Efficacy and safety of green laser photocoagulation for threshold retinopathy of prematurity

Lira, Rodrigo Pessoa Cavalcanti; Calheiros, Antônio Bezerra de Melo; Oliveira, Cristiano Viana de; Viana, Sabrina Lima Siqueira; Lima, Danielle Cabral

doi:10.1590/s0004-27492008000100010

Cited by 15 publications

(20 citation statements)

References 19 publications

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“…8,9 In our study we did not have babies with APROP. Present study had 100% favourable outcome and followed the ETROP guidelines and is comparable with Lira et al 10 (96.7%) and Sanghi G 11 (97%).…”

Section: Discussionsupporting

confidence: 88%

Prospective Observational Study of Retinopathy of Prematurity in a Tertiary Care Hospital, Tirupati

Sivaramudu¹,

Sravya²,

Mrudula³

et al. 2019

jebmh

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BACKGROUND Retinopathy of prematurity (ROP) is a potentially blinding vasoproliferative disorder of the retina with abnormal proliferation of blood vessels at the junction of vascular and avascular retina occurring in preterm low birthweight infants. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. METHODS This is a hospital based prospective observational study done from October 2017 to September 2018 on all babies with gestational age less than 35 weeks and birthweight less than 1750g admitted in NICU, SVRRGGH, Tirupati during the study period. The babies were registered by optometrist and taken to the ophthalmologist for detailed evaluation by indirect ophthalmoscopy. Babies with ROP changes were followed up for progression and managed appropriately. Chisquare test is used to find association between ROP and risk factors. RESULTS Of the 201 babies included in the study, 23 babies had ROP. Overall incidence of ROP in present study was found to be 11.44%. The mean birth weight (t=2.1188; p=0.03) and mean gestational age (t=4.470, p value <0.0001) was significantly lower in babies with ROP compared to those without ROP. Of the 23 babies, ROP stage-1 was seen in 5 (21.73%), stage-2 in 8 (34.78%), stage-3 in 10 babies (43.47%) and Zone I disease was observed in 1 (4.3%), Zone II in 7 (30.43%) and Zone III in 15 (65.21%) babies was seen. 43.47% of babies with ROP required intervention and underwent laser photocoagulation and were treated successfully without any recurrence on follow up. Common risk factors found in the present study were oxygen-therapy (100%), hyperbilirubinemia (74.1%), RDS (61.7%), sepsis (28.8%), PIH (27.8%), multiple gestation (15.4%) and GDM (2.48%). Among them, oxygen therapy (p =0.000), multiple gestation (p=0.012) and sepsis (p=0.014) were found to be statistically significant risk factors on univariate analysis. On multivariate analysis only oxygen therapy and sepsis were found to be independent risk factors. CONCLUSIONS Oxygen should be used as a drug only if there is a specific indication. Oxygen blenders should be used compulsorily. In NICU strict oxygen protocols have to be followed. Attempts should be made to keep PaO2 between 50-80 mmHg and SpO2 between 90-93%. Meticulous screening and regular follow up of high risk newborns and timely intervention will prevent morbidity due to ROP.

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Section: Discussionsupporting

confidence: 88%

Prospective Observational Study of Retinopathy of Prematurity in a Tertiary Care Hospital, Tirupati

Sivaramudu¹,

Sravya²,

Mrudula³

et al. 2019

jebmh

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“…In the present study, treatment with 532 nm green laser was possible in eyes with tunica vasculosa lentis and vitreous or preretinal haemorrhage, without inducing any cataract, anterior-segment ischemia or hyphaema. The previous report by Lira et al 4 did not include eyes with tunica vasculosa lentis (table 2). The spots of the 532 nm laser were brighter and whiter as compared with those of the diode laser, which appear as duller and greyer.…”

Section: Discussionmentioning

confidence: 97%

“…A frequency-doubled Nd:YAG laser (532 nm green) is commonly used for treatment of retinal vascular disorders. However, its use for treatment of ROP is anecdotal4 and has not been compared with that of a standard diode laser. The purpose of this study was to compare both these laser frequencies in treatment of ROP.…”

mentioning

confidence: 99%

Frequency-doubled Nd:YAG (532 nm green) versus diode laser (810 nm) in treatment of retinopathy of prematurity

Sanghi

Dogra

Vinekar

et al. 2010

British Journal of Ophthalmology

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“…[15] However, there is paucity of data for use of 532 nm green laser for treatment of ROP. [16171819] The additional expense incurred in the purchase of a separate diode laser indirect ophthalmoscope (LIO) for ROP treatment may not be a viable option for many in the developing and underdeveloped countries. Moreover, premature babies with treatment requiring ROP may be few and not enough to justify acquiring a separate diode laser for this purpose.…”

mentioning

confidence: 99%

“…Cataract formation was reported to the tune of 1% to 6% with argon laser compared to 0.003% with diode laser. [11] Previous studies on green laser have either been with a small sample size[161719] or not addressed these concerns directly. [18] Frequency-doubled 532 nm Nd: YAG green laser is being routinely used for the treatment of ROP at our center after the initial published reports.…”

mentioning

confidence: 99%

Safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser photocoagulation for treatment of retinopathy of prematurity

Singh

Katoch

Handa

et al. 2019

Indian J Ophthalmol

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Purpose: To evaluate the safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser for treatment of retinopathy of prematurity (ROP). Methods: This retrospective interventional case series included infants undergoing treatment for ROP with 532 nm green laser between January 2012 and March 2017 at a single tertiary-care referral center. Review of clinical records was done to identify baseline ROP characteristics, procedural difficulties, complications related to the laser procedure and outcome of treatment at ≥ 1 year of follow-up. Results: There are about 347 eyes of 182 infants were included in this present study. ROP presented in zone I in 76 eyes (21.9%) and zone II in 271 eyes (78.1%). Tunica vasculosa lentis (TVL) was present in 43.8% and pre-existing vitreous hemorrhage in 4.6% of the eyes. 532 nm green laser could be performed as a primary procedure in all eyes, including those with TVL. 322 eyes completed a minimum follow up of 1 year with a mean follow up of 22.8 months (range, 12–54 months). At the last follow-up visit, 298 (92.5%) of the 322 eyes had a favorable outcome. On logistic regression analysis, pre-existing fibrovascular proliferation ( p = 0.04) and new-onset fibrovascular proliferation after treatment ( p = 0.001) were the most significant independent predictors of poor outcome. Complications encountered were new-onset hemorrhage in 36 eyes (11.2%), anterior segment ischemia in two eyes (0.006%) and cataract in one eye (0.003%). Conclusion: 532 nm frequency-doubled Nd-YAG green laser appears to be safe and effective in the treatment of ROP.

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Efficacy and safety of green laser photocoagulation for threshold retinopathy of prematurity

Cited by 15 publications

References 19 publications

Prospective Observational Study of Retinopathy of Prematurity in a Tertiary Care Hospital, Tirupati

Prospective Observational Study of Retinopathy of Prematurity in a Tertiary Care Hospital, Tirupati

Frequency-doubled Nd:YAG (532 nm green) versus diode laser (810 nm) in treatment of retinopathy of prematurity

Safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser photocoagulation for treatment of retinopathy of prematurity

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