Refractive and Biometric Outcomes Following Intravitreal Injection of Ranibizumab in Retinopathy of Prematurity: A Long -Term Study.

Objective: To evaluate the long-term effects of intravitreal injection of ranibizumab (IVR) as monotherapy for ROP on refractive and biometric ocular parameters. Methods: This prospective case-control study included three groups were included: the injection group (premature infants who received single IVR) and two control groups: spontaneous ROP regression and premature children with no ROP. Spherical equivalent (SE), average keratometry (AVG-K), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were analyzed at ages of > 1 year and >5 years. Results: Compared to the control groups, the injection group had a higher prevalence of very high myopia and high myopia at both visits, a significantly longer AL (P = 0.017) and higher LT (P <0.001) at the age of > 1 year and a significantly higher AVG-K (P= 0.003) and AL (P = 0.044) at the age of >5 years. The injection group showed a significant increase (P <0.001) in SE, AVG-K, ACD, and AL (P = 0.008) with decrease in LT (P= 0.003) at the second visit compared to the first one. Conclusion: ROP treatment with IVR is associated with a high prevalence of high myopia and very high myopia, which is related to a longer AL, anterior segment changes, and disease severity. Continuous monitoring of the refractive status following IVR treatment is recommended to avoid the risk of amblyopia.