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Outcomes of Pre-Early Treatment for Retinopathy of Prematurity (Pre-ETROP)
Yothin Titawattanakul1, Kittisak Kulvichit1, Adisai Varadisai1
1Vitreo-retina Research Unit, Department of Ophthalmology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
Insights
Early treatment for Retinopathy of Prematurity (ROP) significantly reduces unfavorable outcomes and increases regression. Pre-early treatment for stage 3 ROP is associated with better results and fewer recurrences.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Retinopathy of Prematurity Research
Background:
- Early intervention in stage 3 Retinopathy of Prematurity (ROP) is crucial for optimal outcomes.
- Investigating the benefits of pre-early treatment versus early treatment for ROP.
Purpose of the Study:
- To assess unfavorable outcomes and regression rates following pre-early treatment for ROP.
- To evaluate ROP progression and recurrence requiring retreatment after pre-early intervention.
Main Methods:
- Retrospective analysis of infant ROP cases from January 2009 to January 2014.
- Comparison of outcomes between pre-early treatment (pre-ETROP) and early treatment (ETROP) groups for stage 3 ROP.
- Outcomes included unfavorable outcomes, regression, progression, and recurrence requiring retreatment.
Main Results:
- No unfavorable outcomes were observed in the pre-ETROP group (n=63) compared to 21.43% in the ETROP group (n=28).
- Regression rates were 100% with laser LIO alone in the pre-ETROP group versus 88.46% in the ETROP group.
- Recurrence (7.14%) and progression (10.71%) were observed in the ETROP group, but not in the pre-ETROP group.
Conclusions:
- Pre-early treatment for stage 3 ROP effectively reduces unfavorable outcomes and enhances regression.
- This approach also appears to decrease the recurrence of neovascularization and post-treatment progression of ROP.
Introduction:
The earlier treat stage 3 ROP is more likely to achieve better outcomes.
Primary Purpose:
To study the unfavorable outcomes and regression after pre-early treatment for ROP.
Secondary Purpose:
To evaluate the progression and recurrence of ROP requiring retreatment after pre-early treatment for ROP.
Patients And Methods:
The data were retrieved retrospectively from the medical records of all infants who were screened and treated for ROP from January 2009 to January 2014 at a tertiary care facility. The outcomes measured the following: 1. unfavorable outcomes; 2. regression of ROP; 3. progression of ROP and 4. recurrence of ROP requiring retreatment. We treated all stage 3 ROP in any zone, with or without plus. The study also compared the outcomes between the pre-ETROP and the ETROP subgroups.
Results:
There were 91 eyes with stage 3 ROP. Of the total of 91 eyes, there were 63 eyes with the pre-ETROP group and 28 eyes of the ETROP group. The unfavorable outcomes after treatment occur 6 eyes from 28 eyes (21.43%) in the ETROP group but no unfavorable outcomes in the pre-ETROP group (P=0.001). The pre-ETROP group who were treated with laser LIO alone had 100% regression, while the ETROP group who were treated with LIO (26 eyes) had 88.46% regression. There were 2 eyes of this group who were treated with a combination of LIO and IVT Bevacizumab. Both of them did not have regression. The recurrence of ROP requiring retreatment occurred in 2 eyes (7.14%) of the ETROP group, but no recurrence in the pre-ETROP group (P=0.092). The progression after treatment occurred in 3 eyes (10.71%) in the ETROP group, but no progression in the pre-ETROP group (P=0.027).
Conclusion:
The pre-ETROP treatment is useful for reducing unfavorable outcomes and increasing the regression of ROP. Further, the treatment can reduce the recurrence of neovascularization and progression after treatment.
