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Saad Al-Dahmash, Trad Alkadi, Ahmad Abu El-Asrar; Anatomical outcome of retinal ablation by diode laser photocoagulation for type 1 prethreshold retinopathy of prematurity in zone 1 retina. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):983.
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© ARVO (1962-2015); The Authors (2016-present)
To study the anatomical outcome and complications of retinal ablation by diode laser photocoagulation for type 1 prethreshold retinopathy of prematurity (ROP) in zone 1 retina.
A retrospective charts review for all patients with active type 1 prethreshold ROP disease located posteriorly in zone 1 retina who were treated with peripheral retinal ablation by diode laser photocoagulation at King Abdulaziz University Hospital between January 2003 and December 2013, with a minimum follow up of 6 months. The anatomical outcomes after laser treatment were: flat retina, dragging of the macula, formation of falciform retinal folds, and progression to retinal detachment. Post laser treatment complications were noted also.
86 eyes representing 46 patients were included in the study, 24(52%) males and 22(48%) females. The average birth weight was 906 grams (median 860 grams, range 500-1400grams), the mean gestational age was 27 weeks (median 27 weeks, range 22-34 weeks). There were no associated medical conditions (n=40, 87%), bronchopulmonary dysplasia (n=5, 11%), and cardiac anomalies (n=1, 2%). The stages of the disease at the time of treatment were: stage 2 (n=5, 5.8%), stage 3 (n=81, 94.2%). Plus disease presented in all eyes (n=86, 100%). The vitreous hemorrhage at presentation noted in (n=15, 17.4%) eyes. The treatment by diode laser completed in one session (n=84, 97.7%), in two sessions (n=2, 2.3%). The mean follow up postoperatively was 27 months (median 11 months, range 6-124 months). The final anatomical outcomes after a minimum follow up of six months post laser treatment were: flat retina (n=64, 74.4%) eyes, flat retina with macular dragging (n=6, 7%) eyes, formation of falciform retinal fold (n=2, 2.3%) eyes, development of partial retinal detachment with flat macula (n=6, 7%) eyes, development of partial retinal detachment involving the macula (n=3, 3.5%) eyes, progression to total retinal detachment (n=5, 5.8%) eyes which was open funnel (n=2, 3.5%) and closed funnel (n=3, 3.5%) eyes. There were no postoperative complications other than failure of laser treatment.
Diode laser retinal ablation for type 1 prethreshold ROP in zone 1 is a safe modality of treatment, resulted in involution of the aggressive posterior ROP disease and arrest the progression to total blinding retinal detachment in almost 94% of the cases.
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