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Retinopathy of prematurity in practice. II: long-term results following treatment for threshold disease
L Gnanaraj1, R Brennan, D G Cottrell
1Department of Ophthamology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Insights
Long-term outcomes for treated threshold retinopathy of prematurity (ROP) show favorable results. This study confirms that established treatment protocols yield good visual acuity and retinal status in ROP patients.
Area of Science:
- Ophthalmology
- Neonatal Care
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Threshold ROP requires timely intervention to prevent severe visual impairment.
- Long-term outcomes of ROP treatment are crucial for assessing therapeutic effectiveness.
Purpose of the Study:
- To evaluate the long-term visual and structural outcomes of treating threshold retinopathy of prematurity (ROP).
- To assess the durability of treatment effects in a UK clinical setting.
- To compare real-world outcomes with those reported in major clinical trials.
Main Methods:
- Retrospective review of 35 infants treated for threshold ROP between 1987 and 1998.
- Follow-up included 21 patients with direct examination and 6 with detailed records.
- Assessment of visual acuity, refraction, motility, and fundoscopy.
Main Results:
- 57.5% of treated eyes achieved visual acuity of 6/12+.
- 90% of eyes showed favorable retinal status.
- Overall favorable structural outcome in 81.4% and functional outcome in 74.6% of eyes.
Conclusions:
- Favorable outcomes for threshold ROP treatment can be achieved in routine clinical practice.
- These positive results are maintained over long follow-up periods.
- Findings support the efficacy of established ROP treatment protocols.
Objective:
To determine the long-term outcome of treatment for threshold retinopathy of prematurity (ROP) in one UK unit.
Methods:
A total of 35 infants diagnosed with threshold ROP were treated by a single ophthalmologist (DGC) between 1987 and 1998. The parents of the 29 surviving patients were contacted; 21 brought their child for special review of acuity, motility, refraction and fundoscopy (Group 1). Of the eight patients who were unable to attend, six patients (Group 2) had sufficient follow-up detail in their records to be included in the study.
Results:
A total of 40 eyes in the 21 patients in Group 1 had been treated; 10 had received cryotherapy (eight bilateral) and 11 had bilateral laser. Mean follow-up was 5 years (range 2-12 years). A total of 23 treated eyes (in 16 patients) had an acuity of 6/12+ (57.5% of treated eyes). Four eyes of three patients had no light perception. Seven eyes in four patients had myopia of more than 3 D. Eight patients had a manifest squint: six esotropia, two exotropia. The retinal status of 36 eyes (90%) showed a favourable outcome. The four blind eyes had stage 5 disease. In Group 2, four eyes of two patients (33%) had 6/12+ acuity recorded; five eyes in three patients had stage 5 disease and no perception of light. In total, a favourable structural outcome was achieved in 81.4% and favourable functional outcome observed in 74.6%.
Conclusion:
These results show that the favourable outcomes reported in the CRYO-ROP trial can be achieved in routine practice and maintained after long follow-up.