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Refractive outcome of prethreshold retinopathy of prematurity treated by diode laser: follow-up at 5 years
Phuoc Huu Nguyen1, Caroline Catt2, Tinh Xuan Nguyen3
1Department of Ophthalmology, Thanhhoa Paediatrics Hospital, Thanhhoa City, Vietnam, Australia ; Save Sight Institute and Discipline of Clinical Ophthalmology, University of Sydney, NSW, Australia.
Insights
Diode laser photocoagulation for retinopathy of prematurity (ROP) in infants resulted in favorable outcomes after 5 years. However, high refractive errors like myopia and astigmatism were common, potentially causing visual impairment.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Laser Therapy
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Diode laser photocoagulation is a common treatment for prethreshold ROP.
- Long-term refractive outcomes after ROP treatment require further investigation.
Purpose of the Study:
- To evaluate the long-term refractive outcomes (mean 5 years post-treatment) in eyes treated for prethreshold retinopathy of prematurity (ROP) using diode laser photocoagulation.
- To correlate refractive outcomes with birth weight and gestational age.
- To assess anatomical and visual outcomes post-treatment.
Main Methods:
- A retrospective review of 50 infants treated with diode laser for prethreshold ROP between 2008-2009.
- Cycloplegic refraction was used to determine refractive error (myopia, hypermetropia, astigmatism).
- Eyes with media opacification were excluded; outcomes were correlated with birth weight and gestational age.
Main Results:
- After 5 years, the average spherical equivalent was -2.87 D.
- High myopia (> -5.00 D) was present in 32% of eyes.
- Astigmatism was prevalent (79%), with high astigmatism (> 2.00 D) in 49% of eyes.
Conclusions:
- Diode laser therapy for prethreshold ROP generally leads to favorable anatomical and visual outcomes.
- High refractive errors, including myopia and astigmatism, are common sequelae.
- These refractive errors may contribute to visual impairment in treated individuals.
Background:
The purpose of this study was to evaluate the refraction of eyes treated with diode laser photocoagulation for prethreshold retinopathy of prematurity (ROP) at a mean of 5 years after treatment.
Materials And Methods:
Fifty infants with prethreshold ROP treated with diode laser at Hanoi Childrens' Hospital during the period 2008 to 2009 were reviewed. Refractive error was identified by cycloplegic refraction with Cyclogyl 1%. Myopia was divided into two categories based on magnitude: high myopia (more than -5.00 D) and low myopia (between 0 and -5.00 D). Hypermetropia was subdivided into low hypermetropia (between 0 and +5.00 D) and high hypermetropia (greater than +5.00 D). Astigmatism was classified as high if >2.00 D. Eyes with media opacification that interferes with retinoscopy were excluded. The refractive outcome was correlated with birth weight and gestational age. The anatomical and visual outcomes were recorded.
Results:
One hundred eyes from 50 infants were included in the study. The mean birth weight was 1,426.4 g and the mean gestational age was 29.88 weeks. After 5 years of follow-up, the average spherical equivalent for 100 eyes was -2.87 D. On cycloplegic retinoscopy, high myopia (more than -5.00 D) was seen in 32% of eyes. Twenty (20%) eyes had nonsignificant hypermetropia, and high hypermetropia (more +5.00 D) was seen in only one eye (1%). The prevalence of astigmatism and high astigmatism (more than -2.00 D) was 79% and 49%, respectively. Three infants (6%) had esotropia and two infants (4%) had exotropia. None of the infants had nystagmus.
Conclusion:
The majority of patients who underwent diode laser therapy for prethreshold ROP had favourable anatomical and visual outcomes. High refractive error is common and may be the cause of visual impairment.
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