Progression to severe retinopathy predicted by retinal vessel diameter between 31 and 34 weeks of postconception age.

OBJECTIVE To assess the predictive value of early retinal vascular diameter measurements for the development of severe retinopathy of prematurity (ROP) in high-risk preterm infants. METHODS Digital fundus images were taken of 78 eyes at risk for ROP with a noncontact camera during fundoscopic examination when infants were 31 to 34 weeks of postconception age. Vessel diameters were measured for the major superior and inferior temporal arteries and veins with the use of VesselMap software. Mean vessel diameters from eyes that developed severe ROP requiring treatment were compared with those that developed less severe ROP not requiring treatment or no ROP. RESULTS All 4 major temporal retinal vessels showed significantly larger average diameters in the group of eyes that developed severe ROP requiring treatment. Multivariate analysis adjusted by birth weight, gestational age, and chronologic age showed similar results. Early retinal vessel diameter measurements showed good predictive value for the progression to severe ROP requiring treatment (area under the receiver operating characteristic curve, 0.75-0.94). CONCLUSIONS At 31 to 34 weeks of postconception age, average retinal vessel diameter measurements were significantly larger in infants who developed severe ROP requiring treatment than in infants who developed less severe ROP or no ROP.