Abstract
Purpose :
Children with severe retinopathy of prematurity (ROP) commonly develop myopia or high myopia. One proposed benefit of intravitreal bevacizumab (IVB) over laser is decreased myopia; however, many IVB eyes are later treated with laser. We sought to compare prevalence of myopia and high myopia after primary IVB followed by laser photocoagulation (VEGF/LASER) to primary laser (LASER).
Methods :
Retrospective cohort of infants who had VEGF/LASER or LASER for Type 1 ROP and cycloplegic refraction at age 6-30 months. Primary outcomes were prevalence of myopic (minimum -1D) and highly myopic (minimum -5D) spherical equivalent refractive error by eye.
Results :
28 eyes (15 infants) had VEGF/LASER at mean PMA weeks 33.8/45.2), 297 eyes (151 infants) had LASER at PMA 37.7; Refractions were at mean 19 months post-treatment. Two groups were similar in myopia (46.4% VEGF/LASER, 43.8% LASER,p=0.23) and high myopia (14.3% VEGF/LASER, 16.2% LASER eyes,p=0.29). Subgroup analysis for zone I at first treatment also showed no difference (myopia 64.3% VEGF/LASER, 67.9% LASER, p=0.73); high myopia (14.3% VEGF/LASER, 37.5% LASER, p=0.22). Among all eyes, total laser spots was associated with myopia (aOR 1.07 per100 spots increase, 95% CI 1.03-1.12) and high myopia (aOR 1.06, 95% CI 1.01-1.12), but spots did not differ among treatment groups (mean 2044 VEGF/LASER, 1857 LASER, p=0.60).
Conclusions :
The prevalence of myopia and high myopia did not differ between VEGF/LASER and LASER. Though more laser spots are associated with higher risk of myopia, spot counts were not lower when laser followed primary IVB.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.