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Neurodevelopmental Outcomes for Retinopathy of Prematurity: A Taiwan Premature Infant Follow-up Network Database
Ming-Chou Chiang1, Yen-Ting Chen2, Eugene Yu-Chuan Kang3
1Division of Neonatology, Department of Pediatrics (M.-C.C), Chang Gung Memorial Hospital, Linkou, Taiwan; Taiwan Premature Infant Follow-up Network (M.-C.C); College of Medicine (M.-C.C., Y.-T.C., E.Y.-K, K.-J.C., N.-K.W, L.L., Y.-P.C., Y.-S.H., C.-C.L., W.-C.W.), Chang Gung University, Taoyuan, Taiwan.
Insights
Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections for retinopathy of prematurity (ROP) did not negatively impact neurodevelopment in premature infants. Laser treatment for ROP was associated with poorer cognitive outcomes compared to anti-VEGF treatment.
Area of Science:
- Neonatology
- Ophthalmology
- Developmental Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents are increasingly used to treat ROP.
- Concerns exist regarding the potential neurodevelopmental effects of anti-VEGF treatment in this vulnerable population.
Purpose of the Study:
- To evaluate the neurodevelopmental outcomes of premature infants treated with intravitreal anti-VEGF for ROP.
- To compare neurodevelopmental outcomes across different ROP treatment groups and infants without ROP.
Main Methods:
- Retrospective cohort study using data from the Taiwan Premature Infant Follow-up Network.
- Included 2090 premature infants with a mean gestational age of 31.2 weeks.
- Neurodevelopmental assessments (Bayley-III) at 6, 12, and 24 months corrected age were analyzed using generalized estimating equations.
Main Results:
- Intravitreal anti-VEGF treatment for ROP showed comparable neurodevelopmental scores (cognitive, language, motor) to infants with ROP without treatment and premature infants without ROP.
- Laser photocoagulation for ROP was associated with significantly poorer cognitive composite scores compared to other groups.
- Language and motor scores were similar across ROP treatment groups and controls.
Conclusions:
- Intravitreal anti-VEGF treatment for ROP is not associated with adverse neurodevelopmental outcomes in premature infants.
- Further research is needed to investigate the neurodevelopmental impact of anesthesia/sedation used in laser treatment for ROP.
Purpose:
To evaluate the neurodevelopmental outcomes in premature infants who received intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections to treat retinopathy of prematurity (ROP).
Design:
Retrospective cohort study.
Methods:
This study was conducted using the database from the Taiwan Premature Infant Follow-up Network. Demographic data, systemic risk factors, ROP status, and neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) were collected. Patients were divided into 4 groups: prematurity without ROP, ROP without treatment, ROP with laser treatment, and ROP with intravitreal anti-VEGF treatment. A generalized estimating equation was used for analyzing repeated measurements of Bayley-III at the corrected ages of 6, 12, and 24 months.
Results:
A total of 2090 patients with a mean gestational age of 31.2 weeks were included. The Bayley-III composite scores of patients with ROP treated with anti-VEGF were comparable to those of patients with ROP without treatment (cognitive: P = .491; language: P = .201; motor: P = .151) and premature patients without ROP (cognitive: P = .985; language: P = .452; motor: P = .169) after adjusting for confounders. Patients with ROP treated with laser photocoagulation exhibited poorer cognitive composite scores than did those without treatment (P < .001), premature patients without ROP (P < .001), and those treated with anti-VEGF (P < .001), but they had similar language and motor composite scores.
Conclusions:
Intravitreal anti-VEGF treatment for ROP was not associated with adverse neurodevelopment in premature infants. Further studies are needed to determine whether general anesthesia or sedation used in laser treatment for ROP has significant impacts on neurodevelopmental outcomes.
