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Refractive Error in Patients with Retinopathy of Prematurity after Laser Photocoagulation or Bevacizumab Monotherapy
Hsi-Kung Kuo1, I-Ting Sun, Mei-Yung Chung
1Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan, ROC.
Insights
Premature infants with retinopathy of prematurity (ROP) requiring treatment develop more myopia. Laser therapy and intravitreal bevacizumab (IVB) treatment for ROP yield similar refractive outcomes at age 3.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Retinal Diseases
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Treatment strategies for ROP aim to prevent severe visual sequelae, but refractive outcomes require further investigation.
Purpose of the Study:
- To compare the refractive development in premature infants with ROP treated with laser photocoagulation versus intravitreal bevacizumab (IVB).
- To evaluate refractive errors at 3 years of age in infants with treated ROP compared to controls.
Main Methods:
- Retrospective review of medical records for ROP patients treated between 2003 and 2012.
- Cycloplegic refraction assessed by autorefractometry at 3 years of age in four groups: laser-treated ROP, IVB-treated ROP, non-type 1 ROP, and no ROP.
Main Results:
- Patients treated for ROP (laser or IVB) showed significantly higher myopia compared to those without ROP or with spontaneously regressed ROP.
- Mean spherical equivalents at 3 years were -1.71 D (laser) and -1.53 D (IVB) for treated ROP, versus 0.63 D (non-type 1 ROP) and 0.41 D (no ROP).
- No statistically significant difference in refractive error was observed between laser photocoagulation and IVB treatment groups.
Conclusions:
- Treatment-requiring ROP is associated with increased susceptibility to myopia progression.
- Laser photocoagulation and IVB are comparable in their long-term refractive outcomes for ROP at 3 years of age.
- Eyes with ROP managed conservatively or without ROP exhibited less myopic shifts.
Purpose:
To evaluate the refractive development of premature infants with retinopathy of prematurity (ROP) after treatment with laser photocoagulation or intravitreal injection of bevacizumab (IVB).
Methods:
The medical records of patients with ROP treated between 2003 and 2012 who underwent yearly follow-ups were retrospectively reviewed. Patients with residual ROP abnormalities were excluded. The cycloplegic refraction at 3 years of age, assessed using an autorefractometer, was recorded.
Results:
In total, 54 eyes from 54 patients were enrolled. Patients were divided into 4 groups: group 1, including 14 eyes of 14 patients treated with laser therapy; group 2, 15 eyes of 15 patients treated with IVB; group 3, 13 eyes of 13 patients with non-type 1 ROP under conservative follow-up, and group 4, 12 eyes of 12 premature patients without ROP. The mean spherical equivalent at 3 years of age was -1.71 ± 1.27 dpt in group 1, -1.53 ± 2.20 dpt in group 2, 0.63 ± 1.37 dpt in group 3, and 0.41 ± 1.95 dpt in group 4. The mean refractive error differed significantly among the 4 groups (p < 0.001). Patients in groups 1 and 2 were more prone to myopia compared with those in groups 3 and 4. Furthermore, patients with type 1 ROP treated by laser photocoagulation (group 1) and those treated by IVB (group 2) had similar refraction (p = 1).
Conclusions:
The results of this study suggest that treatment-demanding ROP eyes are susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP. In addition, the myopic status between laser and IVB treatment did not differ statistically.
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