Refractive Error in Patients with Retinopathy of Prematurity after Laser Photocoagulation or Bevacizumab Monotherapy

Abstract

Purpose: To evaluate the refractive development of premature infants with retinopathy of prematurity (ROP) after treatment with laser photocoagulation or intravitreal injection of bevacizumab (IVB). Methods: The medical records of patients with ROP treated between 2003 and 2012 who underwent yearly follow-ups were retrospectively reviewed. Patients with residual ROP abnormalities were excluded. The cycloplegic refraction at 3 years of age, assessed using an autorefractometer, was recorded. Results: In total, 54 eyes from 54 patients were enrolled. Patients were divided into 4 groups: group 1, including 14 eyes of 14 patients treated with laser therapy; group 2, 15 eyes of 15 patients treated with IVB; group 3, 13 eyes of 13 patients with non-type 1 ROP under conservative follow-up, and group 4, 12 eyes of 12 premature patients without ROP. The mean spherical equivalent at 3 years of age was -1.71 ± 1.27 dpt in group 1, -1.53 ± 2.20 dpt in group 2, 0.63 ± 1.37 dpt in group 3, and 0.41 ± 1.95 dpt in group 4. The mean refractive error differed significantly among the 4 groups (p < 0.001). Patients in groups 1 and 2 were more prone to myopia compared with those in groups 3 and 4. Furthermore, patients with type 1 ROP treated by laser photocoagulation (group 1) and those treated by IVB (group 2) had similar refraction (p = 1). Conclusions: The results of this study suggest that treatment-demanding ROP eyes are susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP. In addition, the myopic status between laser and IVB treatment did not differ statistically.

The inner retinal structures of the eyes of children with a history of retinopathy of prematurity

“…Previous studies reported that IVB was associated with less myopia than either laser photocoagulation or combined laser and bevacizumab treatment for type 1 ROP, 37,38 and treatment-requiring ROP eyes were susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP. 39 The intraretinal layer thicknesses in high myopic eyes varied significantly from emmetropic eyes. 40 In addition, laser treatment might alter the thickness of the inner layer of the retina, 41 and such changes should be considered in ROP patients after laser photocoagulation treatment.…”

Antivascular endothelial growth factor in the treatment of retinopathy of prematurity

“…Patients who received treatment for ROP were more prone to myopia, regardless of treatment modality. The results suggest that treatment-demanding ROP eyes are susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP [22].…”

Role of cytokines and treatment algorithms in retinopathy of prematurity

“…Some series report higher rates of myopia in eyes treated with laser than in those treated with IVB or ranibizumab(35). Other studies report that having type I ROP, compared to non-type 1 ROP or no ROP, was associated with myopia and that outcomes were similar following laser or IVB at 3 years of age(36), whereas still others report posterior disease, compared to peripheral disease, was associated with myopia(34). Lack of statistical significance may be from small sample sizes, and longer follow up is needed to assess refractive outcomes after laser vs. anti-VEGF agents..…”