Laser Photocoagulation For Retinopathy Of Prematurity Research Articles

INCIDENCE AND RISK FACTORS FOR EXUDATIVE RETINAL DETACHMENT FOLLOWING LASER PHOTOCOAGULATION FOR RETINOPATHY OF PREMATURITY.

Exudative retinal detachment (ERD) may result from laser photocoagulation for retinopathy of prematurity. Although risk factors have been hypothesized from case reports, comparative studies have not been reported. We sought to evaluate risk factors for ERD following laser, comparing affected and unaffected infants. Retrospective cohort study of infants undergoing retinopathy of prematurity laser at the Children's Hospital of Philadelphia over 6 years. All received near-confluent laser of avascular retina. Demographic, medical, and procedural risk factors for ERD were evaluated in univariate analysis because of the rarity of ERD. Among 149 lasered infants, 6 infants (4%, 95% confidence interval [CI] 1.5%-8.6%) developed ERD. Race was a significant risk factor ( P = 0.01). Among 71 African American or Hispanic infants, 6 (8.5%, 95% CI 3.2%-17.5%) developed ERD. Among 78 non-African American or Hispanic infants, 0 (0%, 95% CI 0%-4.6%) developed ERD. There were no significant differences in the other studied factors. Exudative retinal detachment was uncommon (4%) following retinopathy of prematurity laser. Despite so few cases, darker pigmented race with likely increased pigmented fundi was significantly associated with an increased ERD risk. Further study may reveal whether increased choroidal pigment causes greater laser tissue damage or makes it difficult to discern the ora, resulting in inadvertent lasering of the ciliary body, leading to ERD.

Macular Hole as a Complication Following Laser Photocoagulation for Retinopathy of Prematurity.

Complications after laser photocoagulation for retinopathy of prematurity (ROP) are rare but do occur. To the best of our knowledge, we report a previously unreported case of a unilateral macular hole that developed after resolution of an exudative retinal detachment that resulted from laser photocoagulation for ROP. Confluent laser patterns in ROP in infants who have previously received intravitreal anti-vascular endothelial growth factor may result in adverse outcomes such as exudative retinal detachments. Even more rarely, a macular hole may develop. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:510-512.].

Retinal choroidal and retinal nerve fiber layer thickness in former preterm and full-term infants aged 4 to 8years.

To compare the retinal thickness at the fovea center, peripapillary retinal nerve fiber layer (RNFL) thickness and choroidal thickness (CT) in former preterm and full-term infants. A total of 121 healthy children aged 4-8years were divided 4 groups: group 1; children born on time, group 2; preterm children without a history of retinopathy of prematurity (ROP), group 3; preterm children with a history of spontaneously regressed ROP and group 4; preterm children who underwent diode laser photocoagulation for ROP. The retinal thickness at the fovea, peripapillary RNFL thickness at global, superior, inferior, nasal and temporal quadrants and submacular CT at 7 different points were measured by using spectral-domain optical coherence tomography. The mean retinal thickness at the fovea center was statistically higher, whereas the mean RNFL thickness values in global, nasal, superior and inferior quadrants were statistically lower in group 4. No difference was found in the mean submacular CT value of any point between the groups. Transpupillary diode laser photocoagulation treatment for ROP seems to cause an increase in macular thickness and a decrease in RNFL thickness.

Comparison of Bevacizumab, Ranibizumab, and Laser Photocoagulation in the Treatment of Retinopathy of Prematurity in Turkey

ABSTRACTPurpose: To evaluate the efficacies and treatment outcomes following intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR), and laser photocoagulation (LPC) in retinopathy of prematurity (ROP).Methods: This was a retrospective interventional case series study including the data of 134 infants (264 eyes) who were treated with IVB, IVR, or LPC for ROP. The data were collected from two major ROP treatment centers in Turkey without any randomization or masking. Regression of ROP, recurrence profile, complications after each treatment modality, and indications for retreatment were evaluated. The main outcome measures included the total inactivation of ROP with anatomic and refractive outcomes at 1.5 years of adjusted age.Results: There were 55 infants (41.1%) in the IVB group, 22 infants (16.4%) in the IVR group, and 57 infants (42.5%) in the LPC group. All but 3 infants (5.5%) in the IVB group and 11 infants (50%) in the IVR group showed recurrence to stage 1 and 2 ROP following IVB and IVR (p < 0.001). Retreatment was performed in three infants in both IVB and IVR groups (p = 0.098). At 1.5 years of adjusted age, all infants showed favorable anatomic outcome except one infant in the LPC group. No significant difference of the mean spherical equivalent (SE) was observed between the groups (p = 0.131). In Zone I ROP, laser treated infants had significantly higher rates of myopia and high myopia than IVB and IVR treated infants (p = 0.040 and p = 0.019, respectively).Conclusions: Both IVB and IVR treated infants had significantly better refractive outcomes in Zone I ROP as compared to LPC treated infants at 1.5 years of adjusted age. The higher rate of disease recurrence was associated with IVR. Gestational age (GA) and the zone of ROP were also predictive factors for recurrence of ROP in the study.

Systemic Steroid for Exudative Retinal Detachment Following Laser Photocoagulation for Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is one of the causes of blindness in childhood. The treatment modalities of this disease are laser photocoagulation (LP) and/or intravitreal anti-VEGF agents. But there are many side effects of the laser treatment such as lens opacity, iris and cornea burns, retinal and choroidal hemorrhages. Exudative retinal detachment (ERD) has been reported as a rare complication of LP for the treatment of ROP. But there is no consensus about how to treat of this condition. Here we present a case of ERD after LP for ROP although appropriate laser settings and successfully treated by systemic steroid administration.

Treatment for retinopathy of prematurity in an infant with adenoviral conjunctivitis.

Retinopathy of prematurity (ROP) has been a major problematic disorder during childhood. Laser photocoagulation (LPC) has been proven to be effective in most of the ROP cases. Adenoviral conjunctivitis (AVC) is responsible for epidemics among adult and pediatric population. It has also been reported to be a cause of outbreaks in neonatal intensive care units (NICU) several times. We herein demonstrate a case with AVC who underwent LPC for ROP. And we discuss the treatment methodology in such cases.

One-year clinical outcome after laser treatment for retinopathy of prematurity at a tertiary center in Turkey.

The purpose of the study is to evaluate the clinical outcome of laser photocoagulation (LPC) in the treatment of retinopathy of prematurity (ROP) at a referral hospital in Turkey. In this retrospective study, a chart review of infants who underwent LPC for ROP between June 2011 and June 2013 was done. Clinical and demographic characteristics, laser parameters, anatomic, and refractive outcomes were evaluated. Totally 113 infants (202 eyes) were enrolled in the study. Of the 202 eyes, 29 eyes had threshold ROP, 141 eyes had prethreshold ROP, and 32 eyes had aggressive posterior ROP (APROP) at initial interventions. The mean gestational age (GA) was 28.13 ± 1.99 weeks (range between 24 and 33 weeks), the mean birth weight (BW) was 1,147.77 ± 341.77 g (range between 530 and 2,000 g) and the mean postmenstrual age (PMA) at first laser treatment time was 35.79 ± 1.74 weeks (range between 33 and 39 weeks). The mean number of laser spots (NLS) applied for each eye was 1,358.05 ± 369.91. Eyes with APROP had higher number of NLS than eyes with threshold ROP and prethreshold ROP (P < 0.01). Anatomic outcome was favorable for 171 eyes (84.7 %) at the end of the 1-year follow-up. Refractive data were available for 56 infants (100 eyes). The mean refractive error was 0.00 ± 2.48D SE. The incidence of high myopia (>5D) and strabismus was 2 and 14.3 %, respectively. Laser photocoagulation is an effective therapy for ROP. Early and appropriate laser treatment improves the clinical outcome of the disease.

Diode laser photocoagulation of retinopathy of prematurity

ObjectiveTo describe diode laser photocoagulation results in retinopathy of prematurity (ROP) in our hospital. Material and methodRetrospective cross-sectional study based on clinical histories of the premature infants treated during the period from 2004 to 2008. ResultsIn the treated group we found a predominance of pre-threshold retinopathy versus threshold retinopathy (84.35% vs 15.65%). The anatomic results were good in 96.5% of 147 eyes. None of the treated eyes in pre-threshold stage showed a poor result. Nine months after treatment, 84.85% of 132 eyes showed good functional results. A poor visual response was associated in most of the cases with neurological diseases. Infants with intraventricular hemorrhages had the worst anatomical and functional results. Strabismus (23.5%) and nystagmus (10.3%) rates were high, probably due to the increased prevalence of neurological diseases. The mortality rate in treated children was 7.3%. ConclusionsDiode laser photocoagulation in ROP offers very good anatomical results when performed at the appropriate time. Nevertheless, prematurity is still a very important cause of visual dysfunction in infancy due to the associated neurological disturbances.

Fotocoagulación con láser de diodo en la retinopatía del prematuro

Objective To describe diode laser photocoagulation results in retinopathy of prematurity (ROP) in our hospital. Material and method Retrospective cross-sectional study based on clinical histories of the premature infants treated during the period from 2004 to 2008. Results In the treated group we found a predominance of pre-threshold retinopathy versus threshold retinopathy (84.35% vs 15.65%). The anatomic results were good in 96.5% of 147 eyes. None of the treated eyes in pre-threshold stage showed a poor result. Nine months after treatment, 84.85% of 132 eyes showed good functional results. A poor visual response was associated in most of the cases with neurological diseases. Infants with intraventricular haemorrhages had the worst anatomical and functional results. Strabismus (23.5%) and nystagmus (10.3%) rates were high, probably due to the increased prevalence of neurological diseases. The mortality rate in treated children was 7.3%. Conclusions Diode laser photocoagulation in ROP offers very good anatomical results when performed at the appropriate time. Nevertheless, prematurity is still a very important cause of visual dysfunction in infancy due to the associated neurological disturbances.

Technical aspects of laser treatment for acute retinopathy of prematurity under topical anesthesia

Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. The criteria for laser therapy have been revised from threshold ROP to include the earlier stage of high-risk prethreshold ROP. Laser photocoagulation is an established technique for the treatment of ROP. However, the detailed procedure and techniques for laser photocoagulation have not yet been published. Adequate and appropriate laser photocoagulation for ROP is different from the application of lasers in adult retinal vascular diseases, and many ophthalmologists need to be trained in this technique if the outreach of ROP treatment programs is to improve. Laser under topical anesthesia has been practiced in India as a preferred modality especially due to logistics and risks of general anesthesia in these pre-term babies. We discuss the details of the technique as practiced at tertiary care ophthalmic hospitals in India, so that the nuances in treatment parameters and clinical decision-making can be usefully applied to ophthalmic practice. This will ultimately lead to safe and effective treatment delivery in ROP.

Case series of angle-closure glaucoma after laser treatment for retinopathy of prematurity

Laser photocoagulation is the current treatment standard for severe retinopathy of prematurity (ROP). Uncommon, but well recognized complications include cataract, and vitreous and retinal hemorrhage. Angle-closure glaucoma after laser photocoagulation for ROP is rare. The purpose of this study was to identify additional cases of angle-closure glaucoma following laser treatment for ROP. Five eyes of four patients with angle-closure glaucoma following laser treatment for ROP were identified by three ophthalmologists at separate institutions between 1997 and 2001. Demographic and clinical data were obtained from medical records. Clinical and surgical findings associated with the diagnosis and management of angle-closure glaucoma following ROP laser were evaluated. The following data were collected (mean (range)): gestational age, 26.8 (24 to 29) weeks; birth weight, 833 (570 to 1062) g; age at laser treatment for ROP, 35 (33 to 37) weeks; number of laser burns, 1598 (930 to 2400); and time to diagnosis of angle-closure glaucoma, 3.6 (2 to 5) weeks. Three of five eyes had objective data for intraocular pressure (IOP) and corneal diameter with mean IOP 41 mm Hg (35 to 44) and mean corneal diameter 11.1 mm (10.25 to 11.5). Initial treatment included topical and systemic medications. Three eyes required surgical intervention. Angle-closure resolved in all cases with normalization of IOP. Follow-up (5 months to 3.6 years) showed that affected eyes tended to be more myopic than unaffected fellow eyes (mean spherical equivalent -6.5 vs -4.7 diopters). Angle-closure glaucoma can develop following laser treatment for severe ROP. Medical, and frequently surgical, intervention provides effective management.

Laserphotocoagulation for retinopathy of prematurity

Die Evaluierung der Laserkoagulation als Behandlungsmethode der Retinopathia pramaturorum. Neunzehn konsekutive Patienten mit Retinopathia pramaturorum, bei denen eine Laserkoagulation zwischen 1997 und 2002 an der Augenklinik Innsbruck durchgefuhrt worden war, wurden untersucht. Insgesamt wurden 37 Augen einer Laserkoagulation unterzogen, die entweder als transsklerale oder transpupillare Methode ausgefuhrt wurde. Folgende Daten wurden untersucht: Grad der ROP pra- und postoperativ, Geburtsgewicht und perioperative und postoperative Komplikationen. In 97,3% der behandelten Augen kam es zu einer Regression der ROP. Eine Progression auf Grad IV B wurde in einem Auge beobachtet. Auch nach Legen eines Gurtelfadens kam es zu keiner Stabilisierung, sodass eine Vitrektomie durchgefuhrt werden musste. Als perioperative Komplikationen wurden Hamorrhagien in 20,6% beobachtet und in einem Auge kam es zu einer Linsentrubung. Die Laserkoagulation zur Behandlung der ROP erwies sich in unserer Studie als effiziente Methode, die zur Regression der ROP fuhrte. To report the structural outcome after laser photocoagulation for retinopathy of prematurity (ROP). Nineteen consecutive patients who had undergone photocoagulation for ROP between 1997 and 2002 at our clinic were examined. A total of thirty-seven eyes received either transscleral or transpupillary laser treatment. Data consisted of grade of ROP pre- and postoperatively, birth-weight, perioperative and postoperative complications. 97.3% of all eyes responded to laser treatment with regression of ROP. Only one eye out of thirty-seven progressed to stage 4B despite photocoagulation and therefore an encircling procedure was performed. After further progression the eye had to have a vitrectomy. Perioperative complications included hemorrhages in 21.6% that resorbed spontaneously and cataract formation in one eye (2.7%). Photocoagulation for ROP in our patients resulted in regression of threshold ROP.

Laser therapy for retinopathy of prematurity.

Nine patients were treated with indirect ophthalmoscope argon laser photocoagulation for threshold retinopathy of prematurity (ROP). A total of 16 eyes were treated at an average postconceptional age of 36.31 weeks. All eyes demonstrated regression of threshold ROP. Follow up was between 1 and 14 months postoperatively. Laser photocoagulation for ROP may be an effective alternative in treating high risk levels of ROP.