Relationships between retinopathy of prematurity without ophthalmologic intervention and neurodevelopment and vision at 2 years

Background Severe retinopathy of prematurity (ROP) is associated with adverse outcomes. Relationships between milder ROP and outcomes have not been defined. We hypothesized that children with ROP stage <= 3 who did not receive ophthalmologic intervention would have worse motor, cognitive, and language skills and more vision abnormalities than children without ROP. Methods This was a secondary analysis of a randomized trial evaluating the effects of myo-inositol on ROP in the NICHD Neonatal Research Network. Primary outcomes were Bayley Scales of Infant Development composite scores; secondary outcomes included behavioral difficulties and ophthalmologic measures. Outcomes were compared using adjusted linear or modified Poisson models. Results Of 506 children, 173 (34%) had no ROP, 262 (52%) had ROP stage <= 3 without intervention, and 71 (14%) had ROP with intervention. There was no difference in motor, cognitive, or language scores between children with ROP stage <= 3 without intervention and children without ROP. Children with ROP stage <= 3 without intervention had a higher rate of strabismus compared to children without ROP (p = 0.040). Conclusion Children with ROP stage <= 3 without intervention did not have adverse neurodevelopmental outcomes at 2 years' corrected age compared to children without ROP but did have an increased incidence of strabismus. Impact This study addresses a gap in the literature regarding the relationship between milder forms of retinopathy of prematurity (ROP) that regress without intervention and neurodevelopment and vision outcomes. Children with a history of ROP stage <= 3 without intervention have similar neurodevelopmental outcomes at 2 years' corrected age as children born extremely preterm without a history of ROP and better outcomes than children with a history of ROP with ophthalmologic intervention. Counseling about likely neurodevelopment and vision outcomes for children born extremely preterm with a history of ROP may be tailored based on the severity of ROP.

Automated summary

This study found that children with mild retinopathy of prematurity (ROP) who did not receive intervention did not have adverse neurodevelopmental outcomes at 2 years' corrected age compared to children without ROP, but had an increased incidence of strabismus. This study addresses a gap in the literature regarding the relationship between milder forms of ROP that regress without intervention and neurodevelopment and vision outcomes.