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Development of Scotopic Visual Thresholds in Retinopathy of Prematurity

From the Department of Ophthalmology, Children’s Hospital, Harvard Medical School, Boston, Massachusetts.

PURPOSE. To test the hypothesis that the late-maturing parafoveal rod photoreceptors are more vulnerable than peripheral rods to the effects of retinopathy of prematurity (ROP).

METHODS. Twenty-four infants with a history of preterm birth (gestational age at birth 31 weeks) participated in a longitudinal study: 12 had mild ROP that resolved without treatment, and 12 had never had ROP. Thresholds for detecting stimuli (2° diameter, 50 ms duration) presented 10° (parafoveal) and 30° (peripheral) from a central fixation target were estimated by using a preferential-looking method. At each visit, thresholds at both sites were obtained in random order. Thresholds of the preterm subjects were compared with those of previously reported term infants.

RESULTS. The course of threshold maturation in subjects with ROP was significantly prolonged (P 0.01) compared with those who had never had ROP and with term-born control subjects. On average, parafoveal thresholds in subjects with ROP reached the adult level at a median age of 12 (range, 6–18) months, and peripheral thresholds reached the adult level at 9 (range, 5–12) months. Median thresholds in subjects who had never had ROP reached adult levels at both sites by approximately 7 months.

CONCLUSIONS. The slower development of parafoveal compared with peripheral thresholds in subjects with a history of ROP is evidence that the late-maturing parafoveal rods are more affected by the ROP disease process.

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