Role of fluorescein angiography guided laser treatment in aggressive retinopathy of prematurity.

Abstract

To compare disease regression in cases of Fluorescein Angiography (FA) guided laser vs. conventional laser treatment in infants with Aggressive retinopathy of prematurity (AROP). 60 eyes of 30 infants of AROP were randomized into two groups. In both the group's FA was done once. Montage of the fundus, FA images was created and the vascular area, avascular areas, and skip areas after laser treatmentwere demarcated and measured. In group 1, FA-guided laser treatment was done whereas in group 2 they were lasered without seeing FA. Infants were followed up every week to look for skip areas and disease regression. The mean vascular retinal area in group 1 and group 2 on fundus images was 302.7 sq. mm and 245.8 sq. mm respectively, while the same on FA was 285.2 sq. mm and 221.3 sq. mm respectively, suggesting overestimation of the vascular area on fundus imaging compared to FA which enabled more objective estimation of avascular loop areas. Retinal skip areas in group 1 and group 2 after 1st laser were 18.7 sq. mm and 73.1 sq. mm respectively (P = 0.001), after 2nd laser was 3.7 sq. mm and 19.2 sq. mm (P = 0.003), which suggests FA-guided laser led to significantly fewer skip areas. Infants had regression in 4.1 ± 0.3 wks and 4.2 ± 0.4 wks in groups 1 and 2, respectively. FA-guided laser ensured lesser skip areas and more complete laser treatment, though regression was similar in both groups.