Fluorescein angiography in the management of ROP occurred at a late postmenstrual age: our experience on seven premature infants

Abstract

AbstractPurpose To report author’s management with digital camera fluorescein angiography (FA) of Type 1 retinopathy of prematurity (ROP) developed after 45 weeks of postmenstrual age (PMA).Methods Retrospective non comparative case series consisting of seven prematurely born infants with Type 1 ROP that falls outside of usual time line for the disease (PMA > 45 weeks).Results 212 premature infants with gestational age ≤ 30 weeks underwent ROP screening between January 2009 and December 2013 at Neonatal Pathology Department at San Matteo Hospital in Pavia. ROP was found in 86 babies (172 eyes, 40%) and 28 of these (56 eyes, 20.6%) were treated with laser photocoagulation. 14 eyes of 7 children developed temporal peripheral ROP (stage 2, zone 3) between 45 and 50 weeks of PMA and were included in our study. The mean gestational age for this subgroup was 27,8 weeks and mean birth weight was 864 g. Diagnosis and management were performed with indirect ophthalmoscopy, RetCam 3 and digital video FA. In 7 eyes ROP was treated with laser fotocoagulation at 47‐48 weeks PMA, while in 7 eyes regressed spontaneously with full retinal vascularisation between 48‐54 weeks PMA.Conclusion Although rare, Type 1 ROP may occur lately, after 45 weeks PMA. It is insidious because unexpected and located in extreme retinal periphery. In our experience, FA images were very useful to study the clinical features of ROP and to reveal us whether retinopathy was progressing towards threshold disease or regressing. Fluorescein Angiography lead our decisional choose: to perform laser treatment or go on with closely observation over time until the complete retinal peripheral vascularisation.