Risk of Refractive Pathology After Spontaneously Regressed ROP in Emmetropic Patients

Abstract

To evaluate the development of refractive error abnormalities after a normal first examination in children with spontaneously regressed retinopathy of prematurity (ROP). Two hundred twenty-six children with a history of spontaneously regressed ROP who had a cycloplegic refraction prior to 18 months of age were examined by a pediatric ophthalmologist. Children with a history of threshold ROP, strabismus, or a structural abnormality of the eye were excluded. A normal cycloplegic retinoscopy was defined as plano to less than +3.5 diopters of hypermetropia, less than +1.50 of symmetric astigmatism, and no anisometropia greater than 1.5 diopters in any meridian. Of the 226 children, 87 had a second examination and cycloplegic refraction at a mean of 2 years after the initial visit. In 63 of the children, the second examination and refraction remained normal. Three (3.4%) children had significant refractive error and were treated with spectacles: two had anisometropia and one had myopic astigmatism. Twenty-one had symmetric low magnitude myopia that did not warrant treatment. Children with spontaneously regressed ROP and no significant refractive error on cycloplegic retinoscopy at first follow-up examination have a risk of developing ametropia that is similar to that of the general population. Such children can likely be observed with a verbal vision screening in the pediatrician's office at 3 to 4 years of age.