Abstract
Purpose :
Premature neonates are at risk for blindness caused by retinopathy of prematurity (ROP), which is characterized by abnormal growth of the retinal vasculature due to early hyperoxia exposure. Previous research has shown ROP severity in infants as a predictor of brain injury and worse neurodevelopmental outcomes, but have inconsistently controlled for variables which may affect risk of neurodevelopmental impairment. We hypothesized that ROP will not relate to neurodevelopmental outcomes after adjusting for gestational age (GA) and birthweight (BW).
Methods :
A retrospective chart review of infants screened for ROP at a level IV neonatal intensive care unit (UCLA, Los Angeles, CA) during 2011-2018 was performed. Infants born at >30 weeks GA or above >1500 grams birthweight were excluded from analysis, to homogenize the dataset according to current AAO/AAP ROP screening recommendations. Additional inclusion criteria included at least one cognition, language, and motor assessment at 12-23 months or at 24-36 months using the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at the UCLA High-Risk Infant Follow-up Clinic. ROP staging was categorized as no ROP, Type 1 (requiring treatment), and Type 2 (not requiring treatment). The relationship between ROP severity and neurodevelopmental outcomes were assessed via Kruskal-Wallis testing, controlling for GA and BW.
Results :
Of 398 infants screened for ROP, 203 infants met inclusion criteria and were categorized as no ROP=116, type 1=22, or type 2=65. Infants with Type 1 ROP had significantly lower GA and BW (p<0.0001 for both), being on average 2.5 weeks younger and 380 grams lighter at birth than infants with no ROP. In addition, infants with type 1 ROP had lower cognitive, motor, and language Bayley scores (p=0.0001, p=0.0001, and p=0.0012, respectively). However, after controlling for GA and BW, there were no longer neurodevelopmental differences between ROP groups at either time point (12-23 months or 24-36 months).
Conclusions :
Our study shows that ROP severity is not associated with worse neurodevelopmental outcomes, as assessed by Bayley scoring at 12-23 or 24-36 months after correcting for GA and BW, which are known predictors of poor neurodevelopmental outcomes in premature infants.
This is a 2020 ARVO Annual Meeting abstract.