Major Article
Myopia and anterior segment optical coherence tomography findings in laser-treated retinopathy of prematurity eyes

https://doi.org/10.1016/j.jaapos.2020.01.007Get rights and content

Purpose

To evaluate structural features and visual outcomes in eyes with a prior history of laser treatment for retinopathy of prematurity (ROP).

Methods

Laser-treated eyes for type 1 ROP, preterm monitored eyes, and full-term control eyes were included. LogMAR conversion of Snellen best-corrected visual acuity and spherical equivalent based on cycloplegic refraction were measured in children 5-15 years of age. Anterior segment optical coherence tomography (OCT) was used to study structural features, including anterior chamber angle (ACA) in a subset of eyes.

Results

A total of 50 eyes of 50 patients were included (19 full-term eyes, 19 laser-treated type 1 ROP eyes, 12 preterm monitored eyes). Of these, 44 eyes had visual outcomes data, and 15 eyes had anterior segment data. There was no significant difference in sex or age at final examination between the three groups. There was no significant difference in gestational age between the laser-treated and preterm monitored groups. Compared with the full-term control group and the preterm monitored group, the laser-treated ROP group had narrower ACA and more myopic refractive error. There was a significant correlation between ACA and spherical equivalent.

Conclusions

Laser treatment may affect angle configuration in ROP eyes. Anterior segment OCT is an easy and useful modality that could aid in screening for visually impairing conditions such as myopia and glaucoma in children with ROP.

Section snippets

Subjects and Methods

This study was approved by the University of California Los Angeles Institutional Review Board, followed the tenets of the Declaration of Helsinki, and was compliant with the US Health Insurance Portability and Accountability Act of 1996. Subjects were recruited at the Stein Eye Institute, University of California Los Angeles. Informed consent was obtained from the legal guardian prior to recruitment.

Three groups of children (<18 years of age) were recruited: (1) a control group of children

Results

A total of 50 eyes of 50 patients were included: 19 eyes of full-term control subjects, 19 eyes from preterm infants who were monitored only, and 12 eyes of preterm infants with type 1 ROP that received laser treatment (Table 1). Of the preterm monitored eyes, 1 was unknown due to unavailable birth records, 7 had no ROP, and 4 had type 2 ROP; of those with type 2 ROP, all were zone 2 without plus disease that eventually regressed—3 had stage 2 and 1 had stage 1 (Table 1). There were no

Discussion

Vision loss in preterm children can be multifactorial, due to macular dragging, refractive error, strabismus, amblyopia, optic atrophy, or developmental delay. High myopia early in life is common in preterm children and may be affected by either prematurity itself or ROP treatments.17 Cryotherapy and laser have been associated with nonaxial myopia as opposed to axial myopia seen in non-preterm children.18 Studies have also implicated increased corneal curvature, decreased ACD, abnormal

References (28)

  • J. Kim et al.

    Combined intravitreal bevacizumab injection and zone I sparing laser photocoagulation in patients with zone I retinopathy of prematurity

    Retina

    (2014)
  • H.A. Mintz-Hittner et al.

    Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity

    N Engl J Med

    (2011)
  • E. McLoone et al.

    Long term functional and structural outcomes of laser therapy for retinopathy of prematurity

    Br J Ophthalmol

    (2006)
  • A. Cook et al.

    Ocular growth and refractive error development in premature infants without retinopathy of prematurity

    Invest Ophthalmol Vis Sci

    (2003)
  • Cited by (0)

    This research was supported by an unrestricted grant from Research to Prevent Blindness (SLP).

    Disclosures: Dr. Sarraf is a consultant for Amgen, Bayer, Genentech, Optovue; Research: Amgen, Genentech, Heidelberg, Topcon, Optovue, Regeneron; and Speaker: Novartis, Optovue. The other authors have no disclosures.

    View full text