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Advanced cicatricial retinopathy of prematurity--outcome and complications
D M Knight-Nanan1, K Algawi, R Bowell
1Children's Hospital, Dublin, Ireland.
Insights
Advanced retinopathy of prematurity (ROP) often leads to severe visual impairment and requires extensive treatment. Complications like cataracts and glaucoma are frequent, with poor visual outcomes even after surgery.
Area of Science:
- Ophthalmology
- Neonatal Care
- Public Health
Background:
- Advanced retinopathy of prematurity (ROP) poses a significant threat to infant vision.
- Timely diagnosis and intervention are crucial for managing ROP.
- Many infants with ROP present with advanced stages requiring specialized care.
Purpose of the Study:
- To evaluate the outcomes and complications in patients with advanced retinopathy of prematurity (ROP).
- To identify the frequency of specific complications and the need for surgical intervention.
- To highlight the long-term follow-up requirements for children affected by ROP.
Main Methods:
- Retrospective review of patients with stage 4 or 5 ROP.
- Analysis of treatment modalities including cryotherapy and laser photocoagulation.
- Assessment of surgical procedures and resulting complications.
Main Results:
- Thirty-one eyes of 17 patients were analyzed, with many progressing to advanced ROP despite initial treatment.
- High rates of complications were observed, including cataract (54.8%), microphthalmos (48.4%), and glaucoma (22.6%).
- Visual acuity was severely impaired in 93.6% of eyes (3/60 or less), with disappointing outcomes from retinal re-attachment surgery.
Conclusions:
- Advanced ROP frequently results in significant visual impairment and requires complex management.
- Cataract, microphthalmos, and glaucoma are common complications necessitating surgical intervention.
- Long-term follow-up is essential for children with ROP-related blindness.
Aims:
To assess the outcome and complications of patients with advanced retinopathy of prematurity (ROP).
Methods:
All patients with eyes achieving stage 4 or 5 retinopathy of prematurity were reviewed. Twenty one eyes were diagnosed during ROP screening in maternity hospitals and 10 eyes were of infants transferred for treatment.
Results:
Thirty one eyes of 17 patients were included. Thirteen eyes were treated for acute disease but progressed to stage 4 or 5; seven had cryotherapy and six diode laser photocoagulation. Cataract was found in 17 eyes (54.8%), glaucoma in seven eyes (22.6%), microphthalmos in 15 (48.4%), and corneal opacification in four eyes (12.9%). Fifteen eyes had surgical procedures; two (6.5%) had trabeculectomy, four (12.9%) had lensectomy, and nine (29%) retinal detachment repair. Transferred infants had their initial eye examination later than infants in hospitals screened by the authors and 80% of them had progressed beyond threshold ROP by the time they were transferred for treatment. Twenty nine eyes (93.6%) had visual acuities of 3/60 or less and only two eyes (6.5%) achieved 6/18 or less.
Conclusion:
The visual outcome of the eyes undergoing retinal re-attachment surgery was disappointing. Cataract, microphthalmos, and glaucoma were the most frequent complications, and surgical intervention was often required. The need for children who are blind as a result of ROP to have long term follow up is shown.