Near Confluent Laser Photocoagulation for the Treatment of Threshold Retinopathy of Prematurity

Abstract

To evaluate the effect of a near confluent pattern of indirect laser photocoagulation in reducing the rate of progression and re-treatment of threshold retinopathy of prematurity. Methods: This study examined a noncomparative interventional case series. We performed a retrospective review of the medical records of patients who underwent peripheral laser ablation by 1 surgeon for threshold retinopathy of prematurity from 1997 to 2002. A total of 58 eyes from 31 patients were treated, and 44 eyes of 23 patients were included in the study. Ten eyes of 5 infants had zone 1 disease, and 34 eyes of 18 infants had zone 2 disease. Laser spots were placed in a near confluent pattern in the peripheral avascular retina between the ridge of extraretinal proliferation and the ora serrata. The mean±SD number of laser spots was 2534±455 for zone 1 (range, 2100-3378) and 1850 ± 487 for zone 2 (range, 1030-2689). Results: In 7 eyes of 4 infants with zone 1 disease, the retinopathy regressed and did not require any further treatment. Three eyes of 2 infants, however, progressed after laser treatment and required vitrectomy surgery. Progression was defined as the development of stage 4 or 5 disease. None of the patients with zone 2 disease had progression of retinopathy, and none of them needed more than 1 treatment. Patients tolerated the procedure well, and there were no complications at the time of the procedure or at follow-up visits. Conclusions: A near confluent pattern of laser photocoagulation may reduce the rate of progression of threshold retinopathy of prematurity in zone 2 (0%). The near confluent pattern of treatment may also reduce the retreatment rate of the disease (0%). Larger studies are needed to confirm our findings.

Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 12-month experience with telemedicine screening

“…Because effective treatment exists,2 3 focus has shifted towards ensuring that all patients at risk for development of ROP are screened.…”

Phthisis Bulbi After Lensectomy in Retinopathy of Prematurity Eyes Previously Treated With Laser Photocoagulation

“…11 For example, the incidence of cataract formation is less with infrared diode lasers compared with argon lasers. 12 …”

Retinopathy of Prematurity

“…More continous treatment may not only reduce the rate of progression [115,116] but also the need for retreatment [115]. Argon laser was used initially but is now widely replaced by Diode laser, which requires less power.…”