Me. Hartnett et al., GLAUCOMA AS A CAUSE OF POOR VISION IN SEVERE RETINOPATHY OF PREMATURITY, Graefe's archive for clinical and experimental ophthalmology, 231(8), 1993, pp. 433-438
Despite surgical reattachment of the retina in infants with severe ret
inopathy of prematurity (ROP), visual acuity may decline. We performed
gonioscopy and applanation tonometry on 26 eyes of 17 infants with se
vere ROP who were randomly selected and followed prospectively for 2 y
ears. Of these 26 eyes, one eye of one patient had only peripheral ret
inocryopexy for threshold stage III disease and had an attached retina
before enrollment into the study. Sixteen infants subsequently underw
ent vitrectomy, scleral buckle, or both. Retinal reattachment of the p
osterior pole was present in at least one eye each of 10 of the 17 inf
ants. Glaucoma was diagnosed in 5 of the 10 patients; all 5 showed a d
ecrease in visual acuity of greater than 1 octave. Of the 5 infants wi
thout glaucoma, 3 showed visual improvement, and 2 remained the same.
Although we studied a small number of cases, our results suggest that
glaucoma may be a cause of visual decline in infants with severe ROP.
A decline in visual acuity in infants with severe ROP and surgical ret
inal reattachment may warn us of glaucoma, as this diagnosis is diffic
ult to make in these small infants.