Refractive error outcomes after intravitreal ranibizumab for retinopathy of prematurity

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Background:To evaluate the refractive outcomes in children treated with intravitreal injection of ranibizumab (IVR) for retinopathy of prematurity (ROP).Methods:A retrospective study of 95 patients (186 eyes) was conducted. All patients received IVR treatment. The cycloplegic refraction was evaluated at three months, six months, 12 months and 24 months.Result:The average spherical equivalent (SE) refraction value for patients with ROP who were treated with IVR as a monotherapy at the three, six, 12 and 24 months was +1.84 ± 2.11 D, +1.02 ± 2.41 D, +0.43 ± 2.23 D and +0.13 ± 2.73 D, respectively (p < 0.001). Myopia (SE < −0.25 D) was observed in 24 eyes (15.9 per cent) at the three-month follow-up, 33 eyes (21.8 per cent) at the six-month follow-up, 33 eyes (26.5 per cent) at the 12-month follow-up and 34 eyes (37.5 per cent) at the 24-month follow-up, respectively (p < 0.05). The percentage of eyes with high myopia (SE < −5.0 D) was 0.6 per cent, 1.4 per cent, 1.7 per cent and 3.4 per cent at the three-month, six-month, 12-month and 24-month follow-up visits in the IVR group. There were 59 eyes that received repeated IVR injections at the follow-ups. The average SE of patients receiving repeated injections at the three-, six-, 12- and 24-month visits was +1.53 ± 2.03 D, +1.25 ± 1.95 D, +0.58 ± 2.24 D and −0.17 ± 3.22 D, respectively (p = 0.04).Conclusion:Our large sample study found that 37.5 per cent and 3.4 per cent of patients treated with IVR developed myopia and high myopia respectively, at the 24-month follow-up. Furthermore, the mean SE decreased, and the trend of myopia increased, in the IVR group at the follow-ups. Repeated injections might promote myopia in ROP patients. The refractive status needs to be monitored in patients treated with ranibizumab.

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