Macular pigmentary changes as a sequelae of retinal hemorrhages in premature infants with retinopathy of prematurity

PurposeWe assess the incidence of macular changes in ROP patients with retinal hemorrhages.Patients and methodsThe premature group consisted of 360 children born 32 weeks gestation and/or with weight below 1500 g. We used the RetCam-120 Digital Retinal Camera to document retinal changes.ResultsOf the 360 premature infants 241 (67%) had no ROP, and 119 (33%) had ROP. Of the preterm infants with ROP retinal hemorrhages were found in 46 (38%) children. Of the newborns with ROP and with retinal hemorrhages, macular pigmentary changes were found in 3 (6%) patients. Of these 3 patients, the first had prethreshold ROP, the second threshold ROP and had underwent diode laser photocoagulation, and the third patient had stage 2 ROP. In the patients with prethreshold and threshold ROP retinal hemorrhages appeared 6 weeks after birth and macular pigmentary changes were found 6 months after birth. In the patient with stage 2 ROP hemorrhages appeared 7–8 weeks after birth and macular pigmentary changes were detected 12 months after birth.ConclusionsAlthough macular hemorrhages almost always resorb without complications, our study allows the assumption that retinal hemorrhages may cause macular pigmentary changes in the macula, and thus may lead to deprivation amblyopia. Our results may suggest that the presence of the macular pigmentary changes may be related to the hemorrhage and not to the specific therapy or to the disease.