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S.–J. Kim, M. Kim, Y. Yu; Involution Of Retinopathy Of Prematurity After Laser Treatment And Factors Associated With Retinal Detachment And Macular Dragging . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5315.
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To characterize the process of involution of threshold or rush type retinopathy of prematurity and to identify specific features associated with the development of retinal detachment and macular dragging after transpupillary diode laser photocoagulation.
A retrospective study was performed on 77 treated eyes of 40 infants from 1996 to 2005. Presence of retinal or vitreous hemorrhage, presence of vitreous traction before the laser treatment, duration of active plus disease and presence of vitreous hemorrhage after the laser treatment and presence of retinal detachment or macular dragging was reviewed.
Full involution of plus disease was seen in 47%, 64%, 80% and 86% of eyes at postoperative days 10, 20, 30 and 40 days, respectively. Retinal detachments were diagnosed cumulatively in 5 %, 5%, 5% and 9% of eyes at days 5, 10, 20 and 30, respectively. The study was finished 60 days after treatment. A retinal detachment developed in 6 (8%) of 77 eyes. Six (43%) of 14 eyes with vitreous or retinal hemorrhage had retinal detachment.
The presence of the hemorrhage (odds ratio 32.5; P.001) and the vitreous traction(odds ratio 41.2; P .001) before the treatment was related to retinal detachment and macular dragging. Prolonged activity of plus disease more than 21 days after treatment was related to the development of retinal detachment (Odds ratio 11.5(1.3–101); P .021).
New vitreous hemorrhage after the treatment (odds ratio 22; P .002) was associated with retinal detachment. The history of previous laser photocoaculation without involution of retinopathy of prematurity(odds ratio 8.6; P.0.007) was associated with macular dragging (Fisher’s Exact test).
Full involution of laser–treated threshold retinopathy of prematurity required more than 20 days in more than half of treated eyes. The retinal detachment were detected <=5 days or >=20 days after treatment. The associated factors with retinal detachment and macular dragging were the existence of the vitreous traction or vitreous hemorrhage existed before the treatment. New vitreous hemorrhage after the treatment and prolonged presence of plus disease were related to retinal detachment. If the retinopathy of prematurity do not involute after the first laser photocoagulation, the risk of developing of macular dragging increases.
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