Myopia and anterior segment optical coherence tomography findings in laser-treated retinopathy of prematurity eyes

Lenis, Tamara L.; Gunzenhauser, Robert; Fung, S.; Dhindsa, Yasmeen; Sarraf, David; Pineles, Stacy L.; Tsui, Irena

doi:10.1016/j.jaapos.2020.01.007

Cited by 13 publications

(20 citation statements)

References 27 publications

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“…Other predisposing anterior segment abnormalities observed in premature children, with and without ROP, include steep corneal curvature, decreased anterior chamber depth, anteriorly displaced iris planes, and increased lens thickness ( 10 , 18 – 22 ). Eyes with ROP not requiring treatment as well as ROP-treated eyes have been found to have narrower anterior chamber angles (ACA) than full-term children ( 22 ) or preterm monitored eyes ( 23 ). These changes may also explain the high prevalence and magnitude of myopia in preterm children ( 24 ), and the even higher apparent risk in those with laser-treated ROP ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

“…The anterior segment changes observed in premature infants with ROP could be further exacerbated by an arrested state of retinal development, such that the local growth signals involved in anterior segment development are altered ( 24 ). Additionally, laser treatment is considered to contribute significantly to the development of narrow angles and anterior segment defects in children with ROP ( 23 , 24 ). More specifically, laser-induced mechanical changes may impair development of the angle by affecting the posterior ciliary nerve, artery, or pars plana ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

et al. 2021

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Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that occurs due to incomplete development of retinal blood vessels in preterm infants. Glaucoma is an ocular comorbidity in some patients with ROP, and it may be associated with immature anterior chamber development, ROP itself, or the treatment for ROP. There have been a few reports of narrow-angle glaucoma after laser treatment for ROP. In this case report, we describe the course of a female infant born at 24 weeks and 5 days of gestational age with treatment-requiring ROP treated with laser photocoagulation who subsequently developed very elevated intraocular pressure and shallow anterior chambers without pupillary block. The patient required bilateral ab externo trabeculotomy for elevated intraocular pressure, which normalized after the procedure. The patient has remained stable at the last follow-up at 51 weeks postmenstrual age. Differing from previous glaucoma presentations in this setting, we illustrate a case of elevated intraocular pressure and anterior chamber narrowing after laser therapy without pupillary block or synechiae. The possible multifactorial etiology of glaucoma in this patient, including incomplete angle development, ischemia, and laser treatment, highlight the need for glaucoma screening in patients with ROP, both in the short and long term.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

et al. 2021

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“…Myopia associated with ROP relates to abnormalities of the anterior segment. 7,[22][23][24][25][26][27][28][29][30][31] Fielder and Quinn 32 suggested myopia associated with ROP may develop because damaged peripheral retina physically constrains the development of the anterior segment. In support of this mechanical restriction hypothesis, they observed that eyes treated with laser developed less myopia than eyes treated with cryotherapy and suggested this is because laser is less tissue-destructive.…”

Section: Contributions Implications Limitationsmentioning

confidence: 99%

“…37,38 (4) Our study evaluated only refractive error. Other biometric measures would be very helpful in understanding the pathophysiology of myopia associated with ROP (Lenis et al 30 ); however, taking these measurements in young infants is difficult and was beyond the scope of this study. (5) The treatment decisions for patients included in this study were not random, which may have introduced a selection bias.…”

Section: Contributions Implications Limitationsmentioning

confidence: 99%

Longitudinal Development of Refractive Error in Children Treated With Intravitreal Bevacizumab or Laser for Retinopathy of Prematurity

Simmons

Wang

Leffler

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose To compare the patterns of longitudinal refractive error development during the first 3.5 years in children with severe retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB) or laser photocoagulation. Methods This prospective cohort study enrolled extremely preterm infants (birth weight < 1000 g, gestational age 23–27 weeks) with type 1 ROP from multiple hospitals in Dallas between 1999 and 2017; IVB group (N = 22); laser group (N = 26). Cycloplegic retinoscopy was conducted from 0.04 years corrected age and every 0.5 to 1.0 years thereafter until 3.5 years old. Right eye spherical equivalent (SEQ) and astigmatism, anisometropia, and better-eye visual acuity were analyzed over time. Results In all children, both eyes were treated with the same modality. At the final visit, the prevalence of myopia (SEQ ≤ −1D) was 82.7% in the laser group and 47.7% in the IVB group ( P < 0.05) with a mean SEQ of −8.0D ± 5.8D in the laser group versus −2.3D ± 4.2D in the IVB group ( P < 0.001). Longitudinal SEQ were best fit with a bilinear model. Before one year, the rate of SEQ change was −5.0D/year in the laser group, but only −3.5D/year in the IVB group (T = −5.14, P < 0.001); after one year, there was a significant flattening of these slopes (T = 6.23, P < 0.001). Anisometropia in the IVB group was significantly less than in the laser group ( P < 0.05). Final visual acuity in both groups was similar at 0.47 logMAR (∼ 20/60). Conclusions Children with severe ROP treated with IVB developed less myopic refractive error than those treated with laser largely because of a slower rate of refractive change during the first year of life. Translational Relevance These findings may inform decisions regarding ROP treatment timing and modality.

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“…Cryotherapy is an effective ablation therapy of abnormal retinal vasculature in ROP, but some unfavorable systemic and functional outcomes may occur [ 12 , 13 ]. On the other hand, laser photocoagulation has better functional outcomes, but it has a higher risk of cataract, myopia, cornea, and lens burns [ 14 , 15 ]. Recently, the intravitreal injection of anti-VEGF agents became a new approach for treating ROP.…”

Section: Introductionmentioning

confidence: 99%

Potential Effects of Nutraceuticals in Retinopathy of Prematurity

Tsang

Wolf

Pompoes

et al. 2021

Life

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Retinopathy of prematurity (ROP), the most common cause of childhood blindness, is a hypoxia-induced eye disease characterized by retinal neovascularization. In the normal retina, a well-organized vascular network provides oxygen and nutrients as energy sources to maintain a normal visual function; however, it is disrupted when pathological angiogenesis is induced in ROP patients. Under hypoxia, inadequate oxygen and energy supply lead to oxidative stress and stimulate neovasculature formation as well as affecting the function of photoreceptors. In order to meet the metabolic needs in the developing retina, protection against abnormal vascular formation is one way to manage ROP. Although current treatments provide beneficial effects in reducing the severity of ROP, these invasive therapies may also induce life-long consequences such as systemic structural and functional complications as well as neurodevelopment disruption in the developing infants. Nutritional supplements for the newborns are a novel concept for restoring energy supply by protecting the retinal vasculature and may lead to better ROP management. Nutraceuticals are provided in a non-invasive manner without the developmental side effects associated with current treatments. These nutraceuticals have been investigated through various in vitro and in vivo methods and are indicated to protect retinal vasculature. Here, we reviewed and discussed how the use of these nutraceuticals may be beneficial in ROP prevention and management.

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Myopia and anterior segment optical coherence tomography findings in laser-treated retinopathy of prematurity eyes

Cited by 13 publications

References 27 publications

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

Longitudinal Development of Refractive Error in Children Treated With Intravitreal Bevacizumab or Laser for Retinopathy of Prematurity

Potential Effects of Nutraceuticals in Retinopathy of Prematurity

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