Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 4)
Refractive errors in premature infants with retinopathy of prematurity after anti-vascular endothelial growth factor (anti-VEGF) therapy
Authors:
Milena S. Vujanović, Gordana Lj. Stanković-Babić, Ana Oros, Gordana D. Zlatanović, Predrag Jovanović, Sonja P. Cekić, Branislav Tomašević, Jasmina M. Djordjević-Jocić
Background/Aim. Retinopathy of prematurity (ROP) is avasoproliferative retinopathy which affects the blood vessels of the
retina during its development. The aim of this study was to evaluate
the incidence and the degree of refractive errors in premature
infants with severe ROP treated with anti-vascular endothelial
growth factor (anti-VEGF) (bevacizumab). Methods. This prospective
study included 21 patients (42 eyes) nine months old who
received intravitreal injection of anti-VEGF therapy. The control
group consisted of 45 patients (90 eyes) who were subjected to laser
treatment. In cycloplegia each patient underwent retinoscopy,
keratorefractometry, and A-scan ultrasonography. Results. Myopia
was present in 47.62% of the eyes in the study group and in
33.33% of the eyes in the control group, but there were no statistically
significant differences between these groups. Seven (16.67%)
eyes in the study group and 17 (18.89%) eyes in the control group
were discovered to have high myopia (SE–spherical equivalents <
-3.0 D – dioptre). Clinically significant hypermetropia was higher in
the study group (47.62%) than in the control group (34.44%), but
with no statistically significant difference. In addition, high hypermetropia
was significantly greater in the control group (15.56%)
than in the study group (11.90%) (p < 0.001). Astigmatism was
more common in the control group than in the study group
(81.11% vs 71.43%, respectively), especially high astigmatism (56%
vs 43%, respectively). Also the more common form of astigmatism
was with the rule (WTR) both in the study and the control group
(42.86% vs 55.56%, respectively). Anisometropia was significantly
greater in the control group (24.44%) than in the study group
(9.52%) (p < 0.05). The children from the study group had significantly
greater lens thickness, and a shorter anterior chamber depth
than children from the control group (p < 0.01). There was no significant
difference in the axial length of the eye between the
groups. Conclusion. At the 9-month follow-up myopia was present
in the patients with severe ROP treated with anti-VEGF, but
high myopia was present to a lesser degree than in the laser treated
patients. This difference is possibly related to anterior segment development.
Research into the longer-term refractive outcomes is
necessary with observation of the biometric components, visual
acuity, and the visual field in order to monitor the real effects of
this therapy.
