Laser Treatment May Not Increase Myopia Risk in Retinopathy of Prematurity

Using laser treatments for infants with retinopathy of prematurity may not increase the risk of myopia.

Eyes of infants treated with laser for type 1 retinopathy of prematurity (ROP) do not experience a significant myopic change compared with fellow untreated eyes, according to a study published in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

Researchers included 17 infants (median treatment age, 40 weeks postmenstrual) who underwent laser treatment for type 1 ROP in zone 2 and experienced spontaneous regression in the contralateral eye in the analysis. Refractive parameters were compared between the treated and untreated eyes during follow-up visits conducted at a mean [SD] of 14.1 [5.4] and 25.0 [9.1] months. 

[O]ur results indicate that laser treatment for zone II ROP may not always result in increased myopia risk.

At the first-year examination, patients had a mean spherical equivalent of 2.1 diopters (D) in treated eyes and 2.6 D in untreated eyes (P =.310). At the final follow-up, similar spherical errors, astigmatic errors, and spherical equivalents were observed between treated and untreated eyes. Among the cohort, 2 patients had spherical and spherical equivalent (SE) anisometropia of 3 D or greater, 8 had 1 D or greater spherical anisometropia, 2 had 1 D or greater cylindrical anisometropia, and 5 patients had 1 D or greater SE anisometropia. 

“[O]ur results indicate that laser treatment for zone II ROP may not always result in increased myopia risk,” according to the researchers. “Our conclusions are limited to the types of patients who received unilateral laser treatment in our cohort, that is, older infants on the mildest end of the ROP spectrum.”

Study limitations include a small sample size and potential geographic bias.

References:

Bayramoglu SE, Sayin N, Ekinci DY. Refractive outcomes following unilateral laser treatment for type 1 retinopathy of prematurity. J AAPOS. Published online September 12, 2022. doi:10.1016/j.jaapos.2022.07.001