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Long-term surgical outcomes and prognostic factors for advanced-stage retinopathy of prematurity after vitrectomy
  1. Yin-Hsi Chang1,2,
  2. Eugene Yu-Chuan Kang1,2,3,
  3. Kuan-Jen Chen1,2,
  4. Nan-Kai Wang1,2,4,
  5. Laura Liu1,2,
  6. Yih-Shiou Hwang1,2,
  7. Chi-Chun Lai2,5,
  8. Wei-Chi Wu1,2
  1. 1Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
  2. 2College of Medicine, Chang Gung University, Taoyuan, Taiwan
  3. 3Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
  4. 4Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY, USA
  5. 5Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
  1. Correspondence to Dr Wei-Chi Wu; weichi666{at}gmail.com

Abstract

Background/aims The aims of this study is to evaluate the anatomic, visual outcomes and associated prognostic factors in patients with advanced retinopathy of prematurity (ROP) following vitrectomy.

Methods A retrospective cohort study of patients with ROP who underwent vitrectomy from 2005 to 2016 was conducted. All the patients had a follow-up period of at least 5 years. Univariate and multivariable logistic regression analyses were used to explore the factors related to unfavourable outcomes.

Results In total, 81 eyes of 51 patients were included. The mean age at last follow-up was 10.2 years. The anatomic success rate was 96.3% (26/27) for stage 4A, 90.9% (20/22) for stage 4B and 31.3% (10/32) for stage 5 ROP (p<0.01). The mean logMAR best corrected visual acuity of the stage-4A eyes was the highest, followed by those of stage-4B and stage-5 eyes (0.8, 1.5 and 2.6 for stages 4A, 4B and 5, respectively; p<0.01). High myopia (≤ −5.0 D) was noted in 70.8% and 71.4% of stage-4A and stage-4B eyes, respectively. Cataract was the most common complication (25.9%), followed by corneal opacity (17.3%), strabismus (16.1%), and phthisis (16.1%). Stage of the disease was a poor prognostic factor in all vitrectomised eyes (p<0.01). Vitrectomy combined lensectomy was a significant predictor for poor anatomic outcomes for stage-4 eyes (p=0.03). Presence of plus disease was also a possible factor affecting the surgical outcomes.

Conclusion The long-term surgical outcomes of the eyes with stage 4A and 4B ROP were favourable. Management of stage 5 ROP remained challenging.

  • Retina
  • Anatomy
  • Vision
  • Treatment Surgery
  • Child health (paediatrics)

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors W-CW and Y-HC contributed to the study conceptualisation and design. W-CW, K-JC, N-KW, LL, Y-SH and C-CL provided the resources. EY-CK helped with investigation process and data curation. Y-HC contributed in the formal analysis, prepared the images, tables and visualisation. Y-HC wrote the original draft of the manuscript. The draft was critically reviewed and edited by EY-CK and W-CW. W-CW was the guarantor and responsible for funding acquisition. All authors contributed to discussion, and have read and agreed to the published version of the manuscript.

  • Funding This study was supported by Chang Gung Memorial Hospital Research Grants (CMRPG3M0131 and CMRPG3L0151), a Ministry of Science and Technology Research Grant (MOST 109-2314-B-182A-019-MY3). The sponsors had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.