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Published on: July 9, 2016
Long-term outcomes of visual motor integration and motor development children with retinopathy of prematurity
Seval Kutlutürk Yıkılmaz1, Gokhan Celik2, Murat Gunay3
1Department of Physiotherapy and Rehabilitation, Faculty of Hamidiye Health Sciences, University of Health Sciences, Istanbul, Turkey.
Insights
Premature infants treated with intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP) showed poorer visual motor integration (VMI) and motor development compared to laser treatment. Further research is needed to confirm these long-term neurodevelopmental effects.
Area of Science:
- Ophthalmology
- Neurodevelopmental Pediatrics
- Pediatric Medicine
Background:
- Premature infants are at risk for neurodevelopmental deficits.
- Retinopathy of prematurity (ROP) can impact visual motor integration (VMI), crucial for fine motor skills and academic success.
- Concerns exist regarding long-term neurodevelopmental effects of bevacizumab due to systemic absorption.
Purpose of the Study:
- To evaluate long-term visual motor integration (VMI) and motor development outcomes in premature children treated with intravitreal bevacizumab (IVB) versus laser therapy for ROP.
- To compare neurodevelopmental outcomes between IVB and laser treatment groups in a preschool-aged population.
Main Methods:
- A single-center, cross-sectional study included 16 premature infants receiving IVB and 23 receiving laser photocoagulation for ROP.
- At 2-6 years of age, assessments included VMI (Beery-Buktenica Developmental Test), motor development (Peabody Developmental Motor Scales-2), visual acuity, and refractive status.
Main Results:
- The bevacizumab group had a significantly higher incidence of abnormal visual function (p=0.022) and abnormal VMI skills (p=0.024) compared to the laser group.
- Incidences of abnormal gross, fine, and total motor skills were significantly higher in the bevacizumab group (p < 0.05).
- Premature children receiving bevacizumab showed significantly lower VMI and motor development compared to the laser group.
Conclusions:
- Intravitreal bevacizumab (IVB) treatment for ROP may be associated with impaired VMI and motor development in preschool-aged children.
- While bevacizumab's role is suggested, the overall severity of illness in premature infants could also contribute to delayed motor development.
Abstract:
Premature infants have a risk of neurodevelopmental deficits. Little is known, however, about how retinopathy of prematurity (ROP) affects visual motor integration (VMI), which is necessary for both fine motor skills and further school abilities. Due to the systemic escape of bevacizumab in the treatment of ROP, concerns regarding the long-term neurodevelopmental effect of the drug have arisen. The aim is to evaluate VMI and motor development long-term outcomes after intravitreal bevacizumab (IVB) injection and laser treatment for ROP. Two groups of premature children were included: Bevacizumab group - 16 premature children who received IVB treatment and laser group - 23 premature children who underwent laser photocoagulation treatment in this single center cross-sectional study. At 2-6 years of age, VMI (Beery-Buktenica Developmental Test), motor development (Peabody Developmental Motor Scales-2), visual acuity, and refractive status were assessed. The incidence of abnormal visual function was significantly higher in bevacizumab group than in laser group (p = 0.022). The incidence of abnormal VMI skill was significantly higher in bevacizumab group than in laser group (p = 0.024). Incidences of abnormal gross, fine, and total motor skills were significantly higher in bevacizumab group compared to laser group (p < 0.05). Premature children who received bevacizumab for ROP demonstrated significantly lower VMI and motor development features than those with laser treatment at preschool age. Although our results suggest the relevance of bevacizumab injection in impaired VMI and motor development outcomes, general level of sickness rather than treatment might be the cause of delayed motor development.
