Anterior Chamber Angle and Anterior Segment Structure of Eyes in Children With Early Stages of Retinopathy of Prematurity

Chang, Shirley H.L.; Lee, Yung-Sung; Wu, Shih Chi; See, Lai‐Chu; Chung, Cheng Han; Yang, Menglin; Lai, Chi-Chun; Wu, Wei‐Chi

doi:10.1016/j.ajo.2017.04.010

Cited by 32 publications

(25 citation statements)

References 40 publications

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“…The only common denominator in all eyes in our series was the presence of an immature trabecular meshwork with high insertion of iris. This finding in preterm babies with ROP was recently reported in a study by Chang et al [14] that showed presence of a narrower anterior chamber angle along with more anteriorly curved iris insertion than in normal full-term neonates. However, they did not comment on any association of their findings with future development of glaucoma.…”

Section: Discussionsupporting

confidence: 80%

Short-term incidence and management of glaucoma after successful surgery for stage 4 retinopathy of prematurity

Chandra

Tewari

Salunkhe

et al. 2019

Indian J Ophthalmol

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Purpose: The purpose of this study is to describe the short-term incidence, clinical features, and management of glaucoma in children after successful surgery for stage 4 retinopathy of prematurity (ROP). Methods: The retrospective study included all eyes undergoing successful surgery for stage 4 ROP with good outcomes at a tertiary eye care center between June 2014 and June 2016. Cases developing postoperative glaucoma underwent examination under anesthesia for measurement of intraocular pressures (IOP), corneal diameters, Retcam-assisted fundus imaging, and gonioscopy. Outcomes of glaucoma management were evaluated. Results: Hundred eyes of 70 babies underwent successful surgery for stage 4 ROP (with postoperative attached retina, and minimal sequelae) with minimum follow-up of 15 months. Six eyes (6%) developed postoperative glaucoma. Of these, four eyes had undergone lens-sparing vitrectomy and two were managed with lensectomy and vitrectomy (LV). Median time duration for development of glaucoma after primary vitreous surgery was 17.5 weeks. Two cases could be managed with topical IOP-lowering agents alone, whereas four required filtering surgeries (trabeculotomy with trabeculectomy and 0.04% mitomycin C [MMC] application). Average IOP decreased from 25 ± 2.36 to 12.2 ± 2.05 mmHg at 12 months from glaucoma diagnosis. Conclusion: Glaucoma is a potential adverse event following successful vitreous surgery for stage 4 ROP. A combined trabeculotomy–trabeculectomy along with MMC gives favorable outcome.

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Section: Discussionsupporting

confidence: 80%

Short-term incidence and management of glaucoma after successful surgery for stage 4 retinopathy of prematurity

Chandra

Tewari

Salunkhe

et al. 2019

Indian J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Development of the trabecular meshwork is not complete until late in gestation, after at least 25 weeks, which makes the angle anatomy susceptible to many factors that can potentially influence risk of angle-closure glaucoma ( 17 ). Other predisposing anterior segment abnormalities observed in premature children, with and without ROP, include steep corneal curvature, decreased anterior chamber depth, anteriorly displaced iris planes, and increased lens thickness ( 10 , 18 – 22 ). Eyes with ROP not requiring treatment as well as ROP-treated eyes have been found to have narrower anterior chamber angles (ACA) than full-term children ( 22 ) or preterm monitored eyes ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

et al. 2021

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Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that occurs due to incomplete development of retinal blood vessels in preterm infants. Glaucoma is an ocular comorbidity in some patients with ROP, and it may be associated with immature anterior chamber development, ROP itself, or the treatment for ROP. There have been a few reports of narrow-angle glaucoma after laser treatment for ROP. In this case report, we describe the course of a female infant born at 24 weeks and 5 days of gestational age with treatment-requiring ROP treated with laser photocoagulation who subsequently developed very elevated intraocular pressure and shallow anterior chambers without pupillary block. The patient required bilateral ab externo trabeculotomy for elevated intraocular pressure, which normalized after the procedure. The patient has remained stable at the last follow-up at 51 weeks postmenstrual age. Differing from previous glaucoma presentations in this setting, we illustrate a case of elevated intraocular pressure and anterior chamber narrowing after laser therapy without pupillary block or synechiae. The possible multifactorial etiology of glaucoma in this patient, including incomplete angle development, ischemia, and laser treatment, highlight the need for glaucoma screening in patients with ROP, both in the short and long term.

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“…Greater lens thickness and shallow anterior chamber depth is commonly seen in preterm babies with the history of ROP than in normal term babies accounting for the myopia. [16] Laser-treated babies tend to develop more myopia compared to babies where disease regressed without intervention. [17] In our study, we did not find significant difference in refractive change between the two groups at 3 months follow-up, possibly because of the small area of additional laser.…”

Section: Discussionmentioning

confidence: 99%

Posterior laser barrage in advancing retinopathy of prematurity: A prospective randomized study

Tewari

Chandra

Agarwal

et al. 2019

Indian J Ophthalmol

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Purpose: To compare the outcomes of conventional laser photocoagulation versus additional posterior barrage laser in advanced stage 3 retinopathy of prematurity (ROP). Methods: A total of 20 infants with bilateral symmetric zone 2 stage 3 advancing ROP were treated with conventional laser treatment followed by randomization of one eye to receive additional posterior retinal laser treatment. Disc–fovea and inter-arcade distance was measured. The patients were followed up prospectively for 3 months. Structural and functional outcomes and safety profile were analyzed. Results: 18/20 (90%) eyes in the study group and 19/20 (95%) eyes in the control group achieved regression of disease. Faster and complete regression was observed at 4 weeks after posterior laser compared to the control group ( P = 0.024). Disc–fovea and inter-arcade distance was comparable in both groups. Conclusion: Additional posterior barrage laser is a safe technique that led to faster and more complete regression in eyes with advancing ROP. Final regression profile was comparable in both treatment modalities.

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Anterior Chamber Angle and Anterior Segment Structure of Eyes in Children With Early Stages of Retinopathy of Prematurity

Cited by 32 publications

References 40 publications

Short-term incidence and management of glaucoma after successful surgery for stage 4 retinopathy of prematurity

Short-term incidence and management of glaucoma after successful surgery for stage 4 retinopathy of prematurity

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

Posterior laser barrage in advancing retinopathy of prematurity: A prospective randomized study

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