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[Retinopathy of prematurity--functional and structural outcome in children treated with diode laser photocoagulation]
Jelena Petrinović-Doresić1, Ljubica Dorn, Biljana Kuzmanović
1Klinika za ocne bolesti, Opća bolnica Sveti Duh, Zagreb, Hrvatska.
Insights
Diode laser treatment for retinopathy of prematurity can yield favorable structural outcomes, especially when implemented early. However, long-term follow-up reveals significant risks of amblyopia and nystagmus in treated infants.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Context:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Diode laser photocoagulation is a recognized treatment for severe ROP.
- Long-term outcomes of this treatment in infants require further investigation.
Purpose:
- To evaluate the long-term structural and functional results in children treated with diode laser for ROP.
- To assess retinal status, refractive error, and orthoptic outcomes post-treatment.
- To determine the efficacy of diode laser therapy in preventing severe visual impairment.
Summary:
- Diode laser treatment was applied to 12 eyes of 6 premature infants with ROP.
- While 41.7% of eyes showed unfavorable structural outcomes, 100% of eyes treated at threshold stage (3+) had favorable outcomes.
- Long-term follow-up revealed significant rates of amblyopia (83.3%), strabismus (83.3%), and nystagmus (66.6%).
Impact:
- Timely diode laser therapy can halt ROP progression and improve visual outcomes.
- Early intervention is crucial for maximizing the benefits of ROP treatment.
- Increased availability of this treatment modality can enhance care for premature infants with ROP.
Aim:
To present the long-term structural and functional outcome of children treated with diode laser for retinopathy of prematurity.
Patients And Methods:
A total of six premature babies (12 eyes) in whom diode laser treatment was performed for acute retinopathy were followed up. The mean birth weight was 1185.0 +/- 309.6 g and mean gestational age was 28.5 +/- 1.87 weeks. Long term follow-up (18 to 41 months) included retinal examination, refractive status of the eye, and orthoptic evaluation: strabismus, amblyopia and nystagmus assessment.
Results:
Unfavorable structural outcome was detected in five eyes of six children (5/12 eyes, 41.7%). If only the eyes in no higher than threshold stage (3+) according to surgery records were taken in consideration (6/12 eyes), therapy resulted in favorable structural outcome in all six (100%) eyes. The mean spherical equivalent refractive error was -2.27 +/- 2.03 D (range -6.0 to +0.50 D). Profound amblyopia of one eye was found in five of six study children, and was invariably accompanied by heterotropia of the amblyopic eye: deviation in eso direction in three cases, and exodeviation and hypertropia in one case each. Nystagmus was present in four of six (66.6%) patients. All six children used vision as a dominant sense in space orientation and communication.
Conclusion:
Diode laser therapy is a successful method in stopping and reversing the clinical course of severe retinopathy of prematurity, however only if timely implemented. The availability of this treatment modality in Croatia would significantly improve the structural and functional outcome of children with retinopathy.
