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[Clinical appearance and outcome of zone 1 retinopathy of prematurity (ROP)]
M Odehnal1, J Malec, M Hlozánek
1Ocní klinika detí a dospélých UK 2 LF a FN Motol, Praha.
Insights
Early treatment of retinopathy of prematurity (ROP) in zone 1, especially transient forms (TF), shows better outcomes than threshold stage. Very posterior forms (VPR) of zone 1 ROP consistently lead to unfavorable stages.
Area of Science:
- Ophthalmology
- Neonatology
Context:
- Retinopathy of prematurity (ROP) in zone 1 presents unique diagnostic and therapeutic challenges.
- Distinguishing between transient forms (TF) and very posterior forms (VPR) of zone 1 ROP is crucial for prognosis.
Purpose:
- To evaluate treatment outcomes for zone 1 retinopathy of prematurity (ROP).
- To compare outcomes between transient forms (TF) and very posterior forms (VPR) of zone 1 ROP.
- To assess the impact of treatment timing (pre-threshold vs. threshold stage) on zone 1 ROP outcomes.
Summary:
- This study treated 24 eyes with zone 1 ROP using transcleral laser photocoagulation and cryotherapy.
- Eyes with TF ROP treated in the pre-threshold stage had better outcomes than those treated in the threshold stage.
- All 5 eyes with VPR ROP progressed to unfavorable stages (IV or V).
Impact:
- Findings suggest that early intervention during the pre-threshold stage of ROP is critical for improving outcomes in zone 1 ROP.
- The study highlights the diagnostic and therapeutic challenges posed by zone 1 ROP, particularly with increasing survival rates of premature infants.
- Results support the strategy of early treatment for ROP, as indicated by the ETROP study.
Abstract:
The goal of this clinical trial was to evaluate outcomes of the treatment of retinopathy of prematurity (ROP) located in zone 1 (Zone 1 ROP). This disease has a specific clinical appearance and poor prognosis. Usually it is difficult to identify particular stages of ROP and to indicate treatment while following progression of the disease. In the group of zone 1 ROP it is necessary to separate transient forms (TF), in which vascularizations reach edges of zone 2, from very posterior forms (VPR), in which vascularizations and pathological changes are present only in zone 1. There were 24 eyes with zone 1 ROP (15 children) treated with combination of transcleral laser photocoagulation and cryotherapy during the years 2000 till 2005 in our series. Five eyes suffered from VPR, 19 eyes from TF. Average follow -up was 24 months. We found better outcomes in eyes with TF treated in pre-threshold stage of ROP (10 eyes) than in threshold stage of ROP (9 eyes). All 5 eyes with VPR developed unfavourable ROP stage IV or V. Zone 1 ROP becomes diagnostic and therapeutic challenge considering growing incidence of surviving of newborns with low or very low birth weight. Treatment initiation during prethreshold stage of ROP as it is supported by ETROP study (Early treatment of ROP) seems to be promising.
