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Management of bleb-like retinal detachment in aggressive retinopathy of prematurity
Vishakh Padmakumar1, Harshitha K M1, Subhadra Jalali2
1ABRI, LV Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India.
Insights
Bleb-like retinal detachment in retinopathy of prematurity is challenging. A combination of bevacizumab injections and vitrectomy surgery achieved good anatomical and visual success in a preterm infant.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Surgery
Background:
- Bleb-like retinal detachment (BLRD) in posterior zone 1 retinopathy of prematurity (ROP) poses significant therapeutic challenges.
- ROP is a leading cause of childhood blindness, particularly in premature infants.
- Zone 1 ROP is associated with a higher risk of aggressive disease and poor visual outcomes.
Purpose of the Study:
- To present a case of successful management of bilateral stage 4 aggressive ROP with BLRD in posterior zone 1.
- To discuss the risk factors, treatment challenges, and outcomes associated with BLRD in ROP.
- To highlight the combined approach of intravitreal bevacizumab and lens-sparing vitrectomy.
Main Methods:
- A preterm infant (1100 g) with bilateral stage 4 aggressive ROP in posterior zone 1 and BLRD was treated.
- Bilateral intravitreal bevacizumab injections were administered.
- Lens-sparing vitrectomy surgery was performed subsequently.
Main Results:
- The infant tolerated both procedures well.
- The initial postoperative course was uneventful.
- Good anatomical and visual success was achieved postoperatively.
Conclusions:
- A combined approach of intravitreal bevacizumab and lens-sparing vitrectomy can be effective for managing BLRD in aggressive ROP.
- Early intervention and multimodal treatment strategies are crucial for improving visual prognosis in these complex cases.
- Further research is warranted to establish optimal treatment protocols for BLRD in ROP.
Abstract:
Bleb-like retinal detachment (BLRD) in posterior zone 1 retinopathy of prematurity (ROP) presents a significant therapeutic challenge and is associated with a guarded visual prognosis. We present a case of a female infant born preterm with a birth weight of 1100 g. Examination revealed bilateral stage 4 aggressive ROP in posterior zone 1 with BLRD. Given the extent of retinal detachment, a combination of bilateral intravitreal bevacizumab injection, followed by lens-sparing vitrectomy surgery was performed. The baby tolerated the procedures well. The initial postoperative course was uneventful, and the child showed good anatomical and visual success. Through this case, we aim to discuss the risk factors associated with BLRD in ROP, the specific treatment challenges encountered and the potential treatment outcomes.
