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Management of threshold retinopathy of prematurity

P Sternberg1, P F Lopez, A Capone

  • 1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.

Insights

Cryotherapy for Retinopathy of Prematurity (ROP) effectively treats threshold disease. For bilateral ROP, treating both eyes simultaneously is recommended for optimal outcomes in infants.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Pediatric Medicine

Background:

  • Retinopathy of Prematurity (ROP) is a significant cause of visual impairment in premature infants.
  • The Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study established cryotherapy as a beneficial intervention for threshold ROP.
  • Further investigation into treatment strategies for bilateral threshold ROP is warranted.

Purpose of the Study:

  • To review the authors' experience with cryotherapy for threshold ROP in bilateral cases.
  • To evaluate the efficacy and outcomes of treating threshold ROP in infants.
  • To provide recommendations for the management of bilateral threshold ROP.

Main Methods:

  • Retrospective review of 71 eyes from 41 infants treated with cryotherapy for threshold ROP between 1985 and 1990.
  • Analysis of treatment outcomes, including disease progression and complications.
  • Minimum follow-up of 3 months for 65 eyes.

Main Results:

  • Of 65 eyes with adequate follow-up, 7 (11%) progressed to stage 4 ROP.
  • An additional 8 eyes (13%) developed posterior retinal folds.
  • Overall results were comparable to those reported in the CRYO-ROP study.

Conclusions:

  • Cryotherapy remains an effective treatment for threshold ROP.
  • The authors recommend treating both eyes simultaneously when ROP reaches threshold in bilateral cases.
  • Simultaneous bilateral treatment may offer comparable or improved outcomes for infants with threshold ROP.

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