Prevalence of persistent avascular retina in untreated children with a history of retinopathy of prematurity screening

Persistent avascular retina (PAR) in prematurely born individuals may be a risk factor for late sequelae of retinopathy of prematurity (ROP), including retinal detachment in older childhood and adulthood. Although PAR has been associated with use of vascular endothelial growth factor antagonist therapy for treatment-requiring ROP, the prevalence of this finding in patients without prior ROP treatment is unknown. We performed a cross-sectional study to determine the prevalence of PAR in a cohort of patients 4-8 years of age who were screened for ROP in the neonatal intensive care unit and did not receive treatment. Patients were recruited from an existing population-based cohort and underwent ultra-widefield fluorescein angiography (UWFFA). UWFFA images of 43 eyes of 23 patients were evaluated. Average age at time of evaluation was 6.2 years. PAR was observed in 21 patients (91%). Thirteen eyes (30%) had PAR in zone II; 23 (53%), in zone III. Six eyes (14%) had abnormal vessels without clear PAR. These findings indicate a high prevalence of PAR in patients with a history of ROP screening without treatment.