Refractive outcomes of infants treated for Type 1 Retinopathy of Prematurity (ROP), a vision-threatening condition in premature infants characterized by abnormal retinal blood vessel development. The analysis included infants born before 34 weeks’ gestation from 2020 to 2024 who underwent either laser therapy or anti-VEGF injections for Type 1 ROP, with refractive assessments conducted at 1 and 3 years of age. Refractive errors considered were myopia, hyperopia, astigmatism, and anisometropia, defined by specific diopter criteria. A total of 120 infants met the inclusion criteria, with nearly equal numbers treated with laser therapy (54%) and anti-VEGF (46%). The average birth weight was 1,200 grams, and the mean gestational age was 28 weeks. At 1 year of age, 60% of the infants had significant refractive errors, increasing to 75% by 3 years. Myopia was the most prevalent refractive error, affecting 45% of infants at 1 year and 60% at 3 years. Astigmatism and anisometropia were also common, with astigmatism increasing from 35% to 50% and anisometropia from 10% to 20% over the study period. Laser therapy was associated with a higher prevalence of myopia at 3 years (70%) compared to anti-VEGF treatment (45%), and high myopia (≤-5.00 D) was more frequent in the laser-treated group (30% vs. 10%). Astigmatism rates were similar between treatment groups, but anisometropia was more common in the laser group (25% vs. 15%). The findings indicate that refractive errors are prevalent in children treated for Type 1 ROP, with laser therapy posing a higher risk of myopia. The study emphasizes the need for long-term follow-up and early intervention to manage refractive errors and suggests that anti-VEGF treatment may help reduce the risk of high myopia. Further research is needed to evaluate the safety of anti-VEGF, explore combination therapies, and establish new treatment protocols to optimize visual outcomes. Routine ophthalmic evaluations are essential for detecting and managing refractive errors in children treated for ROP..
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