Related Experiment Videos
Longer-term visual outcome of eyes with retinopathy of prematurity treated with cryotherapy or diode laser
M O'Keefe1, J O'Reilly, B Lanigan
1Children's Hospital, Temple Street, Dublin, Ireland.
Insights
Cryotherapy and diode laser treatments for retinopathy of prematurity can lead to optimal visual acuity if structural outcomes are good. Neither treatment method inherently limits visual potential in these cases.
Area of Science:
- Ophthalmology
- Neonatal Care
- Retinopathy of Prematurity
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Cryotherapy and diode laser photocoagulation are established treatments for threshold ROP.
Purpose of the Study:
- To assess the long-term visual outcome of eyes treated for threshold ROP using cryotherapy versus diode laser.
- To correlate structural outcomes with visual acuity following these treatments.
Main Methods:
- A retrospective analysis of 66 eyes in 37 patients treated with cryotherapy (30 eyes) or diode laser (36 eyes) for threshold ROP.
- Structural outcomes were categorized as optimal (flat posterior pole) or suboptimal (macular abnormalities, retinal detachment).
- Visual acuity and refractive errors were assessed at corrected ages ranging from 30 to 98 months.
Main Results:
- Optimal structural outcomes correlated with optimal visual acuity (6/12 or better) in all cases, regardless of treatment modality.
- Suboptimal structural outcomes were invariably associated with suboptimal visual acuity.
- Amblyopia was observed in 8/20 cryotherapy-treated eyes and 5/26 laser-treated eyes with optimal structural outcomes.
- Laser-treated eyes showed significantly fewer refractive errors and less anisometropic amblyopia.
Conclusions:
- Optimal structural outcomes following cryotherapy or diode laser treatment for ROP are associated with good visual acuity (≥6/12).
- The choice between cryotherapy and diode laser does not appear to limit the visual potential of treated eyes.
- Diode laser treatment may offer advantages regarding refractive errors and amblyopia incidence.
Aims:
Visual outcome of 66 eyes in 37 patients who had undergone treatment with either cryotherapy or diode laser for threshold retinopathy of prematurity was assessed.
Methods:
17 patients, representing 30 eyes treated with cryotherapy, were examined at between 56 and 98 months corrected age (median 68 months). 20 patients representing 36 eyes treated with diode laser, were examined at between 30 and 66 months corrected age (median 51 months). Structural outcome was categorised as: optimal--flat posterior pole; suboptimal--macular ectopia, optic nerve hypoplasia, retinal fold involving the macula, and retinal detachment involving the macula.
Results:
Optimal structural outcome was, in the absence of amblyopia, associated with optimal visual acuity (of 6/12 or better) in all cases, with most eyes achieving a visual acuity of 6/9 or 6/6. Suboptimal structural outcome was invariably associated with suboptimal visual acuity. Amblyopia was present in eight out of 20 cryotherapy treated eyes and in five out of 26 laser treated eyes with an optimal structural outcome. Refractive errors were significantly less in laser treated eyes as was the incidence of anisometropic amblyopia.
Conclusion:
Eyes treated with either cryotherapy or diode laser for threshold retinopathy of prematurity with optimal structural outcome are associated with development of optimal visual acuity--that is, 6/12 or better. Treatment with either cryotherapy or laser does not in itself reduce the visual potential of these eyes.