Open AccessLongitudinal Development of Refractive Error in Children Treated With Intravitreal Bevacizumab or Laser for Retinopathy of Prematurity
Author(s) -
Michael Simmons,
Jingyun Wang,
Joel N. Leffler,
Shanshan Li,
Sarah E. Morale,
Angie De La Cruz,
Eileen E. Birch
Publication year - 2021
Publication title -
translational vision science and technology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.508
H-Index - 21
ISSN - 2164-2591
DOI - 10.1167/tvst.10.4.14
Subject(s) - retinopathy of prematurity , medicine , anisometropia , ophthalmology , refractive error , astigmatism , gestational age , visual acuity , birth weight , laser coagulation , bevacizumab , surgery , pregnancy , genetics , physics , chemotherapy , optics , biology
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.