Useful vision maintained long term after lens-sparing vitrectomy for ROP

Aug 31 2012

By Sarah Guy, medwireNews Reporter

Infants treated with lens-sparing vitrectomy (LSV) for retinopathy of prematurity (ROP) maintain a level of visual acuity necessary for useful vision into their eighth year of life, study results show.

Previous studies investigating the outcomes of this procedure have had limited follow-up times, remark the researchers, whose current findings emerge from a study involving 30 children with late-stage (stages 4A, 4B, and 5) ROP, aged a mean of 7.1 years at last follow up.

Petros Euthymiou (Baylor College of Medicine, Houston, Texas, USA) and colleagues found that almost two-thirds of the study cohort had a measurable visual acuity after treatment, but that approximately one-fifth of eyes had no vision or light perception alone.

Their results also show no significant difference in visual outcomes for patients who underwent scleral buckling ‑ to further relieve tractional forces ‑ versus those who did not, despite documented concerns that this additional procedure is ineffective and may result in anisometropic amblyopia, or unequal vision.

"Our results are useful when discussing the potential benefits of surgery, and in setting realistic parent expectations following LSV for ROP," write the researchers in the British Journal of Ophthalmology.

The cohort had a mean gestational age of 25.6 weeks at birth, and was aged a mean 14 weeks at surgery. A total of 21 among the 23 eyes with Stage 4A ROP were successfully attached during LSV.

Of the 16 eyes with measurable visual acuity after treatment, 12 had 20/400 vision (using electronic Early Treatment Diabetic Retinopathy Study charts) or better, with a mean logarithm of the minimum angle of resolution (logMAR) score of 0.92 ‑ where 0.00 is normal vision ‑ at last eye examination.

Three eyes were unable to be measured due to neurologic problems, and the remaining four eyes had light perception or no light perception.

Among the nine eyes with stage 4B ROP, four had measurable visual acuities (mean logMAR=1.63), three of which were 20/800 or better. Three further eyes could not be measured due to neurologic problems, and two eyes had light perception or no light perception.

Just one eye among the five Stage 5 ROP patients was operated on and had measurable visual acuity posttreatment, with logMAR 1.17.

LogMAR scores for eyes that underwent LSV with scleral buckling and LSV without were nonsignificantly different, at 1.05 and 0.88, note Euthymiou et al.

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