities are distinguishable on the basis of retinal vessel morphology.

Methods: The medical records of preterm infants with CHD, lung disease, and ROP with plus disease were reviewed retrospectively. Qualitative vascular findings were validated using computer-based software to analyze 25 representative images, each corresponding to one infant's eye. The images were organized into five groups, based on clinical information. Vessel diameter (d) and tortuosity index (TI) were measured.

Results: A total of 106 infants (mean gestational age, 30.5 ± 2.22 weeks) were initially included. Ophthalmologic evaluation of preterm infants with CHD and lung diseases showed vascular tortuosity without vasodilation at the posterior pole as well as in the periphery. Quantitative analysis showed that venular diameter was significantly increased in the plus disease group (P = 0.0022) compared to other groups. There was significantly less tortuosity in both arterioles and venules in BPD (P < 0.001, P = 0.0453) compared with plus group.

Conclusions: The patterns of retinal vascular tortuosity observed in preterm infants may be unique to different systemic congestive conditions and could have therapeutic implications.

MeSH terms

  • Birth Weight
  • Bronchopulmonary Dysplasia / diagnosis*
  • Diagnosis, Computer-Assisted*
  • Familial Primary Pulmonary Hypertension / diagnosis*
  • Female
  • Gestational Age
  • Heart Defects, Congenital / diagnosis*
  • Humans
  • Image Processing, Computer-Assisted
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Retinal Vessels / pathology*
  • Retinopathy of Prematurity / diagnosis*
  • Retrospective Studies