Ridge-Adjacent Laser With Imaging and Dexamethasone for Treatment of Retinopathy of Prematurity

To describe a less invasive laser therapy for retinopathy of prematurity, referred to as ridge-adjacent laser treatment (RALT), and its outcome regarding the need for re-treatment.

This was a retrospective observational review of medical records of all infants treated with RALT as a primary intervention for retinopathy of prematurity between June 2016 and June 2021 at a tertiary care center in Sweden. The intervention consisted of RALT with intraoperative wide-field imaging, and most patients also received postoperative dexamethasone eye drops. The primary outcomes measured were the number of laser spots applied, re-treatment rates, and the maximum stage of retinopathy of prematurity observed.

Sixty-one eyes of 31 infants were treated with RALT. The median follow-up time was 24 weeks (range: 17 to 45 weeks) after birth. The mean number of laser spots administered was 859 ± 280. Re-treatment was required in 3% of the eyes (6% of the infants). After excluding infants with aggressive retinopathy of prematurity the re-treatment rate for the eyes was 2% (4% of the infants). Seven of the 61 eyes were diagnosed as having aggressive retinopathy of prematurity. In three of these eyes, the retinopathy progressed to a maximum stage greater than 3 following RALT treatment.

Treatment of retinopathy of prematurity using the RALT technique, in conjunction with intraoperative wide-field imaging and, in most infants, postoperative dexamethasone eye drops, was associated with a low number of laser spots and a low re-treatment rate. All eyes that did not have aggressive retinopathy of prematurity regressed after the RALT treatment. Further longitudinal studies are required to assess the long-term structural and functional outcomes.