Five-year visual outcome of treatment for retinopathy of prematurity in infants weighing less than 500 g at birth: A multicenter cohort study from J-CREST

Purpose: To investigate the 5-year treatment outcomes of retinopathy of prematurity (ROP) in infants <500 g birth weight and compare laser and anti-vascular endothelial growth factor (VEGF) therapies. Methods: A multicenter retrospective study comprised 24 eyes of 13 patients treated for type 1 ROP, followed for 5 years. Initial treatment was laser and anti-VEGF in 13 and 11 eyes, respectively. Data collected included sex, birth characteristics, ROP characteristics at the time of treatment, best-corrected visual acuity (BCVA), spherical equivalent (SE), and astigmatism at 5 years post-treatment. Results: Median BCVA was 0.15 logMAR (IQR, 0.0–0.5). Snellen BCVA was ≥20/40 in 73% and ≥20/20 in 27% of eyes. Median SE was -2.37 (IQR, -6.1–-0.1); 75% had myopia (≤ -0.5 D), and 25% had high myopia (≤ -6.0 D). Median astigmatism was 1.25 (IQR, 0.9–3.0); 46% had ≥1.5 D. Anti-VEGF treated eyes showed less myopia (p<0.009), with no BCVA or astigmatism difference (p=0.997, p=0.271) compared to laser-treated eyes. Conclusion: One-quarter of the eyes exhibited good visual acuity (Snellen BCVA of 20/20 or better) 5 years post-ROP treatment. Refractive errors were common. Anti-VEGF therapy may be superior to laser therapy in terms of myopic refractive error.