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Glaucoma in the Early Treatment for Retinopathy of Prematurity (ETROP) study
Don L Bremer1, David L Rogers, William V Good
1Department of Ophthalmology, Nationwide Children's Hospital, Columbus, OH 43205, USA.
Insights
Nearly 2% of infants with severe retinopathy of prematurity (ROP) developed glaucoma within six years. Early ROP treatment improved outcomes but glaucoma remains a risk, impacting vision significantly.
Area of Science:
- Ophthalmology
- Pediatric Medicine
Background:
- Severe retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Early Treatment for Retinopathy of Prematurity (ETROP) study aimed to improve outcomes for high-risk infants.
- Glaucoma is a serious complication that can arise from ROP.
Purpose of the Study:
- To describe the clinical features of infants who developed glaucoma following severe retinopathy of prematurity (ROP).
- To analyze the incidence and timing of glaucoma diagnosis in infants from the ETROP trial.
Main Methods:
- Review of infants randomized in the ETROP trial with high-risk prethreshold ROP.
- Data collection included corneal clarity, anterior chamber depth, optic nerve status, retinal structure, and visual acuity up to 6 years.
- Glaucoma diagnosis was based on investigator clinical judgment.
Main Results:
- 1.67% of eyes (12 of 718) were diagnosed with glaucoma.
- Glaucoma diagnoses occurred between 9 months and 5 years of age.
- Most affected eyes had shallow anterior segments, and 8 had retinal detachments (stage 4B or worse); only one eye had measurable vision at 6 years.
Conclusions:
- Despite improved retinal structure and visual acuity from earlier ROP treatment, approximately 2% of eyes with high-risk prethreshold ROP developed glaucoma.
- Glaucoma can manifest years after initial ROP treatment, leading to severe vision loss.
Purpose:
To report the clinical characteristics of infants with severe retinopathy of prematurity (ROP) and glaucoma-based on review of the Early Treatment for Retinopathy of Prematurity (ETROP) study.
Methods:
All infants randomized in the ETROP trial were included. Each infant developed high-risk prethreshold ROP in at least one eye. Infants were examined until 6 years postnatal age. The following data were collected: corneal clarity, depth of the anterior chamber, status of the optic nerve and cup/disk ratio, retinal structure, and visual acuity. The diagnosis of glaucoma was based on the investigators best clinical judgment. All infants diagnosed with glaucoma were included in the study.
Results:
A total of 12 of 718 eyes (1.67%) were diagnosed with glaucoma. Of these, 5 were first reported as having glaucoma at 9 months, 2 at 2 years, 1 each at 3 and 4 years, and 3 at 5 years. The anterior segment was shallow in 7 eyes. Three eyes had normal retinal structure, 1 had macular dragging, and 8 had retinal detachments involving the fovea (stage 4B or worse). At the 6-year follow-up examination only one eye with glaucoma had measurable vision.
Conclusions:
Although earlier treatment of significant ROP has resulted in better retinal structure and visual acuity outcomes, nearly 2% of the eyes with high-risk prethreshold ROP developed glaucoma at some point during the first 6 years of life.
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