Mizusawa Yutaro, Nishi Tomo, Ogata Nahoko, Shinomiya Kayo, Mitamura Yoshinori, Kimura Naoki, Gomi Fumi, Miki Akiko, Nakamura Makoto, Kinoshita Takamasa, Obata Shumpei, Ohji Masahito, Tsuji Takuya, Yoshida Shigeo, Ueda Tetsuo
Department of Ophthalmology, Nara Medical University, 840 Kashihara City, Kashihara, 634-8522, Nara, Japan.
Department of Ophthalmology, Tokushima University, Tokushima, Japan.
BMC Ophthalmol. 2025 Jun 2;25(1):333. doi: 10.1186/s12886-025-04140-6.
Previous studies have reported the efficacy of photocoagulation (PC) therapy for treating retinopathy of prematurity (ROP); however, its long-term effects on visual function and retinal structure remain unclear. This study compared the visual function and retinal structure of school-aged children (7–12 years) with ROP who underwent PC therapy with those of children with untreated ROP.
Seventy-eight eyes of 78 patients diagnosed with ROP who were followed up until school age were evaluated. Fifty-one eyes that underwent PC therapy and 27 eyes with spontaneously regressed ROP were included in the PC-treated and untreated groups, respectively. One eye of each patient was included in the analysis at random.
The mean best-corrected visual acuity (BCVA) in the PC-treated and untreated groups was 0.05 ± 0.19 and 0.04 ± 0.35 logarithm of the minimum angle of resolution (logMAR) units and no significant differences were observed ( = 0.896, t-test). The mean spherical equivalent in the PC-treated and untreated groups was − 4.2 ± 4.7 D and − 0.8 ± 2.5 D ( < 0.001). PC-treated eyes were treated at ROP zone II in 42/51 eyes, ROP stage 3 in 41/51 eyes and showed plus disease in 31/51 eyes. Untreated eyes were regressed from ROP zone II in 22/27 eyes, ROP stage3 in 8/27eyes, and showed plus disease in 3/27eyes. The eyes in the PC-treated group were more myopic than those in the untreated group; further, they exhibited a unique foveal morphology with thicker foveal thickness (274.2 ± 29.9 μm in the PC-treated and 239.9 ± 25.0 μm in the untreated groups < 0.001), inner retinal layer retention (23.6 ± 12.5 μm in the PC-treated and 14.1 ± 7.1 μm in the untreated groups = 0.004) and a thicker outer nuclear layer (130.3 ± 20.0 μm in the PC-treated and 110.8 ± 20.6 μm in the untreated groups < 0.001). No significant differences were observed in the outer retinal, inner segment (43.7 ± 4.9 μm in the PC-treated and 45.2 ± 5.0 μm in the untreated groups = 0.231), or outer segment (45.0 ± 4.6 μm in the PC-treated and 43.8 ± 4.8 μm in the untreated groups = 0.238) layers’ thickness.
The findings of the present study suggest that school-aged children who underwent PC therapy for ROP had good visual acuity, however the inner retinal structure remained immature.
既往研究报道了光凝（PC）疗法治疗早产儿视网膜病变（ROP）的疗效；然而，其对视觉功能和视网膜结构的长期影响仍不明确。本研究比较了接受PC疗法的ROP学龄儿童（7 - 12岁）与未接受治疗的ROP儿童的视觉功能和视网膜结构。
对78例诊断为ROP且随访至学龄期的患者的78只眼进行评估。接受PC疗法的51只眼和ROP自发消退的27只眼分别纳入PC治疗组和未治疗组。随机选取每位患者的一只眼进行分析。
PC治疗组和未治疗组的平均最佳矫正视力（BCVA）分别为0.05±0.19和0.04±0.35最小分辨角对数（logMAR）单位，未观察到显著差异（P = 0.896，t检验）。PC治疗组和未治疗组的平均等效球镜分别为-4.2±4.7 D和-0.8±2.5 D（P < 0.001）。PC治疗的眼中，42/51只眼在ROP 2区接受治疗，41/51只眼处于ROP 3期，31/51只眼有增值性病变。未治疗的眼中，22/27只眼从ROP 2区消退，8/27只眼处于ROP 3期，3/27只眼有增值性病变。PC治疗组的眼比未治疗组的眼更近视；此外，它们表现出独特的黄斑形态，黄斑厚度更厚（PC治疗组为274.2±29.9μm，未治疗组为239.9±25.0μm，P < 0.001），视网膜内层保留（PC治疗组为23.6±12.5μm，未治疗组为14.1±7.1μm，P = 0.004），外核层更厚（PC治疗组为130.3±20.0μm，未治疗组为110.8±20.6μm，P < 0.001）。视网膜外层、内节（PC治疗组为43.7±4.9μm，未治疗组为45.2±5.0μm，P = 0.231）或外节（PC治疗组为45.0±4.6μm，未治疗组为43.8±4.8μm，P = 0.238）层的厚度未观察到显著差异。
本研究结果表明，接受PC疗法治疗ROP的学龄儿童视力良好，然而视网膜内层结构仍不成熟。
