GLAUCOMA AS A CAUSE OF POOR VISION IN SEVERE RETINOPATHY OF PREMATURITY

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.