Diode Laser Photocoagulation for Retinopathy of Prematurity

Abstract

Objective: The purpose of this study was to determine the effectiveness of laser photocoagulation in eyes with threshold retinopathy of prematurity (ROP), defined as stage 3+, zone 2, with 5 or more contiguous or 8 cumulative clock hours of extraretinal fibrovascular proliferation.Methods: Indirect ophthalmoscopic retinal examinations were performed on 18 premature infants born between 1991 and 1993 to identify those eyes with threshold ROP. Diode laser was used to treat 31 eyes within 48 hours of diagnosis. Each patient was followed post treatment at weekly intervals until regression was starting to occur. Subsequent follow-up visits were tailored to each patient.Results: During the 41 to 60 month follow-up (average 49 months, median 46 months), 27 of 31 lasered eyes (87%) demonstrated regression of the extraretinal neovascularization, and 26 (84%) had functional vision. This includes two Stage 4B eyes that were reattached with scleral buckles. Twenty-two eyes (71%) were myopic and four (13%) progressed to stage 5 retinal detachment that could not be repaired. No cataracts occurred in this group of patients.Conclusions: Although a potentially blinding disorder, threshold ROP is, in many cases, treatable with laser photocoagulation, which may be easier to administer than cryotherapy. Follow-up of patients treated with diode laser demonstrates that functional vision is attainable.

Diode laser treatment of pre‐threshold and threshold retinopathy of prematurity

“…Diode laser (wavelength 810 nm) has been used in the treatment of retinopathy of prematurity since 1991 and has been shown to have a good safety profile 2,11−13 . This finding is consistent with our case series.…”

Diode laser treatment of pre‐threshold and threshold retinopathy of prematurity

“…Diode laser (wavelength 810 nm) has been used in the treatment of retinopathy of prematurity since 1991 and has been shown to have a good safety profile 2,11−13 . This finding is consistent with our case series.…”

Role of Panretinal Photocoagulation in Improvement of Visual Acuity of Patients with Proliferative Diabetic Retinopathy

“…The 73.2% patients with 6/9 or more visual acuity at first visit maintained it at five sitting follow-up while the 14.3% with visual acuity of < than 6/9 manifested poor vision post PRP by then. Our study subjects receiving PRP showed gender equality along with a strong association of outcome of PRP to age , duration of diabetes ,usage of insulin ,lipid profile,FBS, proteinuria,HbA1c along with a negative association to the other diabetic complications like neuropathy, hypertension and nephropathy which is similar to the results of WHO Multinational Study of vascular disease in diabetes [27][28][29]. An association with reduction in visual acuity and PDR was elicited.…”

Multicenter Trial of Cryotherapy for Retinopathy of Prematurity

“…It is likely that the results of the CRYO-ROP study are relevant to laser treatment for severe ROP, because other studies have suggested that results obtained with laser therapy are similar to those with cryotherapy. [14][15][16][17][18][19] Consistent with our previous reports, [3][4][5] the results at age 10 years indicate a significantly beneficial effect of cryotherapy on visual acuity (PϽ.001) and on the anatomic status of the posterior pole of the fundus (PϽ.001) in eyes that develop severe (defined threshold) ROP during the neonatal period. A detailed list of findings from ophthalmologic examination (Table 4) supports the beneficial effects of cryotherapy for eyes with threshold ROP.…”

Diode laser treatment of pre‐threshold and threshold retinopathy of prematurity

“…Diode laser (wavelength 810 nm) has been used in the treatment of retinopathy of prematurity since 1991 and has been shown to have a good safety profile 2,11−13 . This finding is consistent with our case series.…”

Role of Panretinal Photocoagulation in Improvement of Visual Acuity of Patients with Proliferative Diabetic Retinopathy

“…The 73.2% patients with 6/9 or more visual acuity at first visit maintained it at five sitting follow-up while the 14.3% with visual acuity of < than 6/9 manifested poor vision post PRP by then. Our study subjects receiving PRP showed gender equality along with a strong association of outcome of PRP to age , duration of diabetes ,usage of insulin ,lipid profile,FBS, proteinuria,HbA1c along with a negative association to the other diabetic complications like neuropathy, hypertension and nephropathy which is similar to the results of WHO Multinational Study of vascular disease in diabetes [27][28][29]. An association with reduction in visual acuity and PDR was elicited.…”

Multicenter Trial of Cryotherapy for Retinopathy of Prematurity

“…It is likely that the results of the CRYO-ROP study are relevant to laser treatment for severe ROP, because other studies have suggested that results obtained with laser therapy are similar to those with cryotherapy. [14][15][16][17][18][19] Consistent with our previous reports, [3][4][5] the results at age 10 years indicate a significantly beneficial effect of cryotherapy on visual acuity (PϽ.001) and on the anatomic status of the posterior pole of the fundus (PϽ.001) in eyes that develop severe (defined threshold) ROP during the neonatal period. A detailed list of findings from ophthalmologic examination (Table 4) supports the beneficial effects of cryotherapy for eyes with threshold ROP.…”

Diode laser treatment of pre‐threshold and threshold retinopathy of prematurity

“…Diode laser (wavelength 810 nm) has been used in the treatment of retinopathy of prematurity since 1991 and has been shown to have a good safety profile 2,11−13 . This finding is consistent with our case series.…”

Role of Panretinal Photocoagulation in Improvement of Visual Acuity of Patients with Proliferative Diabetic Retinopathy

“…The 73.2% patients with 6/9 or more visual acuity at first visit maintained it at five sitting follow-up while the 14.3% with visual acuity of < than 6/9 manifested poor vision post PRP by then. Our study subjects receiving PRP showed gender equality along with a strong association of outcome of PRP to age , duration of diabetes ,usage of insulin ,lipid profile,FBS, proteinuria,HbA1c along with a negative association to the other diabetic complications like neuropathy, hypertension and nephropathy which is similar to the results of WHO Multinational Study of vascular disease in diabetes [27][28][29]. An association with reduction in visual acuity and PDR was elicited.…”

Multicenter Trial of Cryotherapy for Retinopathy of Prematurity

“…It is likely that the results of the CRYO-ROP study are relevant to laser treatment for severe ROP, because other studies have suggested that results obtained with laser therapy are similar to those with cryotherapy. [14][15][16][17][18][19] Consistent with our previous reports, [3][4][5] the results at age 10 years indicate a significantly beneficial effect of cryotherapy on visual acuity (PϽ.001) and on the anatomic status of the posterior pole of the fundus (PϽ.001) in eyes that develop severe (defined threshold) ROP during the neonatal period. A detailed list of findings from ophthalmologic examination (Table 4) supports the beneficial effects of cryotherapy for eyes with threshold ROP.…”