Risk Factors for Poor Visual Outcome and Myopia in Retinopathy of Prematurity

Abstract

Objective: To identify risk factors for poor visual outcomes and myopia in stage 1-3 retinopathy of prematurity (ROP).Material and Methods: Data from 116 patients with ROP (209 eyes) at a tertiary hospital between January 2011 and December 2020 were analyzed. Participants were categorized into three groups: observed, laser, and combined laser with intravitreal bevacizumab. Final visual acuity (VA) and refractive error changes with age and risk factors for poor visual outcomes and myopia were analyzed.Results: The mean age at the last follow-up was 5.42±2.12 years. Median final refractive error (spherical equivalent) was 0.81 D (0.25, 1.38), 0.13 D (-2.0, 1.0), and -9.63 D (-13.25, -1.94), and median final logMAR VA was 0.18 (0, 1.3), 0.3 (0.1, 0.9), and 0.5 (0.18, 1.12), in the observed, laser, and combined groups, respectively. Individuals with severe ROP tended to develop high myopia at an early age. Multivariate analyses revealed treatment before postmenstrual age of 35 weeks, laser spots >600, and strabismus as risk factors for myopia <-3 D at age 3. The odds for myopia increased 2.37 times for every 100 laser spots. Risk factors for VA <20/40 were male sex, ROP requiring laser treatment, and strabismus.Conclusion: Early ROP treatment, increased laser spots, and strabismus increase the risk of developing myopia and impaired VA at a young age.