Influence of Retinopathy of Prematurity and Laser Therapy on Intraocular Pressure in Preterm Infants.

Abstract

Prcis: Intraocular pressure (IOP) decreases as preterms mature and in moderate retinopathy of prematurity, IOP is initially low and transiently rises after laser treatment.

Purpose: This study aimed to measure intraocular pressure (IOP) in preterm infants with and without retinopathy of prematurity (ROP) and evaluate the effect of laser treatment on IOP.

Method: This prospective nonrandomized comparative study included infants born before 34 weeks of gestation weighing <2000 g at a tertiary care research and referral institute. Those with ocular or systemic conditions or requiring surgical intervention for ROP were excluded. Infants were divided into 3 groups: Group 1 (no ROP), Group 2 (ROP without treatment), and Group 3 (ROP requiring peripheral retinal ablation by laser photocoagulation). IOP was measured using a Perkins tonometer at presentation and at 1 and 3 months. The primary outcome was IOP in preterm infants with and without ROP; and the secondary outcome was change in IOP postlaser treatment.

Results: Of 107 infants, 40 (37.38%) had no ROP (Group 1), 25 (23.36%) had untreated ROP (Group 2), and 42 (39.25%) required laser treatment (Group 3). Average postmenstrual ages were 37.89±2.74 weeks 36.98±3.38, and 35.47±2.84 weeks, respectively. A moderate negative correlation between IOP and postmenstrual age was found in Group 1 ( r2 =-0.382; P =0.01) and Group 2 ( r2 = -0.6; P =0.001). Baseline IOP was significantly lower in Group 3 compared with the other groups, with a transient increase postlaser treatment that typically normalized without needing IOP treatment.

Conclusions: IOP decreases as preterm infants mature. Infants with ROP requiring laser treatment exhibit significantly low IOP at presentation, but have a postlaser spike, which generally normalises without treatment.