title: Macular edema in Asian Indian premature infants with retinopathy of prematurity: Impact on visual acuity and refractive status after 1-year.
abstract: OBJECTIVE
  To report the impact of transient, self-resolving, untreated "macular edema" detected on spectral domain optical coherence tomography in Asian Indian premature infants with retinopathy of prematurity (ROP) on visual acuity (VA) and refraction at 1-year of corrected age.
  
  
  METHODS
  Visual acuity and refraction of 11 infants with bilateral macular edema (Group A) was compared with gestational age-matched 16 infants with ROP without edema (Group B) and 17 preterms infants without ROP and without edema (Group C) at 3, 6, 9 and 12 months of corrected age using Teller Acuity Cards and cycloplegic retinoscopy. Sub-group analysis of the previously described pattern A and B macular edema was performed.
  
  
  RESULTS
  Visual acuity was lower in infants with macular edema compared with the other two control groups throughout the study period, but statistically significant only at 3 months. Visual improvement in these infants was highest between the 3 rd and 6 th month and plateaued by the end of the 1 st year with acuity comparable to the other two groups. The edema cohort was more hyperopic compared to the other two groups between 3 and 12 months of age. Pattern A edema had worse VA compared to pattern B, although not statistically significant.
  
  
  CONCLUSIONS
  Macular edema, although transient, caused reduced VA as early as 3 months of corrected age in Asian Indian premature infants weighing <2000 g at birth. The higher hyperopia in these infants is possibly due to visual disturbances caused at a critical time of fovealization. We hypothesize a recovery and feedback mechanism based on the principles of active emmetropization to explain our findings.
authors.affiliation: Department of Pediatric Retina, Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bengaluru, Karnataka, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Vinekar
authors.forename: Shwetha
authors.initials: S
authors.lastname: Mangalesh
authors.forename: Chaitra
authors.initials: C
authors.lastname: Jayadev
authors.forename: Noel
authors.initials: N
authors.lastname: Bauer
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Munusamy
authors.forename: Vasudha
authors.initials: V
authors.lastname: Kemmanu
authors.forename: Mathew
authors.initials: M
authors.lastname: Kurian
authors.forename: Padmamalini
authors.initials: P
authors.lastname: Mahendradas
authors.forename: Kavitha
authors.initials: K
authors.lastname: Avadhani
authors.forename: Bhujang
authors.initials: B
authors.lastname: Shetty
mesh_terms: D001208:Asia / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008269:Macular Edema / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D015995:Prevalence; D012029:Refraction, Ocular; D012178:Retinopathy of Prematurity / Q000150:complications / Q000208:ethnology* / Q000503:physiopathology; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity