Retinal vascular changes in preterm infants: heart and lung diseases and plus disease.

To report the retinal vascular features of preterm infants with congenial heart disease (CHD), lung disease (pulmonary hypertension [PH] and bronchopulmonary dysplasia [BPD]), and ROP with plus disease to determine whether these disease entities are distinguishable on the basis of retinal morphology.The medical records of preterm infants with CHD, lung disease, and ROP with plus disease were reviewed retrospectively. Qualitative vascular findings were validated using computer-based software to analyze 25 representative images, each corresponding to one infant's eye. The images were organized into five groups, based on clinical information. Vessel diameter (d) and tortuosity index (TI) were measured.A total of 106 infants (mean gestational age, 30.5 ± 2.22 weeks) were initially included. Ophthalmologic evaluation of preterm infants with CHD and lung diseases showed vascular tortuosity without vasodilation at the posterior pole as well as in the periphery. Quantitative analysis showed that the mean venular diameter was significantly increased in the plus disease group (P = 0.0022) compared to other groups. There was significantly less in tortuosity index in both arterioles and venules in BPD (P < 0.001, P = 0.0453) compared with plus group.The pattern of retinal vascular tortuosity in preterm infants may be distinguished in systemic congestive conditions such as CHD, lung diseases, and ROP plus disease, which could have therapeutic implications.