Abstract
Abstract: :
Purpose: ET ROP randomised trial (Dec '03) demonstrated that early treatment of high risk type 1 prethreshold ROP reduce risks of laser unfavourable outcomes. We report one year experience using new criteria for ROP treatment. Materials and Methods: 60 preterm children, born between 12/1/’03 and 10/31/’04, were screened for ROP in the neonatal intensive care unit at the Catholic University Hospital in Rome. According to the CryoROP Study, inclusion criteria were: gestational age (GA) ≤32 weeks and/or a birth weight (BW) ≤1500gr plus all preterm judged at risk; all babies were inborn. The mean BW was 1131,1gr (range 460–1900gr) and the mean GA was 29,1 weeks (range 24–33w). These data were compared with previous year (73 preterms born between 12/1/’02 and 10/31/’03; mean BW 1269,4gr, ranging from 500 to 2100gr; mean GA 29,9 weeks, ranging from 24 to –34wks). Results: ROP was diagnosed in 24 preterms (40%; mean BW 935,2gr and mean GA 28,2). 7 babies (11,7%) needed treatment. Three (mean BW 543,3gr; mean GA 25,7wks) were treated at type 1 pre–threshold level: the mean post conceptional age (PCA) at treatment was 32,3 wks. Four (mean BW 967,5gr; mean GA 26,8wks) were treated when "classical" threshold level was reached at 34,0 wks mean PCA. Favourable outcomes (as defined by Cryo ROP) at 1 mo. were achieved in 4 cases on 7. Between 12/1/’02 and 10/31/’03 22 ROP (30%) were diagnosed and 7 (9.6%) required laser at a mean PCA of 34,7 wks ROP treated according to ET ROP guidelines. Favourable laser outcome improved from 42,9% of treated eyes in 2003 to 57,1% in 2004. Conclusions: ET ROP indications for treatment seems particularly suitable for very low birth weight preterms. Although reduction of unfavourable outcome is consistent, these data clearly show that early laser treatment is not a panacea for severe ROP.
Keywords: retinopathy of prematurity • laser