To correlate visual acuity to macular spectral-domain optical coherence tomography (SD OCT) anomalies detected in children with a history of retinopathy of prematurity (ROP).

Retrospective cohort study.

All charts of children with a history of ROP between 2 and 18 years of age and with SD OCT performed between 2010 and 2012 were reviewed. Central foveal thickness was measured and correlated with visual acuity. Secondary outcome measures included temporal parafoveal thickness, presence of the inner nuclear layer and outer segment, gestational age at birth, sex, spherical equivalent, history of laser treatment, and developmental delay.

The study included 44 better-seeing eyes of 44 patients. Sixty-four percent (28/44) of patients in our study had 20/40 or better visual acuity despite an abnormal foveal morphology in 91% of total eyes.

Patients with a history of ROP demonstrate a high frequency of macular morphologic abnormalities, including retention of inner retinal layers and absent foveal depression, on SD OCT. These structural changes do not always correlate to visual acuity. Instead it appears that cone maturation may be a better indicator of visual acuity. In addition, there is a significant correlation between best-corrected visual acuity and myopia.