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D. Lepore, M. M. Pagliara, F. Molle, A. Baldascino, C. Angora, L. Orazi, F. Lafranceschina, R. De Santis, G. D'Amico, E. Balestrazzi; The Importance of ROP Extension Inside Zone I. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3110.
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CryoROP and ETROP showed that zone I ROP has the worst structural and functional results. 77.8% - 55.2% of zone I ROP progress to RD despite treatment. All multicenter studies consider zone I ROP with an involvement as little as 1 o’clock hour in the most posterior zone. The aim of this study was to retrospectively evaluate the correlation between ROP extension within zone I and laser outcomes.
starting from Nov‘04 until Sep ’06 RETCAM digital fluorescein angiography (Massie Lab. , Pleasanton, CA) became available for ROP screening in the neonatal intensive care unit at the Catholic University Hospital in Rome. Until Sep ‘06 135 inborn preterm with gestational age (GA) ≤32 wks and/or a birth weight (BW) ≤1500gr were screened for ROP. The mean BW was 1176.3 gr. (range 550-2150gr.) and the mean GA was 29.4 wks (range 24-33wks). According to ET ROP 32 eyes (16 babies; mean BW 706.6 gr., mean GA 26.6wks) type1 ROP in zone I were treated. Digital fundus images and fluorescein angiography were taken before treatment. We retrospectively analyse the whole retina to establish the exact ROP location for each o’clock hour. Three months structural outcomes were also evaluated.
although high quality fundus images and fluorescein angiography are helpful, it is sometimes difficult to recognise the macula and define zone I. Retinopathy involved a mean of 5 o’clock hours in zone I (ranging from 1 to 10). Favourable outcomes were never obtained with more than 7 hours of ROP in zone I. Outcomes statistically correlates with ROP extension in zone I.
our study clearly show that not all zone I ROP are the same. Only when the most posterior location involves less than 8 hours ROP is clinically responsive to laser. This data support the need to modify the ICROP definition of zone I.
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