Ophthalmological outcome of 6.5 years children treated for retinopathy of prematurity: a Swedish register study

Abstract

AimsTo determine the ophthalmological outcome at 6.5 years of age in children treated for retinopathy of prematurity (ROP), and registered in the national Swedish National Register for ROP register.MethodsData on ROP, treatment and ophthalmological outcome were retrieved from the register. Visual acuity (VA), refractive errors and strabismus, together with visual impairment (VI) and any significant eye problem, defined as VA >0.5 logarithm of the minimal angle of resolution (logMAR) and/or strabismus and/or any refractive error were analysed. Risk factors such as sex, gestational age (GA), birth weight SD score, number of treatments and retreatments, postnatal age and postmenstrual age at first treatment were analysed.ResultsFollow-up data were available in 232 of 270 children born between 2007 and 2014 who had been treated for ROP. VI (VA >0.5 logMAR) was found in 32 (14%), strabismus in 82 (38%), refractive errors in 114 (52%) and significant eye problem in 143 (65%) children. Retreatment was a risk factor for VI and refractive errors. Male sex and neonatal brain lesion were risk factors for strabismus. An additional week of GA at birth reduced the risk for refractive errors, strabismus and significant eye problems.ConclusionThe results of the present study revealed a high number of eye problems in children treated for ROP, emphasising the need for long-term follow-up. Retreatment of ROP was a risk factor for VI, and emphasises the importance of an accurate first treatment for the long-term ophthalmological outcome.

FIVE-YEAR VISUAL OUTCOME OF TREATMENT FOR RETINOPATHY OF PREMATURITY IN INFANTS WEIGHING <500 G AT BIRTH

“…Several researchers have investigated the long-term treatment outcomes of laser and anti-VEGF therapy in ROP. 15,16,19 However, there is less known about the results after ROP treatment for patients weighing ,500 g at birth. To our knowledge, this is one of the first studies to investigate the 5-year outcomes of ROP treatment in very low BW infants weighing ,500 g.…”

“…Correspondingly, in the present study, the mean SE of the laser and anti-VEGF groups was −5.06 D and −0.93 D, respectively, and eyes in the laser group tended to have more myopic refractive error than the previous studies. Another study that incorporated patients of all BWs (mean BW = 699 g) 16 reported that 102 of 429 eyes (25%) had significant myopia (SE < −3.0 D). In this study, 10 of 24 eyes (42%) had myopia >−3.0 D, i.e., children weighing <500 g at birth had severe myopia among the ROP population.…”

“…However, in the present study, the mean astigmatism of the laser and anti-VEGF groups was 2.34 D and 1.45 D, respectively. Larsson et al reported 16 that 78 of 429 eyes (18%) of patients with ROP had significant astigmatism (<−2.0 D). In the present study, nine eyes (38%) had astigmatism >−2.0 D. As with visual acuity and myopia, patients with ROP who weighed ˂500 g at birth had stronger astigmatism in the ROP population.…”

“…Several studies on long-term treatment outcomes for ROP, which included patients of all BWs (mean BW: 765–1,490 g), have reported that the mean BCVA in eyes treated with laser were 0.11, 15 0.1, 20 0.06, 21 and 0.15, 22 and those in eyes treated with anti-VEGF were 0.10, 15 0.2, 20 0.01, 21 and 0.20, 22 which were relatively better than those observed in this study (0.28 in the laser group, 0.26 in the anti-VEGF group). Larsson et al investigated 16 450 eyes of patients with ROP of all BWs (mean BW = 699 g) at 6.5 years of age. They indicated that 74% of eyes achieved ≤0.3 logMAR and 14% had a visual acuity of >0.5 logMAR.…”

“…Long-term follow-up is essential if patients are to achieve good visual function because amblyopia treatment with refractive correction or strabismus treatment is often necessary even after treatment for retinopathy. 16 There is still much to learn about the long-term outcomes for ROP in infants weighing <500 g, and further information is needed to comprehend the treatment outcomes with anti-VEGF or laser in these infants.…”