FOLLOW-UP AFTER TRANSPUPILLAR DIODE LASER PHOTOCOAGULATION IN RETINOPATHY OF PREMATURITY STAGE 3+
C. Voegele, W. Jendritza, V. Seiberth
Purpose: To evaluate the anatomical and functional outcome after transpupillar diode laser treatment of retinopathy of prematurity (ROP) stage 3+, we prospectively examined preterm infants after transpupillar diode Iaser photocoagulation.
Methods: After transpupillar diode laser photocoagulation for ROP stage 3+ using the laser indirect ophthalmoscope, we examined 90 eyes in 62 infants (gestational age 23 to 31 weeks (mean ± SD 2B.5 ± 1.6); birth weight 430 to 1400 g (848 ± 204)). Examinations included evaluation of anterior segment (handheld slit lamp), fundus (binocular ophthalmoscopy), visual acuity (Teller acuity cards, Snellen equivalents), refractive error (cycloplegic retinoscopy) and strabismus (cover test). Anatomical follow-up ranged from 6 weeks to 4.5 years (88 ± 69 weeks). Functional follow-up was from 11 weeks to 4.5 years (99 ± 65 weeks).
Results: In 88 (98%) of 90 eyes the outcome was an attached retina. Mild to moderate dragging of the retina was present in 8 eyes (9 %). Two eyes (2 %) showed stage 5 ROP (total retinal detachment). In the 88 eyes with attached retina there were no anterior segment complications (e.g., iris burns, synechiae, cataract). Refractive error ranged from -17.5 to +5.0 D (-2.5 ± 5.2) in these eyes. Visual acuity (Snellen equivalents) was from 0.01 to 0.8 (0.2 ± 0.2). Esotropia was present in 21 (34 %) of the 62 children. One (2 %) child with ROP stage 5 showed exotropia. Conclusion: Our results show that transpupillar diode laser photocoagulation can safely be used for the treatment of ROP stage 3+. No adverse or unexpected treatment side effects werenoticed during follow-up.
Department of Ophthalmology, Marienhospital Osnabrueck, D - 49074 Osnabrueck, Germany