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Persistent plus disease after laser in retinopathy of prematurity with tetralogy of Fallot
Yannis M Paulus1, Darius M Moshfeghi
1Department of Ophthalmology, Byers Eye Institute at Stanford, Stanford University, Palo Alto, CA 94303, USA. ypaulus@stanford.edu
Insights
Persistent plus disease in retinopathy of prematurity (ROP) can occur despite panretinal photocoagulation (PRP). This case highlights the potential influence of complex cardiovascular conditions, such as DiGeorge syndrome and tetralogy of Fallot, on ROP progression.
Area of Science:
- Ophthalmology
- Neonatology
- Cardiology
Background:
- Presents a case of retinopathy of prematurity (ROP) in an infant with significant cardiovascular comorbidities.
- The patient had DiGeorge syndrome and tetralogy of Fallot, complicating management.
- Plus disease, a sign of ROP severity, developed despite initial treatment.
Introduction:
We present a patient with retinopathy of prematurity (ROP) who received panretinal photocoagulation (PRP), but in whom plus disease developed, likely secondary to a complicated cardiovascular history, including DiGeorge syndrome and tetralogy of Fallot.
Method:
Interventional case report with clinical and angiographic correlation.
Results:
Our patient had been born at 29 weeks and 2 days gestational age with a birthweight of 940 grams, tetralogy of Fallot, DiGeorge syndrome, and major aortopulmonary collaterals. Type 1 Early Treatment for Retinopathy of Prematurity ROP (zone 2, stage 2 with plus) developed, requiring PRP. Worsening plus disease developed and mild further PRP was performed. Despite this, plus disease persisted.
Conclusions:
We report plus disease even after appropriate PRP therapy for ROP. In this case, it is likely the patient's cardiovascular diseases that caused the persistent plus disease. Vascular tortuosity can be due to a number of different systemic disorders, so it is important to consider an infant's systemic conditions in the evaluation of ROP.
