The rate of change in retinal vessel width and tortuosity in eyes at risk for retinopathy of prematurity

Purpose: To describe the rate of change in retinal vessel width and tortuosity in eyes that develop treatment-requiring, or type 1, retinopathy of prematurity (ROP) versus eyes that do not develop type 1 ROP. Methods: Posterior poles of eyes of 41 infants at risk for ROP were imaged longitudinally with a 30° fundus camera. Retinal vessel width and tortuosity were measured with computer-assisted image analysis. The rate of change per day in width and tortuosity up to the development of most severe ROP was calculated from linear regression and eyes with (n = 10) and without type 1 ROP (n = 31) were compared. Results: Eyes that developed type 1 ROP had a greater rate of change in width for venules and 3 widest vessels (P < 0.0001), and a greater rate of change in tortuosity for arterioles and 3 most tortuous vessels (P < 0.0001) than eyes that did not develop type 1 ROP. These vessel parameters discriminate the 2 groups well (area under the ROC curve, 0.79-0.90). A combination of venular width and arteriolar tortuosity had the best discriminative ability (area under the ROC curve, 0.96). Conclusions: In this pilot study, eyes that eventually developed type 1 ROP demonstrated a faster increase in width and tortuosity of retinal vessels compared with those that did not. Further study of the kinetics of retinal vascular change in a larger sample may allow for the earlier identification of vision-threatening ROP.