The state of refraction in prematurely born children with retinopathy depending on treatment methods used (diode laser and anti-VEGF) and selected demographic characteristics – observations

Introduction:
The authors present the prevalence of refractive errors in premature infants, demonstrating the relationship between refractive development and selected demographic characteristics and the forms of treatment used: diode laser, anti-vascular endothelial growth factor (anti-VEGF) and combination therapy.

Material and methods:
The study included 56 healthy children without retinopathy of prematurity (ROP) and 63 children with ROP. Ophthalmologic evaluation and diagnosis were performed according to the International Classification of Retinopathy of Prematurity assessed in Ret-Cam 3. Treatment of ROP was carried out according to the guidelines of the Polish Ophthalmological Society using a diode laser (IRIDEX IQ 810) and an anti-VEGF intravitreal preparation (ranibizumab, Lucentis) at a reduced dose of 0.18 mg. Refractive measurements were taken at 7 months of age using a handheld computerized autorefractometer (Retinomax) after 1% tropicamide cycloplegia.

Results:
A statistically significantly higher prevalence of high myopia (p = 0.019) and low astigmatism (p < 0.001) was observed in the eyes of premature infants with ROP and moderate hyperopia in the group without ROP (p = 0.031) regardless of the treatment used [mean +1.33 spherical diopters (Dsfr.); SD ±3.09 for eyes with ROP vs. mean +2.42 Dsfr.; SD ±2.11 for eyes without ROP]. Birth weight (p = 0.01) and gestational age (p = 0.048) correlated with changes in spherical refraction in children with ROP. There were statistically significant differences in high myopia (p = 0.041), low myopia (p = 0.010) and low hyperopia (p = 0.014) in the group of premature infants treated for ROP depending on the form of therapy.

Conclusions:
There were statistically significant differences in high myopia (p = 0.041), low myopia (p = 0.010) and low hyperopia (p = 0.014) in the groups of premature infants with ROP and high myopia (p = 0.019) and low astigmatism (p < 0.001) in the groups treated with monotherapy or combined therapy. Birth weight (p = 0.01) and gestational age (p = 0.048) had a significant effect on refractive development in eyes with ROP.