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Sarah Kenny, Richard Jones, J. R. Gallagher, Clio Armitage Harper, III, Hamzah Khalaf; Refractive outcomes after anti-VEGF injections followed by laser photocoagulation for the residual avascular retina in ROP. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2163.
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When threshold disease is met, current treatments for the regression of ROP include laser retinal photocoagulation and anti-VEGF injections. The purpose of our study was to examine long term refractive outcomes of patients treated for ROP with either anti-VEGF injection alone, laser for avascular retina, or laser for threshold disease.
This is an IRB exempt retrospective study of subjects seen at University Hospital in San Antonio, Texas between June 2012 and May 2018. Subjects were diagnosed and treated for threshold ROP disease and had a follow-up appointment that included cycloplegic refraction or retinoscopy at one year of age or later. The subjects were divided into three treatment groups: injection without laser (IVI), laser for avascularity after injection (LA), and laser for threshold disease (LT). The mean gestational age at birth (GA), birth weight (BW), age at initial treatment, age at refraction, and spherical equivalent (SE) were calculated and compared using Mann-Whitney U Test after testing for normality.
Forty-eight eyes were included in this study. All eyes included in the study had Zone 2 threshold disease. There were 10 eyes in the IVI group (6 bevacizumab, 4 ranibizumab) and the LA group had 14 eyes (2 bevacizumab, 12 ranibizumab). The LT group had 24 eyes, 2 of which received anti-VEGF (ranibizumab) initially and laser upon reactivation. The IVI and LA groups had equivalent GA, BW, and ROP severity. Gestational age at first treatment was less in the LA group (Mean 35.4 vs 36.9, p=0.036). The SE was also equivalent between IVI and LA groups (Mean +1.35 vs +1.44, p=0.977). The LA and LT groups had equivalent age at first treatment, BW, and ROP severity. The LT group had higher GA at birth (Mean 26.4 vs 25.1, p=0.024), and the SE was significantly lower in LT group (Mean -1.19 vs +1.44, p=0.045). This demonstrates that eyes which received laser for threshold disease had a higher incidence of myopia compared to eyes which received laser for avascularity.
Laser for avascular retina after treatment with anti-VEGF did not induce a myopic shift at the time of refraction in our study group, and all the eyes were found to be plano or slightly hyperopic. However, laser for threshold disease induced significant myopia compared to laser for avascular retina.
This is a 2020 ARVO Annual Meeting abstract.
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