Abstract
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that occurs due to incomplete development of retinal blood vessels in preterm infants. Glaucoma is an ocular comorbidity in some patients with ROP, and it may be associated with immature anterior chamber development, ROP itself, or the treatment for ROP. There have been a few reports of narrow-angle glaucoma after laser treatment for ROP. In this case report, we describe the course of a female infant born at 24 weeks and 5 days of gestational age with treatment-requiring ROP treated with laser photocoagulation who subsequently developed very elevated intraocular pressure and shallow anterior chambers without pupillary block. The patient required bilateral ab externo trabeculotomy for elevated intraocular pressure, which normalized after the procedure. The patient has remained stable at the last follow-up at 51 weeks postmenstrual age. Differing from previous glaucoma presentations in this setting, we illustrate a case of elevated intraocular pressure and anterior chamber narrowing after laser therapy without pupillary block or synechiae. The possible multifactorial etiology of glaucoma in this patient, including incomplete angle development, ischemia, and laser treatment, highlight the need for glaucoma screening in patients with ROP, both in the short and long term.
Highlights
Retinopathy of prematurity (ROP) is a disorder of incomplete development of retinal blood vessels in preterm infants [1]
We describe the course of an ex-24week-old female infant who developed very elevated intraocular pressure and shallow anterior chambers without pupillary block at postmenstrual age of 38 weeks following laser treatment in both eyes for type 1 ROP
Given the presentation and exam findings of our patient, it is possible that underlying incomplete development of her anterior segment structure, as well as ROP, may have put her at increased risk for glaucoma that was further exacerbated by ROP laser treatment though no effusions or clear sequelae of this were observed
Summary
Retinopathy of prematurity (ROP) is a disorder of incomplete development of retinal blood vessels in preterm infants [1]. There was significant improvement in the anterior chamber (AC) depth with cycloplegia; the patient required bilateral ab externo trabeculotomy for adequate intraocular pressure control This case highlights that glaucoma in the setting of ROP may be multifactorial and should be regularly screened for in any at-risk infant. Due to concern for inadequate laser and poor fundus view with corneal haze, she was re-referred to our institution Upon reevaluation, she was noted to have cloudy corneas, intraocular pressure (IOP) of 40–45 mmHg, and persistent zone 2, stage 3 ROP, with peripheral laser scars in both eyes (Figure 1). Fundus examination revealed persistent stage 3 ROP with inadequate laser, nasally; the view was still somewhat limited for additional laser photocoagulation (Figure 1) She underwent intravitreal injection of bevacizumab 0.625 mg in both eyes at 39 weeks of PMA. Written informed consent was obtained from the legal guardian of the minor for the publication of any potentially identifiable images or data included in this article
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
