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Laser photocoagulation in patients with retinopathy of prematurity undergoing chest physiotherapy
Hassan A Aziz1, Scott Cardone, Magaly Diaz-Barbosa
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA. haaziz@med.miami.edu
Insights
Chest physiotherapy may increase the risk of vitreous hemorrhage in premature infants undergoing laser treatment for retinopathy of prematurity (ROP). This finding highlights a potential complication in fragile neonatal retinal vasculature.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Pulmonology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Laser photocoagulation is a common treatment for ROP.
- Neonates often require respiratory support and physiotherapy for conditions like bronchopulmonary dysplasia.
Observation:
- Two premature neonates with ROP received laser photocoagulation therapy.
- Both neonates also underwent chest physiotherapy for respiratory issues.
- Following treatment, both neonates experienced vitreous hemorrhage.
Findings:
- A correlation was observed between chest physiotherapy and an increased risk of vitreous hemorrhage post-laser photocoagulation in ROP patients.
- The fragile retinal vasculature in neonates with ROP appears particularly susceptible to this complication.
- Chest physiotherapy may exacerbate the risk of hemorrhage in this vulnerable population.
Implications:
- Clinicians should carefully consider the potential risks associated with chest physiotherapy in premature infants with ROP undergoing laser treatment.
- Further research is warranted to elucidate the mechanisms behind this association.
- This finding may necessitate modifications in the management protocols for ROP patients receiving both physiotherapy and laser therapy.
Abstract:
The authors report the correlation between chest physiotherapy and increased risk of vitreous hemorrhage after laser photocoagulation therapy in patients with retinopathy of prematurity (ROP). Two premature neonates, the first born at 26 weeks and the second at 31 weeks gestational age, both underwent chest physiotherapy, the first for congenital cystic fibrosis and bronchopulmonary dysplasia and the second for premature alveolar atelectasis. Both were diagnosed as having ROP that necessitated laser photocoagulation treatment at 34 and 37 weeks, respectively. The first patient developed bilateral vitreous hemorrhage and bilateral cataracts. The second patient developed vitreous hemorrhage in one eye. Chest physiotherapy in neonates with ROP significantly increases the risk of hemorrhage after laser photocoagulation in an otherwise fragile retinal vasculature.
