Laser versus Bevacizumab for Type-1 Retinopathy of Prematurity: long term effects of foveal dislocation on ocular alignment

Abstract

Purpose : To evaluate long term effects of foveal dislocation on ocular alignment in a single center randomized study aimed to compared traditional laser treatment for Type 1 retinopathy of prematurity (ROP) with intravitreal injection of bevacizumab in the fellow eye.

Methods : Twenty-one inborn babies with type 1 zone 1 ROP were included in the study. One eye was randomized to receive an intravitreal injection of 0.5mg bevacizumab; the fellow eye received conventional laser photoablation. Fundus color and fluorescein angiography Images from 32 eyes (16 infants) with type-1 ROP were obtained before 5 years after treatment. 5 babies were lost at follow up. Fovea was localized by three different readers using color image and FA and then its distance from the center of the optic disk measured in pixels. Complete ocular motility exam was performed. In case of strabismus angle of ocular deviation was measured in prismatic diopters by two different examiners. Cycloplegic refraction was also performed using automated refractometer.

Results : Eight babies showed 10 or more pixel of difference in the distance of the foveal to the optic disk between the two eyes: in all cases the foveal of the laser-treated eye was closer to the optic disk compared to the injected eye. Four babies showed a wide angle (up to 40 prismatic dioters) esotropia: all these babies were those ones that had the greater difference in the distance between fovea and optic disk. There was no significant difference in the refractive status of these babies eyes.

Conclusions : treatment seems to deeply affects macular development with a foveal dislocation toward the optic disk in the lasered eyes thus causing eyes misalignment. Further studies are need in order to understand how to manage this ocular misalignment.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.