Abstract
ObjectiveTo investigate refractive error development in preterm children with severe retinopathy of prematurity (ROP) treated with anti-vascular endothelial growth factor (anti-VEGF) agents and laser photocoagulation.MethodsSelection criteria were comparative studies that compared the refractive errors in children, birthweights ≤1500 grams and gestational ages ≤30 weeks, and treatments for Type I ROP with intravitreal bevacizumab (IVB) versus laser photocoagulation. Studies were identified using PubMed, Google Scholar, and published reviews. Meta-analyses were performed on the post-treatment outcomes of spherical equivalent (SEQ), cylindrical power, and prevalence of high myopia. Longitudinal development of refractive error in IVB, or in laser-treated children, or in normal full-term children was visually summarized.ResultsTwo randomized controlled trials and 5 non-randomized studies, including a total of 272 eyes treated by IVB and 247 eyes treated by laser, were included in this study. Compared with laser-treated children, IVB-treated children have less myopic refractive error (P<0.001), lower prevalence of high myopia (P<0.05), and less astigmatism (P = 0.02).ConclusionsTreatment with IVB is associated with less myopia and astigmatism than laser treatment for infants with severe ROP. Given the complexity of ROP and the variability of dosing, our review supports close monitoring of refractive error outcomes in children treated with IVB.
Highlights
For three decades, children with severe retinopathy of prematurity (ROP) have been treated by laser photocoagulation
Two randomized controlled trials and 5 non-randomized studies, including a total of 272 eyes treated by intravitreal bevacizumab (IVB) and 247 eyes treated by laser, were included in this study
Treatment with IVB is associated with less myopia and astigmatism than laser treatment for infants with severe ROP
Summary
Children with severe retinopathy of prematurity (ROP) have been treated by laser photocoagulation. The Early Treatment of Retinopathy of Prematurity (ETROP) study found that, at 3 years of age, the prevalence of myopia in infants with severe ROP was 65–71% and the prevalence of high myopia ( -5.00D) was 51% [2]. It has been suggested that the mechanism for ROP-related myopia is different than that for common myopia which develops in school-age children[4]. We found that myopia associated with severe ROP develops earlier in life, often before 1.5 years of age [5]. Two anti-VEGF agents have been studied: intravitreal bevacizumab (IVB) and intravitreal ranibizumab (IVR). We evaluate refractive error development in IVB-treated infants
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