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Is the severity of refractive error dependent on the quantity and extent of retinal laser ablation for retinopathy of
Tafadzwa Young-Zvandasara1, Magdalena Popiela2, Hazel Preston2
1Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK. tpzvandas@hotmail.com.
Insights
Retinopathy of Prematurity (ROP) laser treatment quantity impacts refractive error. More extensive laser treatment in ROP is linked to increased myopia and anisometropia in children.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Medical Research
Background:
- Retinopathy of Prematurity (ROP) is a leading cause of childhood blindness.
- Acquired refractive error is a common complication following ROP treatment.
- The relationship between laser treatment extent and refractive error severity in ROP requires further investigation.
Purpose of the Study:
- To investigate the association between the quantity of laser photocoagulation delivered and the severity of acquired refractive error in infants with ROP.
- To determine if the proportion of the retina treated with laser influences refractive outcomes at age 6 years.
Main Methods:
- A cohort study comparing age and weight-matched infants with ROP who received laser treatment versus those who did not.
- Quantitative analysis of laser burns and retinal images using computer-aided design software to assess the treated retinal area.
- Longitudinal data collection on refractive error up to 6 years of age.
Main Results:
- Infants treated for ROP showed significantly higher rates of myopia (-2.23 D) compared to untreated controls (+2.04 D) at 72 months.
- Fifty percent of treated eyes were myopic at 72 months, versus 19% in the control group.
- A larger treated retinal area (49%) was significantly associated with higher myopia and anisometropia (P<0.05).
Conclusions:
- The extent of myopia following laser ablation for ROP is directly correlated with the number of laser burns and the proportion of the retina treated.
- Increased laser treatment in ROP management is associated with a higher risk of developing myopia and anisometropia.
- These findings highlight the importance of optimizing laser treatment parameters to minimize refractive error complications in ROP survivors.
Background/Aim:
To test the hypothesis severity of acquired refractive error in Retinopathy of Prematurity (ROP) is dependent on the quantity of laser treatment delivered.
Methods:
Two groups (treated and untreated infants) were age and weight matched. Data on the number of laser burns and Retcam II retinal images were analysed using computer aided design software to determine the proportion of area treated. Data were collected until the age of 6 years.
Results:
The study comprises 43 infants (86 eyes). Twenty-one infants (42 eyes) in the treated group, mean gestational age (GA) was 26.40 (±2.5) weeks versus 27.30 (±1.7) weeks in the matched untreated group (P = 0.650). Birth weight (BW) in the treated group was 812 g (±86) and 804 g (±135) (P = 0.185) in the untreated group. Mean refractive error at 72 months was -2.23 (±4.06) in the treated group and +2.04 (±0.90) in the untreated group (P < 0.005). At 72 months 50% of treated eyes were myopic versus 19% of controls (P = 0.013). Mean laser burns applied were 1855 (±659), mean proportion of retina treated 45% (±10). Myopic eyes had a mean treatment area of 49% (±13) versus 43% (±10) hypermetropia and 42% (±5) emmetropia (P = 0.030). A larger treatment area was associated with a higher degree of myopia and anisometropia at 72 months (P < 0.050). These associations were not found for hypermetropia.
Conclusions:
The extent of myopia after retinal laser ablation for ROP is higher if a greater number of laser burns or a larger proportion of the retina is treated.
