Peer-reviewed article
Nine-year ocular developmental outcomes after ranibizumab or laser treatment for zone II retinopathy of prematurity: follow-up of a randomized trial cohort.
Yaling Liu, Jiannan Tang, Xinyu Zhao, Laijiao Chen, Zhen Yu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed 29 children for 9 years after they were treated as infants for retinopathy of prematurity (a serious eye condition affecting premature babies) using either laser therapy or ranibizumab injections. At school age, both treatment groups had similar vision and eye shape, though some differences in eye structure and electrical activity were detected. The researchers concluded that the two treatments had broadly comparable long-term outcomes for vision and cannot recommend one over the other based on these results alone.
Key points
- Visual acuity outcomes were similar between laser and ranibizumab groups (0.15 vs 0.21 logMAR, p=0.51)
- Spherical equivalent (refractive error) did not differ significantly between groups (−1.22 vs −1.90 D, p=0.65)
- Ranibizumab group showed thinner lens thickness (3.52 vs 3.75 mm, p<0.001) and steeper keratometry (43.8 vs 42.6 D, p=0.048)
- Central retinal thickness was thinner in the ranibizumab group (249.2 vs 286.9 μm, p=0.005)
- Selected electroretinography abnormalities differed between groups, requiring cautious interpretation
Limitations
The study involved a small cohort with differential loss to follow-up, which limits confidence in the findings. The researchers emphasize these preliminary exploratory findings should be interpreted cautiously and do not provide sufficient evidence for clinical decision-making based on long-term outcomes alone.
Abstract
UNLABELLED: The purpose of this study is to describe 9-year ocular developmental outcomes in children previously randomized to intravitreal ranibizumab (IVR) or laser photocoagulation (LP) for zone II treatment-requiring retinopathy of prematurity (ROP). In this follow-up of a single-center randomized trial, infants with stage 2 or 3 ROP with plus disease in zone II were randomized in 2014 to bilateral LP (n = 25) or IVR (n = 25). At school age, 29 children (10 LP, 19 IVR) underwent assessment of best-corrected visual acuity, cycloplegic refraction, ocular biometry, anterior segment parameters, spectral-domain optical coherence tomography, optical coherence tomography angiography, and full-field electroretinography. Eye-level comparisons used generalized estimating equations. Mean spherical equivalent did not differ significantly between LP and IVR groups (- 1.22 vs. - 1.90 D; mean difference 0.68 D, 95% CI - 2.26 to 3.62; p = 0.65), nor did best-corrected visual acuity (0.15 vs. 0.21 logMAR; mean difference - 0.07, 95% CI - 0.27 to 0.13; p = 0.51). Compared with the LP group, the IVR group showed thinner lens thickness (3.52 vs. 3.75 mm, p < 0.001), steeper minimum keratometry (43.8 vs. 42.6 D, p = 0.048), and thinner central internal limiting membrane-retinal pigment epithelium thickness (249.2 vs. 286.9 μm, p = 0.005). Selected electroretinography abnormalities also differed between groups. CONCLUSION: In this small 9-year follow-up cohort with differential loss to follow-up, visual acuity and refractive outcomes were broadly similar after IVR and LP, while selected ocular structural and electrophysiological differences were observed. These preliminary exploratory findings should be interpreted cautiously and do not provide sufficient evidence to recommend one treatment approach over the other on the basis of long-term ocular outcomes alone. WHAT IS KNOWN: • Laser photocoagulation and intravitreal anti-vascular endothelial growth factor therapy are established treatments for severe retinopathy of prematurity. • Long-term ocular developmental and functional outcomes after anti-vascular endothelial growth factor treatment remain incompletely defined, particularly beyond early childhood. WHAT IS NEW: • This follow-up of a randomized trial cohort provides 9-year multimodal ocular outcome data in children treated with ranibizumab or laser for zone II retinopathy of prematurity. • Visual acuity and refractive outcomes were broadly similar between treatment groups, while selected anterior segment, retinal structural, and electroretinography differences were observed and should be interpreted as exploratory.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Intravitreal ranibizumab (IVR) injection versus laser photocoagulation (LP)
- Population
- Infants with stage 2 or 3 ROP with plus disease in zone II, randomized at birth; 29 children (10 LP, 19 IVR) followed to school age (~9 years)
Key finding
Best-corrected visual acuity did not differ significantly between groups (0.15 vs 0.21 logMAR, p=0.51)