Long-term visual function and refractive changes after vitrectomy for stage 4 retinopathy of prematurity

Area of Science:

• Ophthalmology
• Pediatric Medicine
• Surgical Outcomes

Background:

• Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
• Vitrectomy is a surgical intervention for advanced ROP, but long-term visual outcomes require further investigation.
• Limited research exists on serial visual changes and refractive errors post-vitrectomy for stage 4 ROP.

Purpose of the Study:

• To investigate longitudinal changes in best-corrected visual acuity (BCVA) and refraction after vitrectomy for stage 4 ROP.
• To compare postoperative BCVA and refractive errors between ages 5 and 8 years.
• To identify factors associated with visual acuity outcomes in these patients.

Main Methods:

• Retrospective review of 42 eyes from 25 patients with stage 4A or 4B ROP.
• Successful vitrectomy and a minimum follow-up of 8 years.
• Analysis of BCVA and refractive errors at ages 5 and 8, with regression analysis for associated factors.

Main Results:

• Stage 4A ROP eyes showed significant BCVA improvement (0.83 to 0.63 logMAR) between ages 5 and 8.
• A myopic shift of ≥1 D occurred in 61.8% of stage 4A eyes.
• Phakic and dominant eyes at age 5 were independently associated with better BCVA at ages 5 and 8 in stage 4A ROP.
• No significant BCVA improvement was observed in stage 4B ROP eyes.

Conclusions:

• Continued visual improvement is possible beyond age 5 in stage 4A ROP patients post-vitrectomy.
• Myopic progression occurs concurrently with visual improvement in this cohort.
• Dominant eyes in patients with poor initial BCVA may show improvement by age 8.
• Long-term monitoring is crucial for managing visual and refractive changes after ROP vitrectomy.