Long-term follow-up on patients treated with laser for retinopathy of prematurity

To assess long-term functional and structural outcomes in eyes treated with laser photocoagulation for retinopathy of prematurity (ROP).

Patients treated for ROP (1997-2004) underwent best-corrected visual acuity (BCVA) assessment, autorefraction, biometry, OCT, and OCT angiography of the macula and optic disc. Patient characteristics were retrieved from neonatal medical records.

Sixty-three eyes of 33 patients with a mean follow-up of 19 years, and 22 eyes of 11 age-matched controls were included. The laser-treated group had a mean BCVA of 0.133 (±0.17) logMAR. Poor anatomical outcome occurred in 6.3% (n = 4), with 2 eyes requiring surgery. Mean spherical equivalent was -5.04 (±5.13) D. Corneal curvature and lens thickness were significantly higher in the study group (p < .001). Central macular thickness was greater in ROP eyes (311.97 μm vs 252.57 μm; p < .001). Vascular density was increased in the foveal region and decreased in other regions (p < .001), and the foveal avascular zone was smaller (p < .001). Optic disc analysis showed a reduction in cup-to-disc ratios and peripapillary capillary density (p < .001).

Two decades after laser treatment, our patients demonstrated excellent visual acuity and favourable anatomic outcomes. Myopia was linked to increased corneal curvature and lens thickness. Significant alterations in the vascular plexuses of the macula and optic disc occur and may impact visual function in adulthood.