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Kathryn Margaret Haider, Eileen Birch, Jingyun Wang; Refractive Error and Visual Acuity in infants with ROP treated with Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5916.
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Children with severe ROP treated with peripheral laser ablation exhibit a dramatic myopic shift during the first 1.3 years, with little additional myopic progression thereafter. Intravitreal bevacizumab (IVB), which treats retinopathy by reducing neovascularization, has been reported to result in less severe myopia than laser treatment. However, little is known about the developmental time course of refractive error in individuals treated with IVB. The aim of this prospective study is to investigate refractive error development and visual acuity in infants treated with bevacizumab during the first three years.
Seventeen preterm children treated with IVB (n=17; gestational age (GA)=24.2±1.3 wk) were enrolled. Inclusion criteria were birth ≤32 weeks post-conception, initial cycloplegic refraction completed at age ≤1.2 years, and at least 2 cycloplegic refractions by age 3 years. All infants were treated with a single injection. These children had either severe zone 1 or posterior zone 2 ROP, the posterior pole could not be well visualized, or they were not tolerant of laser-therapy. Longitudinal (0-3 years) cycloplegic refraction data (sphere, cylinder and axis) were measured. Visual acuity was measured with Teller cards and reported in logMAR. Analyses were based on spherical equivalent (SEQ, sphere + 0.5 * cylinder), and age (corrected for gestation). Data were divided into two groups: younger (Age≤1 YR, mean age 0.43±0.20 YR) and older (Ag>1 YR, 2.1±0.80 YR).
There was no significant difference between the two age groups (-0.92±2.93 D and -1.15±2.43 D, respectively; P=0.9). Compared with full-term normal children (Mayer et al 2001), both groups had significantly more myopia. Ten children had longitudinal refraction (≥2 measurements). The individual development pattern varied; 4 (40%) had more than a 2.50D increase in myopia compared with the initial refraction. Visual acuity was measured in 12 children; mean visual acuity was 0.95±0.22 logMAR, significantly lower than the full term children (Salomao & Ventura, 1995).
On average, refractive error in children following IVB treatment was myopic. However, individuals had various development patterns in early life. Visual acuity is lower than full-term normal children. With the increasing use of IVB treatment for severe ROP, further study with a larger sample size is required to understand its effect on refractive development.
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