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Macular Sequelae Following Exudative Retinal Detachment After Laser Photocoagulation for Retinopathy of Prematurity
Insights
Exudative retinal detachments (ERDs) are a rare complication after laser photocoagulation for retinopathy of prematurity (ROP). These ERDs can lead to long-term vision impairment due to macular changes, even after treatment.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pediatric Ophthalmology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Laser photocoagulation is a common treatment for ROP.
- Exudative retinal detachments (ERDs) are an uncommon complication following laser treatment for ROP.
Purpose of the Study:
- To report a series of exudative retinal detachments (ERDs) following laser photocoagulation for retinopathy of prematurity (ROP).
- To describe the clinical course and visual outcomes of infants who developed ERDs after ROP laser treatment.
Main Methods:
- Retrospective case series.
- Eleven eyes of seven infants who developed ERDs after laser treatment for ROP were identified.
- Data on gestational age, birth weight, postmenstrual age at laser, time to ERD diagnosis, management, and visual outcomes were collected.
Main Results:
- ERDs occurred in infants with a median gestation of 25 weeks and birth weight of 662 grams.
- ERDs were diagnosed a median of 7 days post-laser and managed with steroids and/or bevacizumab.
- Resolution time ranged from 1 to 5 weeks, with noted macular pigment changes, atrophy, and photoreceptor loss in some cases.
- Long-term follow-up (median 10 years) revealed only one patient with normal vision.
Conclusions:
- Exudative retinal detachment is an infrequently reported complication after laser treatment for retinopathy of prematurity.
- Macular changes following ERD resolution can negatively impact long-term visual outcomes.
- Close monitoring and further research into managing ERDs post-ROP laser are warranted.
Background And Objective:
To report a series of exudative retinal detachments (ERDs) following laser photocoagulation for retinopathy of prematurity (ROP).
Patients And Methods:
Retrospective case series.
Results:
Eleven eyes of seven infants were identified who developed ERD following laser. Median gestation age was 25 weeks (interquartile range [IQR]: 24-27 weeks), and median birth weight was 662 grams (IQR: 538-850 grams). Median postmenstrual age at time of laser was 35 weeks (IQR: 33-39 weeks). ERD was diagnosed at a median of 7 days (IQR: 5-7 days) after laser and was managed with steroids. Bevacizumab was also used for certain cases. Time to resolution ranged from 1 to 5 weeks. Macular pigment changes, atrophy, window defect on fluorescein angiography, and photoreceptor loss on optical coherence tomography were noted in some cases following ERD resolution. Excluding one patient who expired at 3 months, median length of follow-up was 10 years (IQR: 9-13.5 years). Overall, only one patient, who presented with less severe ERD, had normal vision.
Conclusions:
ERD is an uncommonly reported complication following laser for ROP. Macular changes following ERD resolution may have negative visual consequences. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:698-705.].
