Retinopatia da prematuridade: achados refrativos pós-tratamento com crioterapia ou laser

Abstract

Retinopathy of prematurity: refractive errors in patients treated with cryotherapy or laserPurpose: To examine the spherical equivalent of refractive errors in preterm children with threshold retinopathy of prematurity treated with cryotherapy or laser.Patients and Method: A group of 14 one-year-old children (selected from 761 preterm children born at the Hospital São Paulo of the Universidade Federal de São Paulo between 1988 and 1998) with stage 3 threshold retinopathy of prematurity treated with cryotherapy or laser photocoagulation was enrolled in the study and the spherical equivalent under cycloplegia was analyzed. Statistical analysis of the results was performed using Wilcoxon and Mann-Whitney tests.Results: 64.3% of the patients developed myopia. Of the patients who were treated with cryotherapy 80% showed high myopia and 20% low hyperopia. The mean of the spherical equivalent was -3.10 D in the right and -3.25 D in the left eye. There was no statistically significant difference between the two eyes regarding the refractive outcome. Concerning patients treated with laser, 55.6% showed myopia of which 20% was high myopia and 80% low myopia; 11.1% showed no refractive error and 33.3% developed low hyperopia. The mean of the spherical equivalent was -0.58 D in the right eye and -0.83 D in the left eye. A statistically significant diference was found between the two eyes. The correlation of refractive results in both groups of patients showed an increase in the amount of high degree myopia in patients treated with cryotherapy (P<0.05).Conclusions: Myopia is a frequent finding in children treated for retinopathy of prematurity. Myopia not only is more frequent but it appears with higher degrees in children treated with cryotherapy as compared with those treated with laser. Retinopatia INTRODUCTIONRetinopathy of prematurity is a vascular disease related to retinal blood vessel formation affecting preterm newborns and its severity presents an inversely proportional relation to gestational age and weight at birth 1, 2 .At present, advances in neonatology allow survival of children with extremely low gestational age and weight at birth, leading to an increase in the number of patients with ocular alteration 3 , especially retinopathy of prematurity. -ARQ. BRAS. OFTALMOL. 63(5), OUTUBRO/2000Retinopathy of prematurity: refractive errors in patients treated with cryotherapy or laser Different authors 3-8 reported a higher predisposition to ametropia, specially myopia, in children who presented retinopathy of prematurity. Differences in the refractive value according to the severity of retinopathy 5 and to the type of performed treatment, cryotherapy or lasertherapy, were also found 7,8 . The purpose of this study is: -To determine the refractive characteristics of a population consisting of preterm children born at the Hospital São Paulo, Escola Paulista de Medicina -Universidade Federal de São Paulo, who presented retinopathy of prematurity and were submitted to treatment; -To compare the type of refractive error...