Chonnam Med J.  2009 Apr;45(1):60-65. 10.4068/cmj.2009.45.1.60.

Incidence and Risk Factors of Retinal Detachment after Laser Photocoagulation in Anterior Zone I Retinopathy of Prematurity

• Park SW
• Park JW
• Kim DH
• Ahn JK
• Park YG
• Heo H

• KMID: 2172285
• DOI: http://doi.org/10.4068/cmj.2009.45.1.60

Abstract

The aim of this study was to evaluate the incidence and risk factors of retinal detachment after laser photocoagulation therapy in anterior zone I retinopathy of prematurity (ROP). We performed a retrospective analysis of records of 30 eyes (16 patients) with threshold anterior zone I ROP that were treated with diode laser photocoagulation. We investigated the incidence and time of retinal detachment, birth weight, gestational age, systemic problem, vitreous hemorrhage, the interval between diagnosis of first ROP and threshold ROP, and the number of laser burns. We performed statistical analysis of the risk factors. The total incidence rate of retinal detachment was 43.3% (13 eyes), and the mean time was 2.85+/-2.88 (range: 1~12) weeks after laser photocoagulation. There were no significant differences in birth weight, gestational age, systemic problem, the interval between diagnosis of first ROP and threshold ROP, or the number of laser burns between the retinal detachment group and no retinal detachment group. The incidences of vitreous hemorrhage in the retinal detachment group and no retinal detachment group were 46.2% (6 eyes) and 5.9% (1 eye), respectively (p=0.04). The results suggest that vitreous hemorrhage is a risk factor for retinal detachment in threshold anterior zone I ROP after laser photocoagulation therapy. Vitreous hemorrhage should be regarded as a sign of poor prognosis and it is necessary to follow up carefully.

Keyword

Retinal detachment; Retinopathy of prematurity; Risk factors

MeSH Terms

Birth Weight
Burns
Diterpenes
Eye
Follow-Up Studies
Gestational Age
Incidence
Lasers, Semiconductor
Light Coagulation
Prognosis
Retinal Detachment
Retinaldehyde
Retinopathy of Prematurity
Retrospective Studies
Risk Factors
Vitreous Hemorrhage
Diterpenes
Retinaldehyde

Figure

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  Fig. 1 Time-event diagrams of events occurring after diode laser treatment of threshold anterior zone I retinopathy of prematurity for developing a retinal detachment. *ROP, retinopathy of prematurity; †RD, retinal detachment.

Reference

1. International committee for the classification of retinopathy of prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005. 123:991–999.

2. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. Three-month outcome. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol. 1990. 108:195–204.

3. Nissenkorn I, Kremer I, Gilad E, Cohen S, Ben-Sira I. 'Rush' type retinopathy of prematurity: report of three cases. Br J Ophthalmol. 1987. 71:559–562.

4. Flynn JT, Chan-Ling T. Retinopathy of prematurity: two distinct mechanisms that underlie zone 1 and zone 2 disease. Am J Ophthalmol. 2006. 142:46–59.

5. Kychenthal A, Dorta P, Katz X. Zone I retinopathy of prematurity: clinical characteristics and treatment outcomes. Retina. 2006. 26:Suppl 7. S11–S15.

6. Capone A, Diaz-Rohena R, Sternberg P Jr, Mandell B, Lambert HM, Lopez PF. Diode-laser photocoagulation for zone 1 threshold retinopathy of prematurity. Am J Ophthalmol. 1993. 116:444–450.

7. Axer-Siegel R, Maharshak I, Snir M, Friling R, Ehrlich R, Sherf I, et al. Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes. Retina. 2008. 28:839–846.

8. O'Keefe M, Lanigan B, Long VW. Outcome of zone 1 retinopathy of prematurity. Acta Ophthalmol Scand. 2003. 81:614–616.

9. Schaffer DB, Palmer EA, Plotsky DF, Metz HS, Flynn JT, Tung B, et al. Prognostic factors in the natural course of retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Ophthalmol. 1993. 100:230–237.

10. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. One-year outcome-structure and function. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol. 1990. 108:1408–1416.

11. Coats DK. Retinopathy of prematurity: involution, factors predisposing to retinal detachment, and expected utility of preemptive surgical reintervention. Trans Am Ophthalmol Soc. 2005. 103:281–312.

12. Kim SY, Kim SJ, Yu YS. Early ler treatment of rush-type retinopathy of prematurity. J Korean Ophthalmol Soc. 2005. 46:448–455.

13. Fleming TN, Runge PE, Charles ST. Diode laser photocoagulation for prethreshold, posterior retinopathy of prematurity. Am J Ophthalmol. 1992. 114:589–592.

14. Vander JF, Handa J, McNamara JA, Trese M, Spencer R, Repka MX, et al. Early treatment of posterior retinopathy of prematurity: a controlled trial. Ophthalmol. 1997. 104:1731–1735.

15. Récsán Z, Vámos R, Salacz G. Laser treatment of zone I prethreshold and stage 3 threshold retinopathy of prematurity. J Pediatr Ophthalmol Strabismus. 2003. 40:204–207.

16. Gotz-Wieckowska A, Rydlewska-Fojut M, Siennicka A, Burchardt-Kroll E, Gadzinowski J. The analysis of failure diode laser treatment of active phase of retinopathy of prematurity. Klin Oczna. 2006. 108:39–42.

17. Noyola DE, Bohra L, Paysse EA, Fernandez M, Coats DK. Association of candidemia and retinopathy of prematurity in very low birthweight infants. Ophthalmol. 2002. 109:80–84.

18. Hartnett ME, McColm JR. Fibrovascular organization in the vitreous following laser for ROP: implications for prognosis. Retina. 2006. 26:Suppl 7. S24–S31.

19. Ferrone PJ, de Juan E Jr. Vitreous hemorrhage in infants. Arch Ophthalmol. 1994. 112:1185–1189.

20. Cleary PE, Ryan SJ. Histology of wound, vitreous, and retina in experimental posterior penetrating eye injury in the rhesus monkey. Am J Ophthalmol. 1979. 88:221–231.

21. Ehrenberg M, Thresher RJ, Machemer R. Vitreous hemorrhage nontoxic to retina as a stimulator of glial and fibrous proliferation. Am J Ophthalmol. 1984. 97:611–626.

22. Hutcheson KA, Nguyen ATQ, Preslan MW, Ellish NJ, Steidl SM. Vitreous hemorrhage in patients with high-risk retinopathy of prematurity. Am J Ophthalmol. 2003. 136:258–263.

23. Kim EH, Lee JE, Choi HY, Oum BS. Outcome of diode laser photocoagulation for threshold and prethreshold retinopathy of prematurity. J Korean Ophthalmol Soc. 2007. 48:285–290.

24. Hardy RJ, Palmer EA, Dobson V, Summers CG, Phelps DL, Quinn GE. Risk analysis of prethreshold retinopathy of prematurity. Arch Ophthalmol. 2003. 121:1697–1701.