Fibrovascular organization in the vitreous following laser for ROP: implications for prognosis

To study associations between surgical outcome and mean postmenstrual age (PMA) when fibrovascular organization is detected between vascular and avascular retina following laser for acute retinopathy of prematurity (ROP).

PMA at the time of detection of fibrovascular organization was determined in infants who had laser treatment for stage 3 ROP. Retinal features abstracted from examination sheets included zone, stage, and clock hours of fibrovascular organization, PMA at the times of first surgery and diagnosis of fibrovascular organization, and outcomes (retinal attachment after one surgery and retinal attachment at follow-up). Statistical analyses were performed to compare categorical data (Mann-Whitney U test, t-test, Fisher exact test) and determine correlations (Spearman rank test).

Fibrovascular organization was diagnosed in 38/39 eyes that required surgery and 19/41 eyes that did not. In surgical eyes, older PMA at the time of detection of fibrovascular organization, zone II ROP, and stage 4 (versus stage 5) ROP were each associated with successful reattachment of the retina after one surgery and at the end of follow-up. PMA at diagnosis of fibrovascular organization was associated with zone, but not stage, of ROP when surgical intervention was performed.

Fibrovascular organization between the vascular and avascular retina is important because it is associated with the development of retinal detachment after laser for acute ROP. Further study is required to determine if improved detection of fibrovascular organization in eyes of infants of early PMA will improve surgical outcomes for retinal detachment.