Swept-source optical coherence tomography analysis of retinal and choroidal structures in school-aged children after laser photocoagulation for type 1 retinopathy of prematurity.

PURPOSE: To evaluate the long-term structural and functional ocular outcomes in school-aged children with ROP treated by laser photocoagulation, and to compare them with those of term-born controls.

METHODS

This retrospective cohort study included premature children treated with laser photocoagulation for type 1 ROP, leading to regression without progression to advanced stages, and followed up to school age at a single tertiary center. Age- and sex-matched term-born controls were selected. Retinal and choroidal structures were assessed using SS-OCT, and retinal vascular tortuosity was quantified based on fundus photographs obtained during follow-ups conducted between ages 6 and 14 years.

RESULTS

Overall, 23 treated ROP children (45 eyes) and 50 term-born controls (100 eyes) were included. Mean age at examination was 8.83 ± 2.53 years for the ROP group and 9.54 ± 1.79 years for controls. Spherical equivalent did not differ significantly between groups (ROP vs. control; -2.05 ± 3.12 vs. -1.55 ± 1.31, p = 0.307) but treated ROP children had significantly lower vision (ROP vs. control; logMAR 0.16 ± 0.13 vs. 0.08 ± 0.12, p < 0.001). Retinal vascular tortuosity was significantly higher in the ROP group (1.163 ± 0.091 vs. 1.073 ± 0.036, p < 0.001), and SS-OCT measurements revealed statistically significant retinal thickening at central foveal and parafoveal regions. No significant choroidal thinning or differences in choroidal vascularity index was observed (p = 0.918 and p = 0.827, respectively). A negative association was observed between gestational age and central foveal thickness (p = 0.048) and between birth weight and retinal vascular tortuosity (p = 0.001). Central foveal thickness negatively correlated with gestational age and tortuosity with BW. Lower vision was significantly associated with increased retinal vascular tortuosity but not with OCT-derived retinal or choroidal metrics.

CONCLUSION

School-aged children treated with laser photocoagulation for ROP showed increased retinal vascular tortuosity and thickness in the central foveal to parafoveal regions, while choroidal thickness and vascularity remained unchanged in the central 1500 μm zone on SS-OCT device. These findings suggest localized retinal changes with preserved choroidal integrity.