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Incidence of cataract development by 6 months' corrected age in the Early Treatment for Retinopathy of Prematurity
Bradley V Davitt1, Stephen P Christiansen, Robert J Hardy
1Departments of Ophthalmology and Pediatrics, Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St. Louis, MO 63104, USA. davittb@slu.edu
Insights
Cataract development occurred in 1.9% of preterm infants treated for retinopathy of prematurity (ROP). This included eyes that received early treatment (ET) and conventional management (CM), indicating cataracts can develop even without laser treatment.
Area of Science:
- Ophthalmology
- Neonatal care
- Pediatric medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Early intervention for ROP is crucial to prevent vision loss.
- The long-term effects of ROP treatment on ocular development require further investigation.
Purpose of the Study:
- To determine the incidence of cataract formation by 6 months corrected age in preterm infants.
- To analyze cataract development in infants receiving early treatment (ET) versus conventional management (CM) for ROP.
Main Methods:
- Infants at high risk for poor structural outcome in ROP were randomized to ET or CM groups.
- ET involved laser photocoagulation for high-risk prethreshold ROP.
- CM involved treatment only when threshold ROP was reached. Cataract development was assessed at 6 months corrected age.
Main Results:
- Of 366 infants followed, 8 eyes (1.9%) developed cataracts by 6 months corrected age.
- Cataracts occurred in 3 ET eyes and 5 CM eyes.
- Cataract development was observed in CM eyes both with and without laser treatment, and in ET eyes.
Conclusions:
- A small proportion of preterm infants treated for ROP developed cataracts by 6 months corrected age.
- Cataract development can occur following diode laser treatment for ROP.
- Ocular complications like cataracts may develop irrespective of intraoperative findings or laser treatment status.
Purpose:
To report the incidence of cataract development by 6 months' corrected age in preterm children who participated in the Early Treatment for Retinopathy of Prematurity study.
Methods:
Infants who developed prethreshold retinopathy of prematurity (ROP) in one or both eyes and were determined by the RM-ROP2 model to have a high risk of poor structural outcome without treatment were randomized to receive early treatment (ET), defined as laser photocoagulation at high-risk prethreshold ROP, or to be conventionally managed (CM), receiving treatment only if threshold ROP developed. Data on eyes developing a cataract by 6 months' corrected age were analyzed.
Results:
Of 401 randomized infants, 366 survived patients were followed, and 8 eyes of 7 patients (1.9%) developed cataracts by 6 months' corrected age. Among these patients, mean birth weight was 754 g, and mean gestational age was 25.7 weeks. Mean gestational age at treatment was 36.3 weeks for ET patients and 39.5 weeks for CM patients. Three ET eyes and 5 CM eyes developed a cataract. Of the CM eyes, 3 with and 2 without laser treatment developed a cataract. All 6 treated eyes had plus disease when treated. Three eyes had ROP in zone 1, whereas the other 3 had ROP in zone 2. All eyes were treated using a diode laser.
Conclusions:
By 6 months' corrected age, a small number of both ET and CM eyes developed cataracts following diode laser treatment for retinopathy of prematurity. Absence of obvious intraoperative complications does not preclude subsequent cataract development, which can occur without laser treatment.