- Design
- Nine-year follow-up of a single-centre randomised trial
- Population
- 29 of 50 children treated for zone II ROP
- Primary outcome
- Refraction, acuity, ocular structure and function
- Effect
- Spherical equivalent −1.22 vs −1.90 D (p = 0.65); BCVA 0.15 vs 0.21 logMAR
In 2014, a single-centre trial randomised 50 infants with zone II, stage 2 or 3 retinopathy of prematurity with plus disease to bilateral laser or intravitreal ranibizumab. At nine years, 29 children were reassessed (10 laser, 19 ranibizumab).
Spherical equivalent (−1.22 vs −1.90 D) and best-corrected acuity (0.15 vs 0.21 logMAR) did not differ significantly. The ranibizumab group had thinner lenses, steeper corneas and a thinner central retina, and some electroretinogram differences.
With unequal loss to follow-up and very small numbers, the authors call the findings exploratory. They do not favour either treatment on long-term grounds, but they add to the case for long follow-up of children given anti-VEGF for ROP.
- Children treated for ROP with either laser or anti-VEGF need long-term eye follow-up.
- Visual acuity and refraction at school age were broadly similar between treatments here.
- Structural differences after ranibizumab are of uncertain clinical meaning.
- Treatment choice should still rest on short-term efficacy and local expertise.
Why it matters
Anti-VEGF use for ROP has grown faster than the evidence on what it does to the developing eye.
Don't overread it
With 29 children and differential loss to follow-up, this cannot show one treatment is better long term.
The statistics, in plain English
The confidence interval for the refraction difference runs from −2.26 to 3.62 D, which is wide enough to include clinically important differences in either direction.
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