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Myopia dominance in preterm infants without and with retinopathy of prematurity: Indian Twin Cities ROP study
Swapnil Thakur1, Seema Kumari1, Vishwa Sanghavi1
1Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Prof. Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Insights
Myopia is more common in preterm infants, especially those with retinopathy of prematurity (ROP). Severe ROP and laser treatment for ROP increase myopia risk, necessitating regular eye exams.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Pediatric Optometry
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Understanding refractive error progression in infants with ROP is crucial for early intervention.
Purpose of the Study:
- To analyze refractive errors in premature infants with varying stages of ROP.
- To compare refractive outcomes between infants with and without ROP.
- To evaluate the impact of laser treatment on refractive error progression in ROP.
Main Methods:
- Retrospective analysis of 838 premature infants' data.
- Categorization based on ROP presence, stage (1-3, aggressive posterior ROP), and laser treatment.
- Assessment of 1-year refractive error change in a subset of 117 infants.
Main Results:
- Myopia prevalence was higher in infants with ROP (39.7%) versus no-ROP (19.8%).
- Myopia increased with ROP severity: Stage 1 (19.7%) to aggressive posterior ROP (59.5%).
- Laser treatment for ROP doubled myopia risk (54.5% vs. 25.5% in untreated).
- Significant 1-year myopic shift observed in aggressive posterior ROP and Stage 3 ROP.
Conclusions:
- Myopia is prevalent in preterm infants, with higher rates in those with ROP.
- Severe ROP and laser treatment are associated with increased myopia.
- Meticulous periodic refractive error assessment is essential for preterm infants, especially those with ROP.
Purpose:
To investigate the refractive error profile and progression in infants with different stages of ROP, without ROP, and those who received laser treatment for ROP.
Methods:
This retrospective study included the data from 838 infants (baseline mean age 3.7 ± 5.4 months) who had premature birth. Among these, 433 infants had one of the stages of ROP and 405 had no ROP. Infants with ROP were sub-divided into stage 1 (n = 76), stage 2 (n = 142), and stage 3 (n = 136) and aggressive posterior ROP, (APROP, n = 79). They were further categorized into those who received treatment (n = 213) and with no treatment for ROP (n = 220). Data from a subset of 117 infants was used to assess the 1-year change in the refractive error. Myopia was defined as spherical equivalent refraction (SER) <-0.50 diopters (D). Eyes with retinal detachment were excluded.
Results:
Higher percentage of myopia was found in infants with ROP (39.7%) than no-ROP (19.8%), and it increased with severity of ROP: stage 1: 19.7%, stage 2: 33.8%, stage 3: 45.6%, and 59.5% in APROP. Percentage of myopia doubled in those who underwent treatment for ROP (54.5%) compared to no-treatment group (25.5%). Mean (± SEM) change in SER after 1 year was significantly greater in infants with APROP -4.55 ± 1.38 D and stage 3 ROP -2.28 ± 0.57 D compared to other stages and no-ROP.
Conclusion:
Myopia was found to be more prevalent in preterm infants in general, and more in the presence of ROP. Preterm infants without or with any form of ROP, particularly those with severe form of ROP and those who received treatment require meticulous periodic refractive error assessment.
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