Abstract
Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
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.