Long-Term Assessment of Choroidal Thickness and Refractive Outcomes in Patients Treated for Retinopathy of Prematurity: A Case Control Study

Background and Objective The aim of this study was to compare choroidal thickness and refractive outcomes in retinopathy of prematurity (ROP) patients treated with either intravitreal bevacizumab (IB), laser, or a combination of anti-vascular endothelial growth factor (anti-VEGF) therapy and laser with each other as well as to preterm and full-term controls. Patients and Methods Data was collected from preterm infants in three treatment groups and two control groups. The patients in the treatment groups underwent ROP treatment with either IB injections, laser, or anti-VEGF and laser. The control groups consisted of preterm infants with no ROP and full-term infants. Spherical equivalent (SE) and choroidal thickness were collected. Results One hundred eyes from 51 patients were included. Twenty-one patients (41 eyes) received intravitreal bevacizumab, seven (14 eyes) received laser, four (seven eyes) received anti-VEGF treatment and laser, five (10 eyes) were born preterm without ROP development, and 14 (28 eyes) were born full-term without ROP. The average age at testing/imaging among all patients was 6.72 ± 2.71 years. No significant differences were noted between eyes receiving IB, laser, or a combination in terms of SE and choroidal thickness. After adjusting for age, birth weight (BW), gestational age (GA), and ROP characteristics (stage, zone, plus disease), there was increased myopia among patients who received anti-VEGF therapy and laser compared to those receiving IB alone ( P = 0.042). When controlling for age, myopia was significantly higher in the treatment group patients compared to patients in the control groups. Furthermore, choroidal thickness was significantly lower when adjusted for age, BW, or GA in treatment groups in comparison to control groups. Conclusions Pediatric patients who previously required treatment for ROP had lower choroidal thickness and a greater degree of myopia compared to those without ROP. No significant difference was seen in refractive or structural outcomes when comparing laser, anti-VEGF, and a combination therapy. [ Ophthalmic Surg Lasers Imaging Retina 2025;56:XX–XX.]