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Refractive status of Chinese with laser-treated retinopathy of prematurity
Lu Ruan1, Hai-Dong Shan, Xing-Zong Liu
1*MD †PhD Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China (all authors).
Insights
Laser treatment for retinopathy of prematurity (ROP) in children is linked to increased myopia and astigmatism. Regular eye screenings are crucial to monitor refractive changes and prevent amblyopia.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Refractive Error Research
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Laser treatment is a common intervention for threshold and Type 1 prethreshold ROP.
- Understanding long-term refractive outcomes post-ROP treatment is critical for patient management.
Observation:
- A retrospective study analyzed refractive outcomes in children treated for ROP versus controls.
- Cycloplegic retinoscopy assessed myopia, astigmatism, and anisometropia between 12 and 36 months post-treatment.
- Aggressive posterior ROP (APROP) cases were analyzed separately.
Findings:
- Laser-treated ROP eyes showed significantly higher myopia and astigmatism compared to controls.
- Children with APROP exhibited even greater myopia progression than those with non-APROP.
- APROP eyes also had a higher prevalence of high myopia and spherical anisometropia.
Implications:
- Laser treatment for ROP, particularly APROP, increases the risk of myopia, astigmatism, and anisometropia.
- These refractive errors may lead to amblyopia if not managed.
- Routine refractive error screening is essential for children undergoing ROP laser treatment.
Purpose:
To analyze changes in myopia, astigmatism, and anisometropia after laser treatment of retinopathy of prematurity (ROP), including aggressive posterior retinopathy of prematurity (APROP), in Mainland Chinese children.
Methods:
This was a retrospective study of children who had laser treatment for threshold or type 1 prethreshold ROP between January 2004 and October 2012 and age-matched control subjects with spontaneously regressed type 2 prethreshold ROP. One hundred fifteen eyes of 60 patients were included as the laser-treated group, which were further subdivided into APROP and non-APROP groups. Thirty-seven eyes of 20 patients who were diagnosed during the same period were included as the control group. Between 12 and 36 months postnatal age (PA) (mean [±SD], 22.9 [±8.1] months), cycloplegic retinoscopy was performed to measure refractive outcomes. A general linear model was used to analyze refractive changes among different groups at each PA.
Results:
After adjusting for PA and the correlation between right and left eyes, the magnitude and proportion of astigmatism (p = 0.04 and p = 0.004, respectively) and myopia (p < 0.0001 and p = 0.006, respectively) were greater in the laser-treated group than in the control group. The differences in myopia were even greater in children with APROP than those with non-APROP, whereas the differences in astigmatism were not. Eyes with APROP had higher prevalence of high myopia and spherical anisometropia than the control (p = 0.002 and p = 0.02, respectively) and the non-APROP groups (p < 0.0001 and p = 0.04, respectively).
Conclusions:
Children with laser treatment for ROP, including APROP, tended to have higher myopia, astigmatism, and anisometropia, which may progress to amblyopia. These findings highlight the need for regular refractive screening after laser treatment of ROP.
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