Abstract
Abstract: :
Purpose: To evaluate the physical findings of ROP exams and treatment outcomes during a 24 month period at the Cleveland Clinic NICU to compile a data base as a resource for ROP investigations. Methods: Exams were performed on children between 5–7 weeks of life for any infant less than 1500 grams birth weight or 32 weeks gestational age or unstable clinical course or 24 hours of oxygen therapy. A retrospective chart review of exams was conducted to analyse gestational age, birth weight, Zone, Stage, threshold disease, treatment and final outcome. Results: Total exams were 521 with new exams numbering 240 (2.2 exams per patient). Average birth weight was 750 grams (range 400–1700 grams). Average gestational age was 25 weeks (range 23–32 weeks). Fifty percent of eyes developed ROP, 18.3 % of those eyes developed threshold disease (9.1 % overall) and were treated with diode laser indirect ophthalmoscopy. One eye (1/44 eyes, 2.3%) progressed to stage IVb detachment after treatment. No infant developed bilateral unfavorable outcome. Zone I eyes were treated with laser if 4/4 plus disease was noted with any ROP. Zone 2 eyes were treated at standard threshold disease. All threshold infants were average 24 weeks gestational age and 503 grams birth weight. Average corrected gestational age at time of treatment was 34 weeks. Thirty–three percent of threshold eyes were Zone I. Conclusions: Zone I disease comprises an increasing percentage of threshold ROP. Our data suggests that the rate of unfavorable outcomes can be reduced to less than 3 % in level III nursery if Zone I eyes are treated when 4/4 plus disease with any ROP is noted.
Keywords: retinopathy of prematurity • laser • clinical (human) or epidemiologic studies: outcomes/complications