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Published on: May 25, 2020

Final visual acuity results in the early treatment for retinopathy of prematurity study

1, William V Good, Robert J Hardy

  • 1Smith-Kettlewell Eye Research Institute, San Francisco, CA 94115, USA. good@ski.org

Archives of Ophthalmology (Chicago, Ill. : 1960)
|April 14, 2010
PubMed

Insights

Early treatment for retinopathy of prematurity (ROP) in Type 1 eyes improved visual acuity by age 6. Early treatment for Type 2 ROP did not show a significant visual acuity benefit.

Area of Science:

  • Ophthalmology
  • Neonatal care
  • Pediatric medicine

Background:

  • Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
  • High-risk prethreshold ROP requires careful management to optimize visual outcomes.
  • Early intervention versus conventional management strategies are debated for specific ROP classifications.

Purpose of the Study:

  • To compare visual acuity at 6 years of age in infants with high-risk prethreshold ROP.
  • To evaluate the impact of early treatment versus conventional management on visual outcomes.
  • To assess the effect of treatment timing on retinal structural integrity.

Main Methods:

  • Randomized controlled trial comparing early treatment with conventional management for high-risk prethreshold ROP.
  • Symmetrical and asymmetrical ROP cases were analyzed separately.
  • Visual acuity (ETDRS) and retinal structure were assessed at 6 years of age by masked testers.

Main Results:

  • No overall statistically significant visual acuity benefit for early treatment across all high-risk prethreshold ROP cases.
  • Early treatment demonstrated a significant visual acuity benefit for Type 1 ROP eyes (25.1% vs 32.8% unfavorable outcome; P = .02).
  • Early treatment resulted in significantly better retinal structural outcomes (8.9% vs 15.2% unfavorable outcome; P < .001) without increasing ocular complications.

Conclusions:

  • Early treatment for Type 1 high-risk prethreshold ROP eyes improves visual acuity outcomes at 6 years.
  • Early treatment for Type 2 high-risk prethreshold ROP eyes does not offer a significant visual acuity advantage.
  • Clinical practice should prioritize early treatment for Type 1 ROP eyes, as Type 2 eyes may regress spontaneously.
Abstract

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