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Visual and refractive outcomes of retinopathy of prematurity in school-age patients

Yi-Hsuan Tseng1, Wei-Yu Wang2, Pei-Liang Wu3

  • 1Department of Medicine, Mackay Medical University, New Taipei City, 252, Taiwan.

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
|June 27, 2026
PubMed

Insights

Retinopathy of prematurity (ROP) and its treatments impact ocular development. Laser treatment led to more myopia and astigmatism, while anti-VEGF injections showed outcomes similar to untreated ROP.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Retinal Diseases

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
  • Understanding the long-term ocular and refractive outcomes of ROP and its treatments is crucial for patient management.

Purpose of the Study:

  • To evaluate visual and refractive outcomes in school-aged patients with a history of prematurity and ROP.
  • To compare outcomes between different ROP treatment modalities (laser vs. anti-VEGF) and untreated ROP.

Main Methods:

  • Retrospective cross-sectional study of 310 patients categorized into five groups: full-term, preterm without ROP, untreated ROP, IVI-treated ROP, and LIO-treated ROP.
  • Comprehensive ophthalmic examinations including cycloplegic refraction and optical biometry.
  • Comparisons stratified into two age cohorts (5-9 and 10-13 years) assessing refractive errors, axial length (AL), anterior chamber depth (ACD), and corneal parameters.

Main Results:

  • Significant intergroup differences in AL, ACD, corneal diameter, and best-corrected visual acuity (BCVA) were observed.
  • Laser indirect ophthalmoscopy (LIO)-treated eyes in older cohorts showed shorter AL, shallower ACD, smaller corneal diameter, and steeper corneal curvature compared to full-term controls.
  • Intravitreal injection of anti-VEGF (IVI)-treated eyes had biometric and refractive profiles similar to untreated ROP.

Conclusions:

  • ROP and its treatments have lasting effects on ocular development and refractive status.
  • Laser treatment for ROP is associated with increased myopia, astigmatism, shorter AL, shallower ACD, and smaller corneal diameters, especially in older children.
  • IVI treatment for ROP resulted in ocular biometry closer to that of untreated ROP, suggesting potentially different long-term impacts compared to laser therapy.
Abstract

Keywords:
Anti-VEGFAstigmatismLaser photocoagulationMyopiaRefractive errorRetinopathy of prematurity

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