WAVY OBLONG RETROGRADE MOVING SEGMENTS (WORMS) INTRAVENOUS FLUORESCEIN ANGIOGRAPHIC FINDING IN A NEONATE WITH RETINOPATHY OF PREMATURITY.

PURPOSE: To describe the clinical course and imaging phenomenon we term "wavy oblong retrograde moving segments" or "WORMS" in intravenous fluorescein angiography in a neonate with retinopathy of prematurity (ROP).

METHODS

A 50 week post menstrual age (PMA) premature neonate with retinopathy of prematurity presented with regressed stage 3, zone IIp disease in both eyes. Intravenous fluorescein angiography was performed to evaluate for leakage or neovascularization.

RESULTS

Intravenous fluorescein angiogram demonstrated multiple localized hyperfluorescent segments moving through venous retinal vasculature, rather than typical arterio-venous transit phase with hyperintensity in a laminar pattern. Additional typical ROP-associated findings such as shunt vessels, arborization, ischemia, and neovascularization with leakage were also noted. Treatment with intravitreal off-label bevacizumab was previously performed at age 17 weeks, and laser treatment of peripheral avascular retina was performed at age 27 weeks. ROP regressed and age-appropriate visual acuity was noted at age 22 months.

CONCLUSIONS

Wavy oblong retrograde moving segments (WORMS) are a rare feature associated with advanced ROP in this case. This report demonstrates the appearance of this phenomenon and describes the successful treatment of ROP.