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Long-term follow-up of the cognitive function in children after intravitreal ranibizumab for retinopathy of prematurity

  • Retinal Disorders
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Abstract

Purpose

To evaluate the long-term cognitive function in children treated with intravitreal ranibizumab (IVR) for retinopathy of prematurity(ROP), and the impact of IVR on the growth and ocular development.

Methods

In this retrospective study, the premature children aged 4 to 9 years who received monotherapy of IVR (IVR group, n = 25) or monotherapy of laser photocoagulation (LP) (LP group, n = 33) for ROP, and the same age premature children with no ROP (Control group, n = 26) were enrolled from 2020 to 2022 in the pediatric fundus clinic of Shenzhen Eye Hospital. Main outcome measures were full-scale intelligence quotient (FSIQ) and index score using the Chinese version of the Wechsler intelligence scale for children-fourth edition (WISC-IV) and Wechsler preschool and primary scale of intelligence-fourth edition (WPPSI-IV). All children were examined and analyzed for growth and ocular development by recording the height, weight, head circumference, spherical equivalent (SE), best corrected visual acuity (BCVA) and axial length (AL).

Results

There were 17 children in IVR group, 17 in LP group, and 11 in Control group who received the WISC-IV assessment. There were no significant differences in FSIQ, verbal comprehension index, perceptual reasoning index, working memory index, processing speed index, general ability index and cognitive efficiency index among the three groups. There were 8 children in IVR group, 16 in LP group, and 15 in Control group who received the WPPSI-IV assessment. There were no significant differences in FSIQ, verbal comprehension index, visuospatial index, fluid reasoning index, working memory index, non-verbal index, general ability index and cognitive efficiency index among the three groups. There was no significant difference in BCVA among the three groups (P = 0.74), however, there is an increase for AL in IVR group when compared with LP group (22.60 ± 0.58 vs. 22.13 ± 0.84, P = 0.003), and the ROP patients of IVR group have a significant increase in the AL compared to the Control group(22.60 ± 0.58 vs. 22.03 ± 0.71, P < 0.0001).

Conclusions

Children with a history of IVR have a similar cognitive function outcomes compared to those with a history of LP or were premature without ROP. ROP children with a history of IVR has longer AL than those treated with LP.

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Acknowledgements

The authors would like to thank the patients who participated in this work. In addition, the authors would like to thank staffs in Department of Pediatric Retinal Surgery (Shenzhen Eye Hospital) who helped with the running and recruitment of this trial.

Funding

This study was supported by National Natural Science Foundation of China (No. 82271103, 82301269, 82301226), Sanming Project of Medicine in Shenzhen (No. SZSM202311018), Guangdong Basic and Applied Basic Research Foundation (No. 2022A1515012326, 22201910240002529), Shenzhen Medical Research Fund (No. C2301005), Shenzhen Key Medical Discipline Construction Fund (No. SZXK038), Shenzhen Fund for Guangdong Provincial High Level Clinical Key Specialties (No. SZGSP014), Shenzhen Science and Technology R&D Fund Project (No. JCYJ20220530153607015), China Ophthalmology New Technology Incubation Project.

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Authors and Affiliations

  1. Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China

    Zixin Fan, Xianlu Zeng, Zhen Yu, Xiaofeng Lu, Xinyu Zhao, Zhenquan Wu, Honghui He, Jian Zeng, Lei Zheng, Shaochong Zhang & Guoming Zhang

  2. Department of Ophthalmology, Guizhou Provincial People’s Hospital, 18 Zhongshan East Road, Guiyang, 550002, Guizhou, China

    Ya Tian

  3. Department of Child Health Care, Shenzhen Children’s Hospital, 7019 Yitian Road, Shenzhen, 518040, Guangdong Province, China

    Linlin Zhang

  4. Retina Service, Ines and Fred Yeatts Retina Research Laboratory, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA

    Victor S. M. C. Correa

  5. Center for Preventative Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 700, Philadelphia, PA, 19104, USA

    Guishuang Ying

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  1. Ya Tian
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Contributions

YT, ZXF, XLZ and ZY contributed to the data collection, XFL, XYZ, ZQW and HHH contributed the investigation, GMZ and SCZ contributed the project administration, YT, LZ and LLZ contributed the patient data resources and the software. YT and JZ contributed writing the original draft. GSY and VSC revised the original manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Guoming Zhang.

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Ethics approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the Shenzhen Eye Hospital affiliated to Jinan university (No.2021J003-01) and with the 1964 Helsinki declaration and its later amendments. Informed written consent Written informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Tian, Y., Fan, Z., Zeng, X. et al. Long-term follow-up of the cognitive function in children after intravitreal ranibizumab for retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol (2024). https://doi.org/10.1007/s00417-024-06486-x

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