The Correlation of Visual Function with Posterior Retinal Structure in Severe Retinopathy of Prematurity

The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity previously reported reduced incidence of both poor structural and functional outcomes after cryotherapy. We compared the results in 304 eyes of patients in the randomized portion of the trial in whom both structural and functional assessments were performed 12 months after randomization. Two hundred fifty-five eyes (83.9%) had concordant outcomes: 153 eyes had favorable structural and functional outcomes and 102 eyes had unfavorable structural and functional outcomes. Twenty-nine eyes (9.5%) had discordant outcomes: 20 eyes had favorable structural and unfavorable functional outcomes and nine eyes had unfavorable structural and favorable functional outcomes. The small number of discordant outcomes could generally be accounted for by three factors: (1) retinal abnormalities beyond those considered in the photographic grading system (12 eyes), (2) nonretinal visual pathway disease (five eyes), or (3) false-positive and false-negative results in the measurement systems used to evaluate structure and function (five eyes). In 20 eyes (6.6%), photographs could not be graded or the visual acuity was untestable. We conclude that the appearance of the posterior pole of the eye correlates well with grating acuity in the 12-month-old infant with a history of severe retinopathy of prematurity.