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Diode laser photocoagulation for retinopathy of prematurity. Preliminary results
J A McNamara1, W Tasman, J F Vander
1Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.
Insights
Diode laser photocoagulation and transscleral cryotherapy show similar effectiveness in treating threshold stage 3+ retinopathy of prematurity. Both treatments achieved high regression rates in infants followed for up to one year.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Medical Technology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Threshold ROP requires timely intervention to prevent severe visual impairment.
- Current treatments include laser photocoagulation and cryotherapy.
Purpose of the Study:
- To compare the efficacy of diode laser photocoagulation versus transscleral cryotherapy.
- To evaluate treatment outcomes in "threshold" stage 3+ retinopathy of prematurity.
- To assess long-term regression rates for both interventions.
Main Methods:
- Prospective, randomized clinical trial.
- Inclusion of 32 infants with stage 3+ ROP.
- Treatment allocation: diode laser photocoagulation in one eye, cryotherapy in the fellow eye.
- Follow-up at 3 months and 1 year post-treatment.
Main Results:
- Regression observed in 25/28 eyes (89%) treated with diode laser photocoagulation at 3 months.
- Regression observed in 20/24 eyes (83%) treated with cryotherapy at 3 months.
- All 7 eyes treated with diode laser and 7/7 eyes treated with cryotherapy showed regression at 1 year.
Conclusions:
- Diode laser photocoagulation is as effective as transscleral cryotherapy for threshold ROP.
- Both treatments demonstrate high success rates in achieving regression.
- Laser photocoagulation offers a comparable alternative to cryotherapy for ROP management.
Abstract:
In a prospective, randomized clinical trial comparing transscleral cryotherapy with laser photocoagulation in the treatment of "threshold" stage 3+ retinopathy of prematurity, 32 infants were treated with diode laser photocoagulation in one eye. Twenty-eight infants have been followed up for at least 3 months, and seven have been followed up for at least 1 year. Twenty-five of 28 eyes treated with diode laser photocoagulation and followed up for at least 3 months have undergone regression. Of 24 fellow eyes treated with cryotherapy and followed up for at least 3 months, 20 have undergone regression. All seven eyes treated with diode laser photocoagulation and followed up for at least 1 year have undergone regression. Of seven fellow eyes treated with cryotherapy and followed up for at least 1 year, all have undergone regression. Our results suggest that diode laser photocoagulation is as effective as cryotherapy in the treatment of retinopathy of prematurity.