Nine-year ocular developmental outcomes after ranibizumab or laser treatment for zone II retinopathy of prematurity: follow-up of a randomized trial cohort

The purpose of this study is to describe 9-year ocular developmental outcomes in children previously randomized to intravitreal ranibizumab (IVR) or laser photocoagulation (LP) for zone II treatment-requiring retinopathy of prematurity (ROP). In this follow-up of a single-center randomized trial, infants with stage 2 or 3 ROP with plus disease in zone II were randomized in 2014 to bilateral LP (n = 25) or IVR (n = 25). At school age, 29 children (10 LP, 19 IVR) underwent assessment of best-corrected visual acuity, cycloplegic refraction, ocular biometry, anterior segment parameters, spectral-domain optical coherence tomography, optical coherence tomography angiography, and full-field electroretinography. Eye-level comparisons used generalized estimating equations. Mean spherical equivalent did not differ significantly between LP and IVR groups (- 1.22 vs. - 1.90 D; mean difference 0.68 D, 95% CI - 2.26 to 3.62; p = 0.65), nor did best-corrected visual acuity (0.15 vs. 0.21 logMAR; mean difference - 0.07, 95% CI - 0.27 to 0.13; p = 0.51). Compared with the LP group, the IVR group showed thinner lens thickness (3.52 vs. 3.75 mm, p < 0.001), steeper minimum keratometry (43.8 vs. 42.6 D, p = 0.048), and thinner central internal limiting membrane-retinal pigment epithelium thickness (249.2 vs. 286.9 μm, p = 0.005). Selected electroretinography abnormalities also differed between groups.