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Infants with acute ROP remain at risk of vision-threatening outcomes in later life

Article

Investigators stress the need for timely surgical intervention to ensure favorable visual outcomes in patients with severe complications, including retinal detachment and vitreous hemorrhage.

A new investigation into late vitreoretinal complications suggest infants with acute retinopathy of prematurity (ROP) remain at high risk of vision-threatening complications throughout childhood and adulthood.

As a result, the investigative team led by Wei-Chi Wu, MD, PhD, Chang Gung Memorial Hospital in Taiwan, suggests the continual follow-up of patients with ROP remains important to detect risk and ultimately, better patient outcomes.

“When severe complications, such as retinal detachment or vitreous hemorrhage, timely surgical intervention is necessary to ensure favorable visual outcomes in these patients,” wrote Wu and colleagues.

Wei-Chi Wu, MD, PhD

Wei-Chi Wu, MD, PhD

They set out to investigate late vitreoretinal complications and visual outcomes in patients with regressed ROP with or without prior treatment. The study was part of an international, multicenter, noncomparative retrospective case series. In the study, a total of 238 patients from 13 centers worldwide who developed complications (retinal detachment, vitreous hemorrhage, or retinal break) ≥2 years after the resolution of acute ROP were analyzed by investigators.

According to a patient’s primary diagnosis, each participant was assigned to 1 of 3 groups, either retinal detachment, vitreous hemorrhage, or retinal break. Investigators documented and compared the average age at presentation, visual acuities, refractive error, axial length, gestational age, birth weight, acute ROP classification, prior treatments for acute ROP, postoperative visual acuity (VA), and concomitant eye conditions in the 3 groups.

The main outcome measures were clinical features and visual outcomes of late vitreoretinal complications in patients with regressed ROP. A total of 264 eyes of 238 patients were included in the study.

In the analysis, the prior acute ROP status was comparable among the 3 groups. However, the vitreous hemorrhage group had a higher proportion of patients with type 1 ROP (P = .03) and prior treatment (P <.001) than the other groups. Data showed the average age at presentation was earlier in the retinal detachment (20.3 ± 15.5 years) and vitreous hemorrhage (21.4 ± 18.9 years) groups than in the retinal break group (31.9 ± 18.2 years; P < 0.001).

The investigative team noted the retinal break group had the best presenting best-corrected visual acuity, followed by the retinal detachment and vitreous hemorrhage groups (P <.001). Moreover, the surgical intervention improved visual acuity in both the retinal detachment and vitreous hemorrhage groups (both P <.05).

Results suggest the overall trend of visual acuity was the most favorable in the retinal break group, followed by that in the vitreous hemorrhage and retinal detachment groups. The findings further showed cicatricial changes in the fellow retina were observed in >90% of patients with unilateral involvement.

This article was published by our sister publication HCP Live.

Reference

Hsu HT, Yu-Chuan Kang E, Blair MP, et. al Late vitreoretinal complications of regressed retinopathy of prematurity: Retinal Break, vitreous hemorrhage, and Retinal Detachment. Ophthalmology Retina. 2022;7(1):72-80. doi:10.1016/j.oret.2022.07.005

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