Multimodal imaging in children with retinopathy of prematurity history: a prospective study from the Shenzhen Prematurity Eye Study

Investigate the multimodal characteristics, including fundus structural changes, microvascular changes, and refractive outcomes, in participants with a history of retinopathy of prematurity (ROP) treated with laser photocoagulation (LP) or anti–vascular endothelial growth factor (VEGF) therapy. The study included 26 participants (52 eyes) with a history of ROP who underwent routine summer follow-up at Shenzhen Eye Hospital, with a follow-up duration of ≥ 6 years. ROP staging at diagnosis included stage 2 (7 eyes), stage 3 (34 eyes), aggressive ROP (6 eyes), and regressive lesions (5 eyes). Treatments included LP in 31 eyes, anti-VEGF therapy in 12 eyes, combined anti-VEGF therapy with LP in 3 eyes, and LP combined with anti-VEGF therapy and vitrectomy in 1 eye. All participants underwent color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), and cycloplegic refraction. Among 52 eyes, 13 exhibited indistinct optic disc margins, 5 demonstrated surface traction over the optic disc, and 4 showed an enlarged cup-to-disc ratio. Macular findings included foveal displacement due to traction in 3 eyes, macular schisis in 2 eyes, and loss of foveal reflex in 8 eyes. A total of 4 eyes showed persistent plus disease. Peripheral retinal abnormalities were prevalent: 20 eyes exhibited peripheral vitreoretinal traction, 1 eye developed rhegmatogenous retinal detachment, 1 eye developed peripheral lattice degeneration with retinal holes, 2 eyes showed peripheral retinoschisis, and 8 eyes demonstrated peripheral retinal thinning. OCTA revealed peripheral avascular zone in 22 eyes. Lens opacity was observed in 3 eyes and vitreous opacities in 21 eyes. Refractive error included myopia in 15 participants (28 eyes), and stigmatism in 45 eyes. Peripheral vitreoretinal traction, retinal atrophic changes, and refractive errors were noted in some eyes with a history of LP, while persistent avascular retina and late-onset retinal holes or detachment were observed in some eyes following anti-VEGF treatment. These descriptive findings highlight the importance of long-term surveillance after ROP treatment. Multimodal imaging may facilitate longitudinal assessment of retinal structure and vascular development, supporting individualized follow-up and timely intervention.