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Visual Field Extent at 6 Years of Age in Children Who Had High-Risk Prethreshold Retinopathy of Prematurity

Early Treatment for Retinopathy of Prematurity Cooperative Group
Arch Ophthalmol. 2011;129(2):127-132. doi:10.1001/archophthalmol.2010.360.
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Objective  To compare monocular visual field extent at 6 years of age in eyes with high-risk prethreshold retinopathy of prematurity (ROP) randomized to early treatment (ET) with eyes that underwent conventional management (CM) and were treated at threshold or regressed without treatment.

Methods  Subjects were 370 surviving study participants who developed high-risk prethreshold ROP and were enrolled in the Early Treatment for Retinopathy of Prematurity Study between October 1, 2000, and September 30, 2002. When the participants were 6 years of age, vision testers unaware of ROP status used white-sphere kinetic perimetry to measure visual field extent along the superotemporal, inferotemporal, inferonasal, and superonasal meridians.

Results  The extent of the visual field was 0.1° to 3.7° larger in ET eyes when blind eyes were assigned a score of 0°. When data were examined from eyes of participants with 1 sighted ET eye and 1 sighted CM eye, ET eyes showed a small (1.3°-3.1°) reduction, which was statistically significant only along the superonasal meridian (P = .005). In bilaterally sighted children, visual field extent was not significantly reduced for high-risk type 1 ET eyes (−0.9° to 1.8°). However, in ET eyes with high-risk type 2 disease, visual field extent was significantly smaller compared with that of CM eyes (3.6°-8.7° superonasal field [P = .003]; inferonasal field [P < .001]).

Conclusion  Early treatment preserves peripheral vision, with only a small reduction of visual field extent.

Application to Clinical Practice  Early treatment for high-risk prethreshold ROP does not adversely affect visual field extent clinically.

Trial Registration  clinicaltrials.gov Identifier: NCT00027222

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Figures

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Figure 1.

Scheme of retina of right eye (RE) and left eye (LE) showing zone borders and clock hours used to describe the location and extent of retinopathy of prematurity (reproduced from Archives of Ophthalmology1).

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Figure 2.

White-sphere double-arc kinetic perimeter, with arms at 45°, 135°, 225°, and 315°. Fixation stimulus at the intersection of the 4 arms and the peripheral stimulus are 6° white spheres.

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Figure 3.

Visual field extent along the superotemporal (ST), superonasal (SN), inferonasal (IN), and inferotemporal (IT) meridians. Eyes underwent early treatment (ET) or conventional management (CM) and were from the 147 children in the bilateral high-risk prethreshold retinopathy of prematurity group who had quantifiable recognition or grating visual acuity and measurable visual field extent in both eyes. Error bars represent SEMs.

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Figure 4.

Visual field extent along the superotemporal (ST), superonasal (SN), inferonasal (IN), and inferotemporal (IT) meridians. Eyes underwent early treatment (ET) or conventional management (CM) and were from the 100 children who had type 1 prethreshold retinopathy of prematurity (ROP) in both eyes and the 44 children who had type 2 prethreshold ROP in both eyes who also had quantifiable recognition or grating visual acuity and measurable visual field extent in both eyes. Three patients had 1 eye with type 1 and 1 eye with type 2 ROP. Error bars represent SEMs.

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Figure 5.

Visual field extent along the superotemporal (ST), superonasal (SN), inferonasal (IN), and inferotemporal (IT) meridians. Eyes underwent early treatment (ET) or conventional management (CM) and were from the 56 children who had high-risk prethreshold retinopathy of prematurity (ROP) in zone I in both eyes and the 91 children who had high-risk prethreshold ROP in zone II in both eyes who also had quantifiable recognition or grating visual acuity and measurable visual field extent in both eyes. Error bars represent SEMs.

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