New Pattern for ROP Laser Treatment Under Fluorescein Angiography Control

Abstract

Purpose: : to retrospectively evaluate the efficacy laser treatment of ischemical areas inside vascularized retina under fluorescein angiography control in addition to traditional photo ablation for severe ROP.

Methods: : starting from Nov' 04 RETCAM digital fundus images and fluorescein angiography were taken in all preterm before laser treatment for ROP. 63 eyes of 32 inborn babies (mean BW: 696gr; mean GA: 26wks), were treated according to ETROP study criteria. After fluorescein angiography, laser photo ablation of avascular retina was performed in a single session. In 12 eyes (3 bilateral and 6 monolateral) we also treated clearly evident ischemical areas inside vascularized retina. Anatomical results of laser treatment were assessed at 6 month of postconceptional age by means of RETCAM examination.

Results: : Favourable and good outcomes (as defined by Cryo-ROP) were achieved in 49 eyes (77.78%), while 14 eyes underwent other treatment due to laser failure. 37 eyes out of 51 eyes that received "classical" photo ablation of avascular retina showed favourable results. Ten out of 12 eyes treated inside the ridge showed favourable results. No differences between eyes were observed in laser results of the 6 babies that received monolateral treatment inside vascularized retina

Conclusions: : using fluorescein angiography before laser treatment for severe ROP we already demonstrate the presence of ischemical area inside the vascularized retina and/or abnormal extension of capillary free zone. Treatment of these areas seems not able to influence photo ablation results. Further randomized and controlled study are required to confirm this hypothesis

Keywords: retinopathy of prematurity • retina