Characterizing the Treatment Courses of Ranibizumab and Panretinal Photocoagulation for Retinopathy of Prematurity

Journal of Pediatric Ophthalmology & Strabismus · 2026-03-11

PURPOSE: This study characterizes the treatment course and outcomes of infants with retinopathy of prematurity (ROP) treated with ranibizumab, panretinal photo-coagulation (PRP), or combined therapy. METHODS: This retrospective chart review analyzed electronic health record data of infants treated for ROP between 2016 and 2024 at a single academic center. RESULTS: Thirty-seven infants (72 eyes) were analyzed (59.05% male, average 24.7 ± 1.4 weeks). At first treatment, most eyes were zone II, stage 3+ (59.7%). All eyes had plus disease except six treated for persistent avascular retina. PRP was administered as initial therapy for 30 (41.7%) eyes and ranibizumab for 42 (58.3%). Thirty-five eyes (48.6%) underwent only one treatment of either PRP (26 eyes; 36.1%) or ranibizumab (9 eyes; 12.5%). A second treatment consisting of ranibizumab was administered in 4 (13.3%) of 30 eyes treated with PRP and 21 (50%) of 42 eyes injected with ranibizumab. Eight eyes (11.1%) had three treatments: two ranibizumab injections followed by PRP. Four eyes (5.6%) had four treatments: three ranibizumab injections followed by PRP. ROP reactivation occurred in 14 (19.4%) eyes that all received ranibizumab injection initially (mean 50.6 ± 16.7 days after most recent injection). Final outcomes included PRP for persistent avascular retina in 22 (30.6%) eyes, unknown final outcomes due to lost follow-up for 16 (22.2%), documented resolution in 33 (45.8%), and scleral buckling for a peripheral retinal detachment (stage 4a) for one (1.4%). CONCLUSIONS: Ranibizumab was initiated at a younger age with higher retreatment and reactivation events compared to PRP, underscoring variability in real-world ROP treatment patterns and outcomes.

An Alternative to Medial Rectus Muscle Recession for Acute Acquired Esotropia

Journal of Pediatric Ophthalmology & Strabismus · 2025-07-01

Management of a Case of Dragged-Fovea Diplopia Syndrome

Journal of Pediatric Ophthalmology & Strabismus · 2025-07-01

The Influence of Myopia Progression in Children on the Risk of Retinal Detachment: A Comprehensive Outcomes Analysis

Journal of Pediatric Ophthalmology & Strabismus · 2025-06-26

Purpose: To investigate the long-term association between childhood myopia and the risk of retinal detachment over a 10-year follow-up period. Methods: A retrospective cohort study was conducted using the TriNetX platform, which included 66 United States health care organizations' electronic medical records. Children diagnosed as having myopia (n = 151,499) were compared to a control group of children without myopia who received routine health examinations (n = 5,073,124). Propensity score matching was applied to control for age, gender, and race, resulting in 145,814 patients in each cohort for analysis. Results: Within the study period from October 16, 2004 to October 16, 2024, 657 children (0.5%) in the myopic cohort and 63 children (0.04%) in the control cohort developed retinal detachment. The risk difference was 0.004 (95% CI: 0.004 to 0.004, P < .001), with a risk ratio of 10.43. The odds ratio was 10.47 (95% CI: 8.09 to 13.56). The average number of retinal detachments per child between the cohorts was not statistically significant. Conclusions: Children with myopia are at an increased risk of retinal detachment over a 10-year period. This highlights an urgent need for early detection and monitoring of these children to prevent myopia progression and retinal detachment. The findings reinforce the growing need for public health measures and clinical approaches aimed at slowing myopia progression in pediatric populations.

Causes of Acute Esotropia and Diplopia in Adults

Journal of Pediatric Ophthalmology & Strabismus · 2025-11-01

large study from Wills Eye Hospital by Adhan et al in this issue examines patients with adult-onset comitant esotropia (AOCET), characterized by horizontal comitant strabismus and diplopia, many with greater esotropia at distance fixation, especially in the older patients.Many cases presented with divergence insufficiency typical of sagging eye syndrome, attributed to age-related connective tissue laxity between the superior and lateral rectus muscles.These patients, frequently pseudophakic or at least in the age group when cataracts are common, typically do not require neurological evaluation unless additional findings suggest sixth nerve palsy.Notably, the study found a significant prevalence of myopia among younger adults with AOCET.The mean refractive error was -3.20 3.84 diopters, with myopia more common in younger patients and hypermetropia increasing with age of onset.Among phakic patients, 67.9% were myopic; 21.4% had mild, 43.9% had moderate, and 2.67% had severe myopia.There is limited literature on AOCET in myopic patients, and the etiology remains unclear.One proposed mechanism is prolonged near work and uncorrected myopia leading to increased medial rectus tone and esotropia, as described by Guyton. 1 This so-called Bielschowskytype acute comitant esotropia occurs in adolescents and young adults with varying degrees of myopia and typically yields negative neurological work-ups.As in other recently reported visual problems, one wonders if excessive use of small electronic devices held closer than the usual reading distance may contribute to this condition.Incidentally, because many of these patients have good binocular vision they are expected to do well following strabismus surgery.The new onset of diplopia is always concerning and the question of who should be evaluated neurologically is frequently raised.The authors identified the results of neuroimaging in 97 (36.2%) patients.Abnormalities were found in a minority (including thyroid eye disease and multiple sclerosis), and no tumors were detected.The data from this large cohort provides valuable guidance for clinicians in diagnosing and treating adults presenting with acute esotropia and diplopia.

Addressing Inquiries About the Management of Retinopathy of Prematurity

Journal of Pediatric Ophthalmology & Strabismus · 2025-03-01

Surgical Options for Intermittent Exotropia

Journal of Pediatric Ophthalmology & Strabismus · 2025-03-01 · 1 citations

Why Does Myopia Occur Frequently in Children with Significant Retinopathy of Prematurity?

2024-05-28

It is common for children who were premature at birth and had retinopathy of prematurity (ROP) to require glasses for correction of myopia at an early age. The myopia is often significant and in the range of what is considered high myopia (> -5.00 diopters). Furthermore, many of these children will require occlusion therapy to treat refractive amblyopia resulting from asymmetric myopia. The myopia associated with ROP is generally not the axial type of myopia seen in typical progressive myopia of childhood.

Pediatric Ophthalmology and Large Language Models: AI Has Arrived

Journal of Pediatric Ophthalmology & Strabismus · 2024-03-01 · 2 citations

Prescribing Glasses in Preverbal Children

Journal of Pediatric Ophthalmology & Strabismus · 2024

• Medicine
• Optometry
• Pediatrics