Retinopathy of prematurity (ROP) is a significant cause of potentially preventable blindness in preterm infants worldwide. It is a disease caused by abnormal retinal vascularization that, if not detected and treated in a timely manner, can lead to retinal detachment and severe long term vision impairment. Neonatologists and pediatricians have an important role in the prevention, detection, and management of ROP. Geographic differences in the epidemiology of ROP have been seen globally over the last several decades because of regional differences in neonatal care. Our understanding of the pathophysiology, risk factors, prevention, screening, diagnosis, and treatment of ROP have also evolved over the years. New technological advances are now allowing for the incorporation of telemedicine and artificial intelligence in the management of ROP. In this comprehensive update, we provide a comprehensive review of pathophysiology, classification, diagnosis, global screening, and treatment of ROP. Key historical milestones as well as touching upon the very recent updates to the ROP classification system and technological advances in the field of artificial intelligence and ROP will also be discussed.
A
bstract
Aim
To describe the current practice patterns and perceptions of Canadian ophthalmologists using laser trabeculoplasty (LTP).
Materials and methods
A cross-sectional survey of 124 members of the Canadian Ophthalmological Society (COS) who perform LTP was conducted. Descriptive statistics and Chi-square comparative analyses were performed on anonymous self-reported survey data.
Results
Of the 124 respondents, 34 (27.4%) completed a glaucoma fellowship. Use of selective laser trabeculoplasty (SLT) (94.4%) was preferred over argon laser trabeculoplasty (ALT) (5.6%). The most frequently cited reasons for SLT preference was less damage to trabecular meshwork (30.7%), availability (16.2%), and repeatability (16.2%). In all, 47.6% of the respondents performed LTP concurrently with medical treatment, 33.9% used it after medical treatment, and 17.7% used it as first-line treatment. Majority (87.1%) of the respondents believed that SLT is effective when repeated. In suitable patients, 41.9% of the respondents stated on average they repeat SLT once, 26.6% twice, and 19.4% greater than 2 times, respectively. Of those who repeat SLT on patients, 80.7% found repeat SLT treatments have good outcomes for patients. In all, 105 (84.7%) ophthalmologists responded they would benefit from an LTP practice guideline. Significantly more ophthalmologists without glaucoma fellowships perceived they would benefit from a practice guideline (
p
value <0.001).
Conclusion
This survey provides valuable practical information on how LTP is used in the treatment of glaucoma in Canada.
Clinical significance
The findings may serve as a baseline survey to trend future practices.
How to cite this article
Lee EY, Farrokhyar F, Sogbesan E. Laser Trabeculoplasty Perceptions and Practice Patterns of Canadian Ophthalmologists. J Curr Glaucoma Pract 2020;14(3):81–86.
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