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Outcome of eyes developing retinal detachment during the Early Treatment for Retinopathy of Prematurity study
Michael X Repka1, Betty Tung, William V Good
1Wilmer Eye Institute and Department of Pediatrics, The Johns Hopkins University, Baltimore, MD 21287-9028, USA. mrepka@jhmi.edu
Insights
Retinal detachment (RD) in retinopathy of prematurity (ROP) can be treated with surgery or observation. Macular attachment was achieved in about one-third of eyes, with some cases showing favorable visual acuity, particularly in stage 4A ROP.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Retinal Surgery
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Retinal detachment (RD) is a severe complication of ROP.
- The Early Treatment for Retinopathy of Prematurity (ETROP) study investigated treatments for ROP.
Purpose of the Study:
- To evaluate the long-term structural and visual outcomes of RD in infants with ROP.
- To assess outcomes at age 6 years following treatment for RD in the ETROP cohort.
- To analyze the efficacy of different treatment modalities for ROP-related RD.
Main Methods:
- Prospective, multicenter, nonrandomized study of infants with high-risk prethreshold ROP.
- Infants who developed RD by 6 months corrected age were treated with observation or vitreoretinal surgery.
- Structural and visual outcomes were assessed at age 6 years.
Main Results:
- Of 401 patients, 63 (89 eyes) developed RD. Follow-up at age 6 years was available for 70 eyes.
- Macular attachment was achieved in 34% of eyes after vitrectomy with or without scleral buckle, 67% after scleral buckle only, and 18% with observation.
- Favorable visual acuity (>20/200) was achieved in 9% of eyes, with 5 cases of stage 4A RD.
Conclusions:
- Macular attachment can be achieved in approximately one-third of eyes with ROP-related RD.
- Favorable visual acuity is possible in some eyes, particularly those with stage 4A RD.
- Long-term structural and visual outcomes vary based on RD stage and treatment modality.
Objective:
To describe the structural and visual outcomes at age 6 years of retinal detachment (RD) from retinopathy of prematurity (ROP) in the Early Treatment for Retinopathy of Prematurity (ETROP) study.
Methods:
Prospective multicenter nonrandomized series of infants with high-risk prethreshold ROP who developed an RD by 6 months corrected age treated with observation or vitreoretinal surgery.
Results:
Of 401 patients, 63 (89 eyes) experienced RD. Follow-up at age 6 years was available for 70 eyes (79%) of 49 surviving patients. The RDs were stage 4A in 28 eyes (40%), stage 4B in 14 (20%), stage 5 in 13 (19%), and not classified in 15 (21%). The macula was attached in 17 of 50 eyes (34%) after vitrectomy with or without scleral buckle, in 6 of 9 (67%) after scleral buckle only, and in 2 of 11 eyes (18%) observed. An attached macula at age 6 years after vitreoretinal surgery was present in 5 of 16 eyes (31%) with stage 4A, 6 of 10 (60%) with stage 4B, and 0 of 10 with stage 5. Favorable visual acuity (>20/200) was found in 6 of 70 eyes (9%); 5 had stage 4A, and 1 was not classified.
Conclusions:
Macular attachment was achieved in approximately one-third of eyes with RD and favorable visual acuity in some eyes with stage 4A.
