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Influence of Retinopathy of Prematurity and Laser Therapy on Intraocular Pressure in Preterm Infants
Poonam Verma1, Deeksha Katoch1, Simar R Singh1
1Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Intraocular pressure (IOP) in preterm infants decreases with age. Laser treatment for retinopathy of prematurity (ROP) causes a temporary IOP increase, which usually resolves without intervention.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Research
Background:
- Intraocular pressure (IOP) dynamics in preterm infants, particularly those with retinopathy of prematurity (ROP), are not fully understood.
- ROP is a significant cause of visual impairment in premature infants.
Purpose of the Study:
- To measure IOP in preterm infants with and without ROP.
- To evaluate the impact of laser treatment on IOP in ROP patients.
Main Methods:
- Prospective comparative study of 107 preterm infants (<34 weeks gestation, <2000g).
- Infants categorized into three groups: no ROP, untreated ROP, and laser-treated ROP.
- IOP measured using Perkins tonometer at presentation and at 1 and 3 months post-treatment.
Main Results:
- A negative correlation was observed between IOP and postmenstrual age in infants without ROP and with untreated ROP.
- Infants requiring laser treatment for ROP had significantly lower baseline IOP.
- Laser treatment resulted in a transient IOP increase that normalized without medical intervention.
Conclusions:
- IOP naturally decreases as preterm infants mature.
- Laser treatment for ROP induces a temporary IOP spike that typically resolves spontaneously.
PréCis:
Intraocular pressure (IOP) decreases as preterms mature and in moderate retinopathy of prematurity, IOP is initially low and transiently rises after laser treatment.
Purpose:
This study aimed to measure intraocular pressure (IOP) in preterm infants with and without retinopathy of prematurity (ROP) and evaluate the effect of laser treatment on IOP.
Method:
This prospective nonrandomized comparative study included infants born before 34 weeks of gestation weighing <2000 g at a tertiary care research and referral institute. Those with ocular or systemic conditions or requiring surgical intervention for ROP were excluded. Infants were divided into 3 groups: Group 1 (no ROP), Group 2 (ROP without treatment), and Group 3 (ROP requiring peripheral retinal ablation by laser photocoagulation). IOP was measured using a Perkins tonometer at presentation and at 1 and 3 months. The primary outcome was IOP in preterm infants with and without ROP; and the secondary outcome was change in IOP postlaser treatment.
Results:
Of 107 infants, 40 (37.38%) had no ROP (Group 1), 25 (23.36%) had untreated ROP (Group 2), and 42 (39.25%) required laser treatment (Group 3). Average postmenstrual ages were 37.89±2.74 weeks 36.98±3.38, and 35.47±2.84 weeks, respectively. A moderate negative correlation between IOP and postmenstrual age was found in Group 1 ( r2 =-0.382; P =0.01) and Group 2 ( r2 = -0.6; P =0.001). Baseline IOP was significantly lower in Group 3 compared with the other groups, with a transient increase postlaser treatment that typically normalized without needing IOP treatment.
Conclusions:
IOP decreases as preterm infants mature. Infants with ROP requiring laser treatment exhibit significantly low IOP at presentation, but have a postlaser spike, which generally normalises without treatment.
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