Neurodevelopmental findings in patients treated for retinopathy of prematurity

Purpose: To analyze neurodevelopmental status with Denver Developmental Screening Test II (DGTT-II) in patients who received treatment for retinopathy of prematurity (ROP), in patients with a history of spontaneously regressed ROP, and in premature control group patients without observed ROP development; To examine the effects of intravitreal bevacizumab (İVB) and laser photocoagulation (LFK) procedures on neurodevelopment and to determine whether there are neurodevelopmental changes before clinical findings appear. Materials and Methods: The study included premature patients who were between 0-6 years of age at the time of our study, who were admitted to the Pediatric Ophthalmology Unit of Karadeniz Technical University Ophthalmology Department between 2011-2022 as an inpatient consultation or outpatient for ROP screening, and whose brain Magnetic Resonance (MR) imaging was reported as "normal" or "compatible with prematurity" without any pathological findings, and whose 5th minute APGAR score was at least 6 were included. Premature patients who were not diagnosed with ROP during the screening were included in the control group. The patients were divided into 3 groups: patients diagnosed with ROP who underwent İVB or LFK (Group 1), patients with a history of spontaneously regressed ROP (Group 2), and premature patients without the development of ROP (Group 3 = control group). Based on the inclusion criteria, 19 patients in Group 1, 23 patients in Group 2 and 24 patients in Group 3 were included in the study. For all patients included in the study, gender, birth week, birth weight, spherical equivalent values, ROP stage, ROP zone, treatment applied, week of treatment application, head circumference, height, weight, deep tendon reflex responses, educational status of the parents, complete blood count, biochemistry tests, history of thrombocytopenia in the neonatal period, duration of stay in intensive care, history and duration of mechanical ventilation, history of sepsis, Patent Ductus Arteriosus (PDA), Bronchopulmonary Dysplasia (BPD), Necrotizing Enterocolitis (NEK), Intracranial Hemorrhage (İKH), and 5th minute APGAR values were recorded. Best-corrected visual acuity on the Snellen chart and biometric measurements were recorded in patients who were able to comply. Neurodevelopment was evaluated with the DGTT-II and the relationship between the parameters was examined statistically. Results: There were no significant differences between the groups in the DGTT-II result, the difference between the mean of the subtests and the age at the time of the test, the difference between each of the subtests (gross motor, fine motor, language, cultural social) and the age at the time of the test, the education level of the parents, and the need for mechanical ventilation (p>0,05). Intensive care time and mechanical ventilation time in Group 1 were significantly higher than Group 2 and Group 3 (p<0,05). The 5th minute APGAR score in Group 3 was significantly higher than Group 1 and Group 2 (p<0,05). The rates of sepsis, BPD and NEC in Group 1 were significantly higher than Group 2 and Group 3 (p<0,05). Conclusion: In our study, no significant difference was found in the results of the DGTT-II and its subtests in any of the groups who were treated with a diagnosis of ROP, had a history of spontaneously regressed ROP, and did not develop ROP. Since the patient population in the study was selected from the neurologically milder group, it can be considered that the effect of ROP diagnosis and treatment on neurodevelopment is minimal. To reach consistent results in this field, more multicenter studies with a larger group of patients with various neurological effects are needed. Key Words: Retinopathy of prematurity, Intravitreal bevacizumab, Laser photocoagulation, Denver developmental screening test