Recurrence Risk Factors of Intravitreal Ranibizumab Monotherapy in Retinopathy of Prematurity: A Retrospective Study at One Center

Purpose: The risk factors for retinopathy of prematurity (ROP) recurrence in patients with intravitreal ranibizumab (IVR) treatments after long-term follow-up are unclear, so we aimed to identify risk factors of recurrence of this disorder after IVR monotherapy. Methods: : We retrospectively reviewed 33 eyes of 19 patients who underwent initial IVR treatments for type 1 ROP at our center between April 1, 2016 and December 31, 2017. Patient demographics, the side of ROP, multiple gestations, Apgar scores, zone, stage, plus disease, postmenstrual age at injection, surfactant therapy, blood transfusion therapy, hemorrhage before IVR, hemorrhage after IVR, gestational diabetes mellitus, pregnancy-induced hypertension, anemia, intraventricular hemorrhage, sepsis, respiratory distress syndrome, carbohemia, and congenital heart defects were recorded. Adjusted hazard ratios (HRs) and 95% confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression. Results: : Of the 33 eyes, 12 (36.4%) had ROP recurrences 45.3 (5.1, 50.9) months after initial IVR treatments. The independent risk factors for ROP recurrences were zone [Ⅱ vs. Ⅰ, hazard ratio (HR): 0.056, P = 0.003] and gestational diabetes mellitus (no vs. yes, HR: 0.095, P < 0.001). The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR (0.13, 0.70) at 55.0 (51.0, 58.9) months after the initial IVR treatment. The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR (0.19, 0.63) at 48.0 (43.8, 58.4) months after the initial IVR treatment. Conclusions: : We identified two independent risk factors for type 1 ROP recurrence after IVR treatment involving zone Ⅰ and gestational diabetes mellitus, and the mean uncorrected visual acuity was 0.46 logMAR at 51.0 (44.0, 58.9) months. The findings of this study are important for follow-up management and for improving the visual function of ROP patients.