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Published on: September 16, 2020
Insights
Cryotherapy effectively treated retinopathy of prematurity (ROP) in premature infants, preventing disease worsening in most treated eyes compared to controls. Further research is needed for statistical significance.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Premature infants, especially those under 1000 grams, are at high risk for severe ROP.
- Plus disease indicates aggressive ROP requiring prompt intervention.
Purpose of the Study:
- To evaluate the efficacy of cryotherapy in treating stage 3 retinopathy of prematurity with plus disease.
- To compare outcomes of cryotherapy versus observation in affected eyes.
Main Methods:
- A randomized controlled trial involving 17 premature infants with symmetrical stage 3 ROP and plus disease.
- One eye per patient was randomized to cryotherapy, the other served as a control.
- Cryotherapy was administered at an average age of three months.
Main Results:
- 71% of cryotherapy-treated eyes showed ROP resolution.
- 59% of untreated control eyes worsened significantly.
- Limited cases (5/17) showed treated eye improvement and untreated eye progression, insufficient for statistical significance.
Conclusions:
- Cryotherapy demonstrates a positive trend in resolving ROP and preventing progression in premature infants.
- While promising, larger studies are needed to establish statistical significance for cryotherapy's benefits in ROP treatment.
- Surgical intervention (scleral buckling) was required for advanced ROP with retinal detachment in some cases.
Abstract:
Seventeen patients with symmetrical stage 3 retinopathy of prematurity (ROP) and plus disease as described in the International Classification of ROP had one eye randomized to cryotherapy and the other to control. Seventy-seven percent of the patients were under 1000 grams at birth and females outnumbered males by a 2 to 1 ratio. The average chronologic age at which cryotherapy was performed was three months. Twelve of seventeen treated eyes (71%) showed resolution of the ROP and 10 of 17 untreated eyes (59%) became significantly worse. However, only five patients had improvement in the treated eye and progression in the untreated eye, a number too small to provide statistical significance. Six eyes with Stage IV ROP were operated by encircling scleral buckling techniques because of total retinal detachment secondary to peripheral traction and cicatrization arising from the ridge. In five patients the unoperated eye had already developed a retrolental membrane, and in one patient bilateral detachments were present. Five of the six operated retinas were reattached.
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