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  • Two-thirds of high-risk prethreshold ROP eyes are myopic at age six

    Pediatric Ophth/Strabismus

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    This study of the Early Treatment for Retinopathy of Prematurity (ETROP) cohort found that approximately two-thirds of eyes with high-risk prethreshold retinopathy of prematurity (ROP) during the neonatal period are likely to be myopic between ages three and six.

    However, the authors found that the increasing proportion of eyes with high myopia between ages six months and three years observed in both earlier-treated and conventionally managed eyes does not continue between ages three and six years. Additionally, earlier treatment of eyes with high-risk prethreshold ROP did not appear to influence refractive error development.

    The original ETROP cohort included 401 children born preterm with birth weights less than 1251 g who developed high-risk prethreshold ROP in one or both eyes. They underwent cycloplegic retinoscopy at six and nine months corrected age and yearly between two and six years postnatal age. Eyes were randomized to receive treatment when they reached high-risk prethreshold ROP or conventional management with treatment only if threshold ROP developed.

    The authors found that at ages 4, 5 and 6, there was no difference in the percentage of eyes with myopia (range, 64.8 to 69.9 percent) or high myopia (range, 35.3 to 39.4 percent) between earlier-treated and conventionally managed eyes.

    Similarly, previous reports on refractive error development from the ETROP study showed no treatment-related difference in the prevalence of myopia or high myopia during the first three years between earlier treated and conventionally managed eyes. However, the prevalence of myopia was high in previous ETROP reports, increasing from approximately 58 to 68 percent between six and nine months of age and changing little between nine months and three years of age.

    The current study did find, though, that conventionally managed eyes in which ROP progressed to require peripheral retinal ablation are more likely to develop myopia and high myopia than conventionally managed eyes in which ROP regressed.