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Seema Emami, Maram Isaac, Kamiar Mireskandari, Nasrin Najm Tehrani; Informing informed consent: outcomes of laser photocoagulation for ROP in a Canadian tertiary care center.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4738.
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Few studies have described the outcomes associated with laser photocoagulation therapy for retinopathy of prematurity (ROP) using large cohorts after the ETROP study. We performed a retrospective chart review to report the structural, visual, and refractive outcomes of patients who received laser treatment for ROP at a Canadian tertiary care centre.
We reviewed charts for all infants treated with laser photocoagulation for ROP at our institution between January 2004 and March 2014. Patients who had follow-up eye examination at 8-15 months corrected age (CA) and/or 3 years ± 6 months of age were included in the study. Eyes treated for type 1 ROP were included in this analysis. Primary outcome was structural outcome as defined by ETROP criteria. Secondary outcomes were refractive error and monocular visual acuity (VA) reported in spherical equivalent (SE) and logMAR respectively.
A total of 114 infants (202 eyes) were treated for type 1 ROP in zone I (n=37; 18.32%) or zone II (n=165; 81.68%). Seventy-three were males (64.04%). Mean gestational age was 24.4±1.6 weeks and mean birth weight was 759.5±273.5 grams. Mean postmenstrual age at treatment was 37.7±4.3 weeks. Twenty-six infants (22.81%) were treated for unilateral type 1 ROP. Five infants (n=7/202 eyes, 3.47%) received retreatment for failure of regression. Five infants (n=6/202 eyes, 2.97%) had unfavorable structural outcome and had surgery for retinal detachment; 3 of these eyes were in zone I. One hundred and seven infants (n=189 eyes) were examined between 8-15 months CA. Mean refractive error was -3.24±4.38 diopters (range -18.50 to +6.50, n=179/189 eyes). Mean VA was 0.9±0.35 logMAR (range 0.00 to 2.00; n=125/189 eyes). Eighty-six infants (n=151 eyes) were examined at 3 years. Mean refractive error was -5.27±7.89 diopters (range -21.00 to +2.25, n=141/151 eyes). Mean VA was 0.41±0.38 logMAR (range 0.00 to 1.90, n=113/151 eyes).
We report lower rates of unfavorable structural outcomes following laser photocoagulation for type 1 ROP in the decade after ETROP. Our results highlight the value of reporting upon institutional treatment-related outcomes when obtaining informed consent for ROP management. This is particularly important when parents are offered the choice between laser and anti-vascular endothelial growth factor injection as treatment modalities.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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