Rescue treatment for retinopathy of prematurity tied to poor refractive outcomes

Infants requiring rescue treatment for retinopathy of prematurity (ROP) seem to be at higher risk of refractive errors and see a greater need for glasses by 2 years of age, a recent study has found.

Researchers conducted a single-centre, retrospective analysis of 208 infants who had received treatment for ROP, using either antivascular endothelial growth factors or laser photocoagulation. The primary endpoint was abnormal refractive outcomes by 24 months of corrected age.

Fifty-seven participants needed rescue treatments, while most (n=151) required only one such intervention. Refractive data at 18–24 months of corrected age were available for 189 infants, in whom refractive abnormalities manifested at a significantly greater rate in those who needed rescue treatments (67 percent vs 21 percent; adjusted odds ratio [OR], 7.56, 95 percent confidence interval [CI], 3.3–17.2; p<0.001).

Other ocular outcomes were also significantly worse in the rescue group, who showed heightened rates of myopia (49 percent vs 11 percent; adjusted OR, 7.86, 95 percent CI, 3.54–17.5; p<0.001) and very high myopia (20 percent vs 1.5 percent; adjusted OR, 15.9, 95 percent CI, 3.6–40.44; p<0.001).

Similarly, rescue therapy correlated significantly with the need for spectacles at follow-up (47 percent vs 7.7 percent; adjusted OR, 10.4, 95 percent CI, 4.4–24.6; p<0.001).

“[O]ur study highlights the burden of refractive abnormalities in infants exposed to rescue treatments for ROP. There is a need for additional prospective studies of long-term visual outcomes of rescue treatment in large and diverse neonatal cohorts,” the researchers said.