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G. A. Gole, D. J. Gunn, D. Cartwright; ROP Treatment Outcomes in Extremely Low Birth Weight (ELBW) Infants Over an 18 Year Period. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5915.
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© ARVO (1962-2015); The Authors (2016-present)
To report efficacy of diode laser treatment of ROP in ELBW infants between 23 and 25 weeks 6 days (25.6 weeks) gestational age (GA) treated from 1992-2009 by one operator (GG).
Retrospective study of 66 infants treated for ROP. 4286 infants < 32 weeks GA were admitted to RBWH NICU between 1992 and 2009. 561 infants were between 23 and 25.6 weeks GA, 345 survived to undergo screening for ROP (beginning at 32 wks GA). 282 patients were diagnosed with ROP; 66 infants required laser which was applied anterior to the ridge and in some severe cases, posterior to the ridge as well. Patients were reviewed in NICU and then at 6 months, 1 year and then annually.
128 eyes from 66 infants underwent laser treatment with mean gestational age 24.3 weeks, mean birth weight 711.4 g. Fifty-six eyes were treated at pre-threshold disease and 72 eyes at threshold disease. At treatment, 23 eyes had zone one disease, and 15 had aggressive posterior ROP. Over the study period, the number of laser spots and regression rate of ROP increased, while the need to retreat decreased. At 40 weeks 119 eyes had regressed ROP (93%), two advanced to stage 4a, three to stage 4b and four to stage 5. Zone 1 and AP-ROP disease were associated with poorer outcomes. Eight treated infants died before leaving NICU or attending first follow up. No deaths were attributed to examination or laser treatment. Forty-three patients (65%) were followed up for an average of 56.5 months and the mean refractive error was -2.25 D. There was significant correlation between number of laser spots and subsequent refractive error.
Laser diode therapy is a safe and effective technique to halt the progression of most cases of ROP in ELBW infants.
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