Transscleral diode laser retinal photocoagulation for the treatment of threshold retinopathy of prematurity. 2009

Mohammad Mehdi Parvaresh, and Mehdi Modarres, and Khalil Ghasemi Falavarjani, and Karim Sadeghi, and Parisa Hammami
Eye Research Center, Iran University of Medical Sciences, Tehran, Iran.

OBJECTIVE To evaluate the outcomes of transscleral diode laser photocoagulation for treatment of threshold retinopathy of prematurity (ROP). METHODS Retrospective interventional case series of infants with ROP treated at our center with transscleral diode laser retinal photocoagulation. All patients were followed for 2 months, and regression of ROP, unfavorable outcomes, and incidence of adverse effects were assessed. RESULTS A total of 103 eyes of 52 infants with ROP at the threshold stage were treated with transscleral diode laser photocoagulation under topical anesthesia, without conjunctival incision. Supplemental transpupillary diode laser photocoagulation was used for posterior zone 2 and zone 1 in 5 eyes. In 99 eyes (96.1%) neovascularization regressed completely; in 96 eyes (93.2%) the outcome was favorable. In the other 3 eyes, macular dragging formed after regression of neovascularization. Four eyes progressed to more advanced stages of ROP. Repeated laser therapy was performed with the same technique in 10 eyes (9.6%). There was no statistically significant association of unfavorable outcomes with age, birth weight, gestational age, clocks of retinal involvement, and rush disease. No adverse effects of diode laser treatment were observed except for mild injection and edema of conjunctiva in all patients, small conjunctival lacerations in 10 eyes, and small self-limited vitreous hemorrhage in 2 eyes. CONCLUSIONS Transscleral laser treatment may be technically easier for the treatment of retinal periphery, especially in poorly dilating pupils, and obviates the occasional anterior segment complications of the transpupillary approach. This technique can be performed under topical anesthesia.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D001724 Birth Weight The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms. Birthweight,Birth Weights,Birthweights,Weight, Birth,Weights, Birth
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012178 Retinopathy of Prematurity A bilateral retinopathy occurring in premature infants treated with excessively high concentrations of oxygen, characterized by vascular dilatation, proliferation, and tortuosity, edema, and retinal detachment, with ultimate conversion of the retina into a fibrous mass that can be seen as a dense retrolental membrane. Usually growth of the eye is arrested and may result in microophthalmia, and blindness may occur. (Dorland, 27th ed) Retrolental Fibroplasia,Fibroplasia, Retrolental,Fibroplasias, Retrolental,Prematurity Retinopathies,Prematurity Retinopathy,Retrolental Fibroplasias
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012590 Sclera The white, opaque, fibrous, outer tunic of the eyeball, covering it entirely excepting the segment covered anteriorly by the cornea. It is essentially avascular but contains apertures for vessels, lymphatics, and nerves. It receives the tendons of insertion of the extraocular muscles and at the corneoscleral junction contains the CANAL OF SCHLEMM. (From Cline et al., Dictionary of Visual Science, 4th ed) Scleral Spur,Scleral Spurs,Scleras
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017075 Laser Coagulation The use of green light-producing LASERS to stop bleeding. The green light is selectively absorbed by HEMOGLOBIN, thus triggering BLOOD COAGULATION. Laser Thermocoagulation,Thermocoagulation, Laser,Coagulation, Laser,Coagulations, Laser,Laser Coagulations,Laser Thermocoagulations,Thermocoagulations, Laser

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