Laser treatment for severe ROP may lead to severe myopia

In the treatment of patients with severe retinopathy of prematurity (ROP), laser appears to increase the trend to severe myopia, according to a study. Meanwhile, intravitreal bevacizumab (IVB) does not affect myopic progression and reduces the need to consequently undergo laser treatment.

The study compared thee longitudinal cycloplegic refraction data of premature infants with ROP treated with IVB within 2011–2020 to that of ROP infants treated with laser during the same timeframe. Researchers also examined a subset of infants treated with IVB and subsequent laser. The analysis included cycloplegic refractions from 789 cumulative visits over a median of 3.2 years.

In a linear mixed-effects model with a log decay function, a significant trend in refraction emerged—from slight hyperopia to relatively more myopic states (p<0.001). However, progression occurred more rapidly in laser-treated eyes (p<0.001), regardless of previous treatment with IVB.

Of note, the number of laser spots resulted in increased myopic progression by ∼0.16 dioptre per 100 laser spots.

Both ROP stage and zone exerted a significant effect on myopic progression, with more severe disease leading to faster myopic progression. The effect of laser persisted despite accounting for differences in ROP stage and zone.

Random effects, including individual subject variation with nested variance for left and right eyes, accounted for 86.4 percent of the remaining variance not explained by age and treatment.