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Better visual outcomes seen from earlier ROP treatment
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Premature infants at high risk of vision loss from retinopathy of prematurity retain better vision when therapy is administered early than when treatment is held until the traditional threshold, a large clinical study has found. The study, sponsored by the National Eye Institute, used an improved risk assessment model to identify infants at risk for developing vision loss from ROP.
“The results of this study allow us to improve treatment for ROP, and, hopefully, the quality of life for children who most need sight-saving therapy,” said Paul Sieving, MD, PhD, director of the NEI, in a press release describing the findings of the Early Treatment of Retinopathy of Prematurity (ETROP) study.
Previous treatment standards advised delaying treatment of ROP until the likelihood of retinal detachment was around 50%. The ETROP study used a computerized risk model to identify high-risk infants early in the disease. The model assesses factors including birth weight, ethnicity, whether the patient is a single or multiple-birth baby, gestational age, ophthalmic exam findings and whether the infant was born in a hospital that participated in the study.
Infants with bilateral high-risk prethreshold ROP (317) had one eye randomized to early treatment with the fellow eye serving as a control eye with conventional treatment.
The eyes assigned early treatment had a significantly reduced likelihood of poor vision, from 19.5% to 14.5%, at about 1 year of age. Early treatment also considerably reduced the likelihood of structural damage to the eye from 15.6% to 9.1%.
“It is crucial that infants with high-risk ROP be identified early and be given timely treatment,” said William Good, MD, of the Smith-Kettlewell Eye Research Institute in San Francisco, the chair of the ETROP study. “The results also clearly indicate that for certain subgroups of eyes, watchful waiting and not immediate treatment is the best approach.”
The study will continue to follow the patients until age 6 to monitor whether treatment benefits continue into childhood.
The study is published in the December issue of Archives of Ophthalmology.