Effects of Early Treatment of Retinopathy of Prematurity at a Tertiary Care Hospital in Saudi Arabia: A Retrospective Study

Abstract

Purpose: To estimate the prevalence of retinopathy of prematurity (ROP) among high-risk neonates and to illuminate the benefits of early treatment in type 2 ROP (zone II, stage 3 without plus) and ROP milder than type 1 with pre-plus disease (zone III, stage 3). Methods: This retrospective cross-sectional study was conducted among 307 high-risk neonates (614 eyes) with a gestational age of 32 weeks or younger at birth and a birth weight of 1,500 g or less, from 2011 to 2016. Treatment was initiated for neonates with low-risk type 2 ROP and ROP milder than type 1 with pre-plus disease, whenever retinopathy was evident for 3 clock hours with or without vitreous hemorrhage. Post-treatment progression was recorded. Results: The prevalence of ROP in the current study was 33.71%. Two hundred seven eyes had ROP; 47.34% had mild retinopathy that did not require treatment, and 52.66% received laser treatment, including the early treated group. Of the 207 eyes with ROP, 46.86% had low-risk type 2 ROP disease and ROP milder than type 1 with pre-plus disease, and underwent photocoagulation therapy. After treatment, 15.38% and 10.71% eyes were stable, 84.62% and 88.10% eyes had regressed retinopathy, and 0% and 1.19% progressed in both groups, respectively. Conclusions: Early treatment of type 2 ROP and ROP milder than type 1 with pre-plus disease in certain cases significantly decreased the rate of progression to more advanced stages and resulted in good clinical outcomes. [ J Pediatr Ophthalmol Strabismus . 2021;58(4):240–245.]

Refractive Changes among Diode Laser-treated Retinopathy of Prematurity Patients: A Retrospective Study

“…In the present study, earlier treatment for ROP was adapted in our center, based on a previous study done on our population that highlighted the benefit of early treatment of type 2 ROP and ROP milder than type 1, in which they had significantly decreased rates of progression to more advanced stages and had resulted in good clinical outcomes. [ 23 ] In our study, the hyperopic trend that was noted in our patients could be related to the early quantification of spherical equivalence in terms of follow-up visits. In subsequent years, our patients may develop more levels of myopia attributed to the normal expected emmetropization that should ensue throughout the years.…”

“…Early treatment has been adopted in our center based on a previous study done on our population which reported the benefit of early treatment of type 2 ROP and ROP milder than type 1. [ 23 ] The ETROP study findings provided definite guidelines for the treatment of ROP; however, despite the well-defined criteria for treatment, experts in ROP also highlighted the clinical implications and recommended treatment for patients with less than type 1 ROP in previous multicenter studies. [ 24 25 ] ROP experts in those studies also highlighted the importance of clinical judgment in individual cases which are not covered by treatment guidelines.…”