Comparative outcomes for treatment of type 1 retinopathy of prematurity in a contemporary cohort.

Abstract

Background: The current mainstays of treatment for type 1 retinopathy of prematurity (ROP) are laser therapy and anti-VEGF intravitreal injections (IVI) or a combination of the two. Data comparing treatment outcomes between these modalities are heterogenous and limited by short-term follow-up. There is limited data on visual acuity after treatment. The purpose of this study was to investigate visual acuity, structural outcomes, and refractive error (RE) between primary laser and primary IVI in a contemporary cohort treated for ROP.

Methods: The medical records of patients treated for type 1 ROP at a tertiary care center from 2006 to 2022 were reviewed retrospectively. Demographics, treatment, visual acuity, adverse outcomes, and RE were analyzed between primary IVI and primary laser treatment groups. Adverse outcomes that were analyzed were strabismus, macular dragging, optic atrophy, retinal detachment, and amblyopia.

Results: A total of 179 patients (358 eyes) received treatment for type 1 ROP. Most patients received primary laser therapy (83.5%). We were able to collect formal visual acuity testing on 92 eyes. Most had vision of 20/40 or better (60%), and all patients had vision better than 20/200 in at least one eye. There was no difference in adverse ocular outcomes or RE between the primary laser and primary IVI groups.

Conclusions: In contrast to prior studies, there were no differences in adverse ocular outcomes between primary IVI and primary laser for ROP. Our study demonstrates high effectiveness of both anti-VEGF and ROP laser, with low rates of retinal detachment and blindness.