Risk Factors and Ocular Outcomes in Preterm Infants with Treated Retinopathy of Prematurity: A Retrospective Observational Study from Western India

Introduction Retinopathy of prematurity (ROP), requiring treatment (type 1 ROP) causes severe visual impairment and blindness in childhood. In this study, we aimed to study the risk factors and ocular outcomes in preterm infants with type 1 ROP. Methods This retrospective study was conducted in a level III neonatal intensive care unit (NICU) from January 2020 to January 2023 in preterm infants with type 1 ROP after getting approval from the institutional ethics committee. Results Fifty-nine out of 75 infants (78.7%) received primary laser photocoagulation, and 16 infants (21.3%) received anti-vascular endothelial growth factor (anti-VEGF). The primary outcome of death or blindness at 18-24 months was seen in one infant. The predictors for retreatment of ROP included the need for resuscitation at birth, low birth weight, need for inotropes, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), and the presence of zone 1 ROP [ROC: 0.82 (95% CI: 0.715-0.900)]. ROP regressed in 95% of infants. Among 37 (49%) infants who required retreatment, it was significantly less in the primary laser group (41% vs. 81%) [RR 0.50, 95% CI 0.34-0.74], P = .0005. The retreatment group had significantly increased zone 1 type 1 ROP compared to the single treatment group (7% vs. 5%, P = .01). There was no significant difference between the single and retreatment groups in ocular outcomes. Conclusion Both laser and anti-VEGF may be safe for the primary treatment of ROP, with no difference in mortality and blindness.