Influence of Retinopathy of Prematurity and Laser Therapy on Intraocular Pressure in Preterm Infants.

PRÉCIS: Intraocular pressure (IOP) decreases as preterms mature and in moderate retinopathy of prematurity, IOP is initially low and transiently rises after laser treatment.

PURPOSE: This study aimed to measure intraocular pressure (IOP) in preterm infants with and without retinopathy of prematurity (ROP) and evaluate the effect of laser treatment on IOP.

METHOD: This prospective nonrandomized comparative study included infants born before 34 weeks of gestation weighing <2000 g at a tertiary care research and referral institute. Those with ocular or systemic conditions or requiring surgical intervention for ROP were excluded. Infants were divided into 3 groups: Group 1 (no ROP), Group 2 (ROP without treatment), and Group 3 (ROP requiring peripheral retinal ablation by laser photocoagulation). IOP was measured using a Perkins tonometer at presentation and at 1 and 3 months. The primary outcome was IOP in preterm infants with and without ROP; and the secondary outcome was change in IOP postlaser treatment.

RESULTS

Of 107 infants, 40 (37.38%) had no ROP (Group 1), 25 (23.36%) had untreated ROP (Group 2), and 42 (39.25%) required laser treatment (Group 3). Average postmenstrual ages were 37.89±2.74 weeks 36.98±3.38, and 35.47±2.84 weeks, respectively. A moderate negative correlation between IOP and postmenstrual age was found in Group 1 ( r2 =-0.382; P =0.01) and Group 2 ( r2 = -0.6; P =0.001). Baseline IOP was significantly lower in Group 3 compared with the other groups, with a transient increase postlaser treatment that typically normalized without needing IOP treatment.

CONCLUSIONS

IOP decreases as preterm infants mature. Infants with ROP requiring laser treatment exhibit significantly low IOP at presentation, but have a postlaser spike, which generally normalises without treatment.