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Risk of refractive pathology after spontaneously regressed ROP in emmetropic patients
David G Morrison1, Matthew Emanuel, Sean P Donahue
1Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Insights
Children with spontaneously regressed retinopathy of prematurity (ROP) who initially had normal vision screenings have a low risk of developing significant refractive errors. Further monitoring can likely be managed with routine pediatrician vision screenings.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Genetics
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Spontaneously regressed ROP indicates a favorable outcome but may still carry risks for visual development.
- Early detection and management of refractive errors are crucial for optimal visual outcomes in children.
Purpose of the Study:
- To assess the incidence and progression of refractive error abnormalities in children with spontaneously regressed retinopathy of prematurity (ROP) following a normal initial eye examination.
- To determine if these children require specialized ophthalmological follow-up beyond standard pediatric care.
Main Methods:
- A cohort of 226 children with a history of spontaneously regressed ROP underwent cycloplegic refraction before 18 months of age.
- Children with threshold ROP, strabismus, or ocular structural abnormalities were excluded.
- A normal refraction was defined by specific diopter ranges for hypermetropia, astigmatism, and anisometropia.
Main Results:
- Of 87 children with a second examination (mean 2 years later), 63 maintained normal refractions.
- Three children (3.4%) developed significant refractive errors (anisometropia, myopic astigmatism) requiring spectacle correction.
- Twenty-one children had low-magnitude myopia that did not necessitate treatment.
Conclusions:
- Children with spontaneously regressed ROP and normal initial refractions have a similar risk of developing ametropia as the general population.
- Routine verbal vision screenings by pediatricians at 3-4 years of age may be sufficient for monitoring these children.
Purpose:
To evaluate the development of refractive error abnormalities after a normal first examination in children with spontaneously regressed retinopathy of prematurity (ROP).
Methods:
Two hundred twenty-six children with a history of spontaneously regressed ROP who had a cycloplegic refraction prior to 18 months of age were examined by a pediatric ophthalmologist. Children with a history of threshold ROP, strabismus, or a structural abnormality of the eye were excluded. A normal cycloplegic retinoscopy was defined as plano to less than +3.5 diopters of hypermetropia, less than +1.50 of symmetric astigmatism, and no anisometropia greater than 1.5 diopters in any meridian.
Results:
Of the 226 children, 87 had a second examination and cycloplegic refraction at a mean of 2 years after the initial visit. In 63 of the children, the second examination and refraction remained normal. Three (3.4%) children had significant refractive error and were treated with spectacles: two had anisometropia and one had myopic astigmatism. Twenty-one had symmetric low magnitude myopia that did not warrant treatment.
Conclusion:
Children with spontaneously regressed ROP and no significant refractive error on cycloplegic retinoscopy at first follow-up examination have a risk of developing ametropia that is similar to that of the general population. Such children can likely be observed with a verbal vision screening in the pediatrician's office at 3 to 4 years of age.
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