Ametropia in children with regressed retinopathy of prematurity

Purpose Main aims of this study were:(1)To identify the pattern of refractive changes in children with different degrees of pre-threshold retinopathy of prematurity (ROP). and (2)To establish whether long term follow-up is necessary for these children? Methods ROP screening notes of all premature babies born between Jan 2001 to Jan 2005(5 years) within a defined geographical area (Leicestershire) of the UK and fulfilling the national ROP screening guidelines were reviewed retrospectively. According to the severity, we graded the pre-threshold ROP as follows: (1)Grade1- Any disease restricted to zone 3 or Stage I or II in zone 2, (2)Grade2- Stage II+ or III disease in zone 2, and (3)Grade3 - Stage III+ disease in zone 2 Any zone 1 disease. Eyes of matched eyes were used as controls (same gestational age and weight matched children who were premature but without ROP). Cycloplegic refraction data (minimum follow up period- 24 months) on these children were then collected through the clinic notes. The results were compared statistically. Results Refractive status results (at 24 months age) were available for 116 eyes in 62 children (Electronic search + Case notes review). Eyes were assigned to our predefined grades: Grade1:60 eyes(32), Grade2:34 eyes(18), and Grade3:22 eyes(12). The results of cyclopegic refraction (Mean spherical equivalent, Range) were as follows: Grade1:0.59(-1.75 to +3), Grade 2: -0.04(-4.5 to +2.25), and Grade 3: -1.59 (-7.5 to +1.75). Statistically, refractive outcome of Grade 2 and 3 ROP children were different from controls. Conclusion In pre-threshold ROP, the trend of myopia is directly proportional to the severity of ROP. We recommend that regular follow up is necessary for Grade 2 and 3 ROP babies but no follow up required for babies with Grade 1 disease.