Ocular Hypertension in Adults with a History of Prematurity

Purpose To determine the ocular hypertension (OHT) incidence in patients with a history of prematurity and the effect of intervention for acute retinopathy of prematurity (ROP) in infancy on OHT incidence. Design Retrospective case series at a single tertiary referral vitreoretinal practice. Participants A total of 407 eyes of 213 patients were included, with ROP stage 0 to 5. Methods A retrospective chart review was conducted of patients aged ≥15 years, seen from 1973 to 2013, with a history of premature birth (gestational age Main Outcome Measures Development of OHT, defined as eyes requiring a glaucoma medication for more than 6 consecutive months or surgical intervention for elevated intraocular pressure. Results Of included eyes, 155 (38.1%) developed OHT within 69 years of follow-up. Subgroup analyses revealed an OHT incidence of 23.2% (36/155 eyes) in eyes without a history of any treatment for acute ROP (spontaneously regressed), 23.3% (10/43 eyes) in eyes that underwent ablative therapy alone, and 58.5% (76/130 eyes) in eyes requiring acute incisional retinal surgery ( P P P Conclusions Patients with a history of extreme prematurity are at an increased risk of OHT and glaucoma, even if they did not receive acute ROP treatment. More severe acute ROP is associated with higher incidence of OHT, and this is associated with an increased incidence of incisional surgical intervention. Awareness of the increased lifelong risk of adverse ocular sequelae in patients with a history of prematurity will help guide appropriate monitoring.