Analysis on outcomes of laser photocoagulation for retinopathy of prematurity_Chinese Journal of Ocular Fundus Diseases

Authors：

LiManhong , ZhangZifeng ,  WangYusheng , 王静 , 王晓婕 , 樊静 , 李树志 , 张志红

Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;

Corresponding author：

WangYusheng, Email: wangys003@126.com

Keywords：

Retinopathy of prematurity/therapy; Laser coagulation

DOI：

10.3760/cma.j.issn.1005-1015.2014.01.007

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Objective To observe clinical outcomes of laser photocoagulation on retinopathy of prematurity (ROP). Methods Clinical data of 64 cases of ROP infants (127 eyes) were studied retrospectively. Fifteen infants (30 eyes) were diagnosed of pre-threshold ROP (type Ⅰ, 23.6%) and 49 cases (97 eyes) of threshold ROP (76.4%). All the eyes underwent photocoagulation through binocular indirect ophthalmoscope (532 nm or 810 nm) within 72 hours after the confirmation ROP. In all the 15 cases (30 eyes) of pre-threshold ROP (type Ⅰ), 6 of them (12 eyes) were photocoagulated by laser of 532 nm, and the other 9 ones (18 eyes) were treated with 810 nm. In 49 threshold ROP infants (97 eyes), 37 cases (73 eyes) and 12 ones (24 eyes) were treated with laser of 532 nm or 810 nm respectively. All the infants were followed up 12-36 months (18.4 months) since photocoagulation to investigate regression of ROP. All the data of ROP infants photocoagulated, such as recovery rate of one-time photocoagulation, repeat rate, unfavorable outcomes, and complications, were analyzed statistically according to the severity of ROP and wave length of laser employed. Results In all the 127 photocoagulation treated eyes, ROP regressed completely in 125 eyes (98.4%), temporal retinal traction remained in 2 eyes (1.6%), and no retinal detachment was found. ROP regressed completely in 118 eyes (92.9%) after one-time photocoagulation, recovered totally in 6 eyes (4.7%) after repeating photocoagulation 2-3 times, and resorted to cryotherapy in 3 eyes (2.4%). Subconjunctiva hemorrhage, found in 12 eyes (9.4%), was the most common complication. During photocoagulation, anesthetic accident occurred in 1 infant (1.6%), and 1 eye developed cataract (0.8%). It was suggested from statistical analysis that there was no significant difference on efficiency or safety between pre-threshold (type Ⅰ) and threshold ROP photocoagulated by laser of 532 nm or 810 nm. However, almost all of the ROP infants need repeat photocoagulation or additional cryotherapy, and patients with unfavorable outcomes or severe complications, occurred in threshold ROP treated with 532 nm laser. Conclusion Photocoagulation with 532 nm or 810 nm laser is effective for type Ⅰ pre-threshold or threshold ROP.

Citation： LiManhong, ZhangZifeng, WangYusheng. Analysis on outcomes of laser photocoagulation for retinopathy of prematurity. Chinese Journal of Ocular Fundus Diseases, 2014, 30(1): 24-27. doi: 10.3760/cma.j.issn.1005-1015.2014.01.007 Copy

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16.	李秋平,王宗华,章晟,等. 新生儿重症监护病房床旁激光治疗严重早产儿视网膜病变103例报告[J]. 中华儿科杂志, 2013,51:12-15.
17.	李曼红,张自峰,王雨生,等. 早产儿视网膜病变激光光凝治疗后白内障一例[J].中华眼底病杂志, 2012, 28:89-90.
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1. Good WV, Hardy RJ, Dobson V, et al. The incidence and course of retinopathy of prematurity:findings from the early treatment for retinopathy of prematurity study[J]. Pediatrics, 2005, 116:15-23.
2. Chen Y, Li X. Characteristics of severe retinopathy of prematurity patients in China:a repeat of the first epidemic?[J]. Br J Ophthalmol, 2006, 90:268-271.
3. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity:ophthalmological outcomes at 10 years[J]. Arch Ophthalmol, 2001, 119:1110-1118.
4. Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity:results of the early treatment for retinopathy of prematurity randomized trial[J]. Arch Ophthalmol, 2003, 121:1684-1694.
5. 赵培泉, 费萍. 早产儿视网膜病变诊断治疗研究现状、问题及展望[J]. 中华眼底病杂志, 2012, 28:3-7.
6. 中华医学会. 早产儿治疗用氧和视网膜病变防治指南[J]. 中华眼科杂志, 2005, 41:375-376.
7. 黎晓新, 陈宜. 积极推动早产儿视网膜病变的防治[J]. 中华眼底病杂志, 2008, 24:1-4.
8. 王雨生, 李蓉. 重视我国早产儿视网膜病变的防治工作[J]. 中华眼科杂志, 2011, 47:483-486.
9. 尹虹, 黎晓新, 赵明威, 等. 早产儿视网膜病变激光治疗的疗效分析[J]. 眼科研究, 2007, 25:208-210.
10. 倪颖勤, 黄欣, 单海冬, 等. 早产儿视网膜病变七年筛查治疗结果临床分析[J]. 中华眼底病杂志, 2012, 28:45-48.
11. 张国明, 曾键, 黄丽娜, 等. 广角数码儿童视网膜成像系统引导下激光光凝治疗早产儿视网膜病变[J]. 中华眼底病杂志, 2008, 24:17-19.
12. 王雨生,张自峰,李曼红,等. 西安地区早产儿视网膜病变筛查的初步结果[J]. 中华眼科杂志, 2010, 46:119-124.
13. International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited[J]. Arch Ophthalmol, 2005, 123:991-999.
14. Reynolds JD. 王雨生, 译. 小儿视网膜. 西安:第四军医大学出版社, 2013:91-127.
15. Houston SK, Wykoff CC, Berrocal AM, et al. Laser treatment for retinopathy of prematurity[J]. Lasers Med Sci, 2013, 28:683-692.
16. 李秋平,王宗华,章晟,等. 新生儿重症监护病房床旁激光治疗严重早产儿视网膜病变103例报告[J]. 中华儿科杂志, 2013,51:12-15.
17. 李曼红,张自峰,王雨生,等. 早产儿视网膜病变激光光凝治疗后白内障一例[J].中华眼底病杂志, 2012, 28:89-90.
18. 李曼红,张自峰,王雨生,等.早产儿视网膜病变筛查相关意外和并发症分析[J].中华眼底病杂志, 2012, 28:73-74.

Chinese Journal of Ocular Fundus Diseases

Analysis on outcomes of laser photocoagulation for retinopathy of prematurity

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