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Eyes with type 1 ROP show benefit of early treatment at 6 years
Arch Ophthalmol. 2011;129(7):840-846.
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Early treatment of type 1 retinopathy of prematurity may improve grating visual acuity outcomes, a study found.
The randomized Early Treatment for Retinopathy of Prematurity Study assessed grating visual acuity in children who were 6 years old. When they were infants, 317 subjects with bilateral, high-risk ROP received early treatment in one eye and conventional management in the other. Another 84 subjects had ROP in only one eye, which was randomized to early or conventional treatment.
A masked tester evaluated grating visual acuity using the Teller acuity card procedure (Stereo Optical). Overall, grating acuity outcomes for all patients showed no statistically significant benefit with early treatment. However, sub-analyses showed a benefit for type 1 eyes, with 25.2% of those undergoing normal treatment vs. only 16.4% undergoing early treatment experiencing unfavorable outcomes (P = .004).
In contrast, the rate of unfavorable outcomes was higher for those with early treatment than conventional treatment, 21.3% vs. 15.9%, for eyes with type 2 ROP, but the difference was not statistically significant.
Grating acuity assessments have the disadvantage of potentially underestimating loss in optotype acuity in certain situations, such as in cases with amblyopia, the study authors noted.
As these findings coincide with outcomes from the Early Treatment of Diabetic Retinopathy Study, careful observation and identification of the international classification of ROP characteristics were strongly encouraged.