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S. L. Williams, A. M. Berrocal, D. J. Hess, W. Shi, T. G. Murray; Fundus Pigmentation in Treatment-requiring Retinopathy of Prematurity (ROP). Invest. Ophthalmol. Vis. Sci. 2009;50(13):3157.
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To access the clinical outcomes and the role of fundus pigmentation in the severe (treatment-requiring) ROP population at the Jackson Memorial Hospital (JMH).
A review of all ROP patients at JMH from 2002 to 2008 revealed 161 infants whom required laser treatment. All infants requiring laser during this time period received digital fundus photography with the RetCam camera (Clarity Medical Systems, Pleasanton, CA). Clinical data for these infants included gestational age (GA) at birth, GA at threshold, birth-weight (BW), race, ROP severity (using Early Treatment-ROP criteria), number of laser treatments, and need for adjunctive treatment (e.g., surgery, intra-vitreal anti-VEGF). Infants were excluded if they were transferred to JMH for treatment or had missing clinical/photographic data. Images of both eyes of each infant, at each date of treatment were reviewed and each infant was designated as having low pigment or heavy pigment based on an ordinal scale developed by the co-authors.
Of the 108 infants (216 eyes) that met criteria for the study, 51 (47.2%) were male. The average (standard deviation) BW, GA, and GA at threshold were 662.6 (156.5) grams, 25 (1.7) weeks, and 37 (3.1) weeks, respectively. Light fundus pigmentation was observed in 34 of 56 (60.7%) White non-Hispanic patients, 6 of 11 (54.5%) White Hispanic patients, 2 of 39 (5.1%) Black non-Hispanic patients, 0 of 1 (0%) Black Hispanic patients. There was no statistically significant difference between the two pigment groups in terms of BW, GA at birth, GA at threshold, number of laser treatments (p=0.24, 0.72, 0.06, 0.18, respectively). Of the 12 infants with Zone 1 disease, 7 had light pigment and 5 had heavy pigment (p=0.21). All 3 infants requiring adjunctive treatment were in the light pigment group (p=0.028).
Light fundus pigmentation may decrease the efficacy of laser treatment for severe ROP.
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