Purchase this article with an account.
Robert Koucheki, Maram Isaac, Nasrin Najm Tehrani, Kamiar Mireskandari; Outcomes and Risk Factors for Treatment of Stage 3 Retinopathy of Prematurity Persisting Beyond 40 Weeks of Post Menstrual Age. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5534.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
A retrospective chart review was performed to evaluate structural outcomes of infants with stage 3 (S3) retinopathy of prematurity (ROP) persisting beyond 40 weeks of post menstrual age (PMA) and to identify morphological risk factors in infants who required treatment.
We reviewed charts of all premature infants screened from January 2004 to July 2015. All infants with S3 ROP persisting beyond 40 weeks of PMA were included. Infants treated before 40 weeks of PMA were excluded. We collected data on patients’ demographics and ROP parameters at first, most severe and at last diagnosis of S3 ROP. We also collected data on structural outcome at last follow up as defined by ETROP criteria. In addition, the presence or absence of macular drag was noted. We performed univariate and multivariate analyses on risk factors associated with requiring treatment.
Out of 2356 screened infants, 115 infants (172 eyes) met inclusion criteria. Thirty-three eyes (19.2%) required laser photocoagulation treatment and 139 eyes (80.8%) were observed. Sixteen eyes (9.3%) were treated for type 1 ROP. Seventeen eyes (9.9%), did not meet type 1 criteria and were treated for persistent temporal band of S3 (PTB-S3 group). When the observed group was compared to the PTB-S3 treatment group; multiple births (OR 3.86, 95% CI (1.05, 14.2), p=0.04), two or more clock hours of S3 (OR 26.74, 95% CI (1.52, 469.29), p=0.025), having vascular tortuosity and/or preplus at most severe diagnosis of ROP (OR 19.08, 95% CI (1.09, 334.81), p=0.044) were the risk factors for receiving treatment. No eye in both treated and observed groups had unfavorable structural outcome. 10/17 eyes that were treated for PTB-S3 and 1/139 eyes of the observed group had a macular drag. Temporal band of S3 crossing the horizontal midline (OR 19.74, 95% CI (1.12, 348.7), p<0.04) was statistically significant risk factor for having a macular drag.
In this cohort, stage 3 ROP persisting beyond 40 weeks of PMA was uncommon and associated with favorable structural outcome. Less than a tenth reached type 1 ROP. A similar number were treated for a persistent temporal band with high risk for macular drag. Persistence of a temporal band of S3 that extends more than two clock hours and crosses the horizontal midline were important factors for considering treatment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only