- Design
- Long-term follow-up of a single-centre randomised trial
- Population
- 29 of 50 children treated for zone II ROP in 2014
- Primary outcome
- Visual acuity, refraction and ocular structure at 9 years
- Effect
- Spherical equivalent -1.90 vs -1.22 D (P = 0.65); BCVA 0.21 vs 0.15 logMAR
This follow-up of a single-centre trial randomised 50 infants with zone II stage 2 or 3 ROP with plus disease to ranibizumab or laser in 2014. At school age, 29 children were examined (19 ranibizumab, 10 laser).
Spherical equivalent (-1.90 vs -1.22 D) and best-corrected acuity (0.21 vs 0.15 logMAR) did not differ significantly. Ranibizumab-treated eyes had thinner lenses, slightly steeper corneas and thinner central retina, and some electroretinography differences.
With fewer than 60% followed up and unequal losses between arms, these are exploratory findings. They neither favour nor condemn anti-VEGF on long-term outcomes. Long-term ophthalmic follow-up of treated children remains essential whichever treatment is used.
- Arrange long-term eye follow-up into school age for every child treated for ROP.
- Check refraction and amblyopia risk regularly after either treatment.
- Discuss with parents that long-term differences between treatments remain uncertain.
- Choose treatment on current evidence and zone of disease, not on these exploratory results.
Why it matters
Parents ask about long-term effects of anti-VEGF, and these data are among the few beyond early childhood.
Don't overread it
Only 29 of 50 children were examined, with unequal loss between groups; the structural differences are exploratory.
The statistics, in plain English
The interval for the refraction difference ran from about -2.3 to +3.6 D, wide enough to hide a meaningful difference either way.
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