Predictors and ocular outcomes of rescue treatment in preterm infants with treated retinopathy of prematurity-a retrospective study

Eye (Lond). 2021 Jul;35(7):1937-1945. doi: 10.1038/s41433-020-01186-2. Epub 2020 Sep 21.

Abstract

Aim: To determine predictors of rescue treatment among infants treated for retinopathy of prematurity and to evaluate their ocular outcomes at 18-24 months of corrected age.

Methods: This is a single centre retrospective study of infants who received treatment for type 1 ROP, using laser photocoagulation or anti VEGF agents. Multivariable logistic regression was used to generate a prediction model for rescue treatment of ROP. The primary outcome was an abnormal refractive outcome by 24 months of corrected age, among infants primarily treated with laser therapy.

Results: Two hundred and eight infants (including 416 eyes) who received single (n = 151) or rescue (multiple) treatments (n = 57) were included. Ninety three percent of the infants were primarily treated with laser photocoagulation. Lower gestational age, small for gestational age, early packed red blood cell transfusion (within 2 weeks of postnatal age), and presence of Zone 1 retinopathy predicted the need for rescue treatment in treated infants [area under the receiver operating characteristic curve: 0.81 (0.73-0.89)]. The incidence of abnormal refractive outcome, assessed in a total of 174 infants, was found to be significantly higher in the rescue treatment group (67% versus 21%, adjusted odds ratio: 7.56 (3.3-17.2), P < 0.001). Myopia, very high myopia and use of spectacles was significantly higher in the rescue treatment group (P < 0.001 for each).

Conclusions: Rescue treatment for ROP was associated with an increased incidence of refractive errors and requirement of spectacles by 2 years of age. Larger prospective multicentre studies are required to confirm the findings from our study.

MeSH terms

  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Intravitreal Injections
  • Laser Coagulation
  • Prospective Studies
  • Retinopathy of Prematurity* / drug therapy
  • Retinopathy of Prematurity* / therapy
  • Retrospective Studies