Retinopathy of prematurity in the United Kingdom: retreatment rates, visual and structural 1-year outcomes

Adams, Gillian; Bunce, Catey; Xing, Wen; Butler, Lucilla; Long, Vernon; Reddy, Aravind; Dahlmann‐Noor, Annegret

doi:10.1038/s41433-018-0151-y

Cited by 16 publications

(11 citation statements)

References 27 publications

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“…A Swedish ROP register (SWEDROP) with a coverage of 97% (Holmstr€ om et al, 2019), however, reveals a high recurrence rate (26%) in infants treated with laser only during the years 2008-2012(Holmstr€ om et al, 2016, remaining the same also during the years 2013-2017(Holmstr€ om et al, 2019. The Swedish retreatment frequency is high as compared to the ETROP Study (13.9%) and a recent British Study (11%) (Adams et al, 2018). Furthermore, the SWEDROP study investigated the experience of the lasertreating surgeon (Holmstr€ om et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Inadequate laser coagulation is an important cause of treatment failure in Type 1 retinopathy of prematurity

Spandau

Larsson

Holmström

2020

Acta Ophthalmologica

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Purpose of the study To examine the cause of treatment failures in Type 1 retinopathy of prematurity (ROP). Patients and Methods The medical charts of all infants with disease persistence after laser treatment at Uppsala University Hospital, Sweden, during a 10‐year period (2009–2019) were reviewed. RetCam photography and angiography were used to document the retinal appearance before and after retreatment. Results Ten infants (18 eyes), of whom nine were referred from other hospitals, had persistence of Type 1 ROP in zone I or zone II despite previous laser treatment. Their mean gestational age was 24 weeks and their mean birth weight was 618 g. Seven eyes were diagnosed as stage 3 plus, eight eyes as stage 4A and three eyes as stage 4B. In eight infants (14 eyes), inadequate laser coagulation was suspected to be the cause for persistence of type 1 disease. Two infants (four eyes) were appreciated to have persistence of plus disease because of presence of zone I disease. For persistence of Type 1 ROP, five infants (seven eyes) were treated with vitrectomy, two infants (three eyes) with laser photocoagulation and anti‐vascular endothelial growth factor (VEGF), two infants (four eyes) with anti‐VEGF alone and finally two infants (four eyes) with laser photocoagulation alone. The anatomical outcome was good in 14 eyes and poor in four eyes (three infants). Conclusions Inadequate laser coagulation is an important cause of treatment failure of ROP Type 1. Another cause is laser coagulation in zone I. To minimize remaining visual disability, some kind of centralization of the ROP treatment is suggested.

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Section: Discussionmentioning

confidence: 99%

Inadequate laser coagulation is an important cause of treatment failure in Type 1 retinopathy of prematurity

Spandau

Larsson

Holmström

2020

Acta Ophthalmologica

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“…Lower recurrence rates have been reported in cohorts comprising infants born with a wider range of GA. 22 It is well known that recurrence is more common after anti-VEGF injections than after laser treatment. [23][24][25] In the Rainbow trial, which formed the basis for approving the anti-VEGF drug ranibizumab for ROP, treatment recurrence rates were 18.9% after laser treatment and 31.1% after ranibizumab treatment. 11 The high recurrence rate after anti-VEGF in our study may be partly due to the high percentage (5.5%) of infants with APROP, the most aggressive form of ROP with high risk for recurrence after treatment.…”

Section: Centre and Treatment Modalitymentioning

confidence: 99%

High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born <24 gestational weeks

et al. 2021

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ObjectivePrematurity is a major risk factor for retinopathy of prematurity (ROP). We aimed to elucidate ROP prevalence, treatment and retreatment in infants born before 24 gestational age (GA) weeks in a Swedish cohort.Methods and analysisInfants with completed ROP screening, born at <24 GA weeks, 2007–2018 in Sweden were included. Data of GA, birth weight (BW), sex, neonatal morbidities, maximal ROP stage, aggressive posterior ROP (APROP), ROP treatments, treatment modality and treatment centre were retrieved.ResultsIn total, 399 infants, with a mean GA of 23.2 weeks (range 21.9–23.9) and a mean BW of 567 g (range 340–874), were included. ROP was detected in 365 (91.5%) infants, 173 (43.4%) were treated for ROP and 68 of 173 (39.3%) were treated more than once. As the first treatment, 142 (82.0%) received laser and 29 (16.1%) received intravitreal injection of antivascular endothelial growth factor (anti-VEGF). Retreatment was performed after first laser in 46 of 142 (32.4%) and in 20 of 29 (69.0%) after first anti-VEGF treatment. Retreatment rate was not associated with GA, BW or sex but with APROP, treatment method (anti-VEGF) and treatment centre where the laser was performed (p<0.001). Twenty eyes progressed to retinal detachment, and two infants developed unilateral endophthalmitis after anti-VEGF treatment.ConclusionInfants, born at <24 weeks’ GA, had high rates of treatment-warranting ROP and retreatments. Treatment centre highly influenced the retreatment rate after laser indicating that laser treatment could be improved in some settings.

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“…Based on the reported refractive outcomes, we divided the studies into four categories: 1) those that revealed a lower rate of refractive error in the anti-VEGF treated eyes [20][21][22]; 2) those that revealed no significant difference in refractive outcomes between the two treatment modalities [9,16,23]; 3) those that revealed a higher rate of refractive error in the anti-VEGF treated eyes [24] or compared refractive outcomes between two anti-VEGF agents [25][26][27]; and 4) those that reported refractive outcome of sequential treatment with laser after initial anti-VEGF treatment [28,29]. Table 1 summarizes the refractive outcomes reported in the 33 primary studies.…”

Section: Resultsmentioning

confidence: 99%

“…The third category consisted of seven papers, including 481 eyes of 337 premature infants, comparing refraction outcomes of anti-VEGF and laser treatments [24], bevacizumab and ranibizumab [25][26][27]31], or reported refraction outcomes of bevacizumab monotherapy [32,33] (Table 1). Despite low levels of myopia in the anti-VEGF-treated eyes, refractive outcomes differed with the anti-VEGF agent, with the eyes treated with bevacizumab being significantly more myopic [25,26].…”

Section: Resultsmentioning

confidence: 99%

Refractive outcomes in infants treated for retinopathy of prematurity

Heidary¹,

Gharebaghi²

2022

Med Hypothesis Discov Innov Optom

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Background: Infants treated for retinopathy of prematurity (ROP) can develop visually significant refractive error. However, the degree of refractive error may differ between laser treatment and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection. We reviewed studies that investigated refractive error outcomes of treatment in premature infants with ROP. Methods: In this narrative review, a literature search was carried out in PubMed/MEDLINE from 01/01/2000 to 20/10/2022 without language restrictions, using the following keywords: “anti-VEGF,” “ROP” or “prematurity retinopathy,” and “laser.” We included comparative studies on refractive error outcomes of intravitreal anti-VEGF and laser treatments, a combination of both modalities simultaneously or sequentially, and two anti-VEGF agents. Results: The initial search yielded 164 records. We reviewed the titles and abstracts of the retrieved papers and the reference list of published systematic reviews and meta-analyses, meta-analyses, or reviews on our topic. Thirty-three records fulfilled our inclusion criteria, which included refractive outcomes in 4350 eyes of 2359 participants treated for ROP. Based on the reported refractive outcomes, we divided the studies into four categories: 1) those that revealed a higher rate of refractive error in the laser-treated eyes than in the anti-VEGF-treated eyes; 2) those that revealed no significant difference in refractive outcomes between the two treatment modalities; 3) those that revealed a higher rate of refractive error in the anti-VEGF-treated eyes or compared refractive outcomes between two anti-VEGF agents; and 4) those that reported refractive outcomes in the eyes that received combined simultaneous or sequential treatment with laser after initial anti-VEGF treatment. We also summarized the refractive outcomes of all included primary studies in each category. Conclusions: This study showed that the laser-treated eyes experienced more myopic shift. However, the refractive outcomes in premature infants of laser treatment, anti-VEGF treatment, and a combination of both modalities simultaneously or sequentially were often contradictory. This variability resulted from obvious differences in the sample size, different follow-up durations, or inhomogeneous study or treatment designs. Further well-designed prospective trials on refractive outcomes and the trend of changes in the refractive status over long-term follow-ups in the eyes treated with ROP are necessary to identify consensus results concerning real-world refractive outcomes of each treatment modality or simultaneous or sequential combination of both modalities, to suggest a safe and effective treatment option for eye care professionals.

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Retinopathy of prematurity in the United Kingdom: retreatment rates, visual and structural 1-year outcomes

Cited by 16 publications

References 27 publications

Inadequate laser coagulation is an important cause of treatment failure in Type 1 retinopathy of prematurity

Inadequate laser coagulation is an important cause of treatment failure in Type 1 retinopathy of prematurity

High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born <24 gestational weeks

Refractive outcomes in infants treated for retinopathy of prematurity

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