Since the 1950s, as more infants afflicted with ROP have survived and matured, the ophthalmic community has gained experience with “adult ROP.” Amblyopia, myopia, early nuclear sclerotic cataract, and glaucoma are among the most common sequelae encountered in formerly premature adults. Common retinal findings of regressed ROP include vascularization over a stage 2 ridge, peripheral vascular straightening and pigment stippling (Figure 15) and peripheral cicatricial changes (Figure 16). Exudative retinopathy, and rhegmatogenous retinal detachment are encountered as well. Collectively, these findings underscore the need for lifelong ophthalmic monitoring of formerly premature adults.
A retrospective review of formerly premature adults (gestational age less than 32 weeks) reported cataract surgery tends to be performed at a young age (on the order of 40 years of age). The authors noted that visual results following cataract surgery in this population were mixed, and the risk of retinal tear or detachment was high (23%). Higher failure rates of retinal tears/detachment treatment in this cohort of formerly premature adults was noted as well, and may be attributable to an abnormal vitreoretinal interface (specifically the posterior border of the vitreous base) combined with the propensity to lattice degeneration-like pathology occurring in the previously avascular peripheral retina.
Kaiser RS, Fenton GL, Tasman W, Trese MT. Adult retinopathy of prematurity: retinal complications from cataract surgery. Am J Ophthalmol. 2008 Apr;145(4):729-735.