Outcomes after laser therapy for threshold retinopathy of prematurity

Objective: To determine the anatomic outcomes of eyes treated with laser photocoagulation for threshold retinopathy of prematurity and to identify potential risk factors for unfavorable outcomes after treatment. Design: Retrospective, noncomparative case series. Intervention: Photocoagulation of the peripheral avascular retina with an argon or diode laser indirect ophthalmoscope. Participants., One hundred twenty eyes of 81 infants with threshold retinopathy of prematurity treated with laser photocoagulation from 1989 through 1997 with at least 12 months of follow-up after treatment. Main Outcome Measures: The principal outcome was the presence of an unfavorable anatomic outcome defined as a retinal detachment, macular fold, or retrolental tissue. Results: One hundred nine of 120 eyes (91%) had favorable outcomes. Eleven eyes (9%) had retinal detachments, and 1 of the 11 also had retrolental tissue. Zone 1 eyes appeared to be 3.3 times more likely to have an unfavorable outcome compared with zone 2 eyes, but the 95% confidence interval (0.8-14.5) did not support this statistically. Twenty-four of 109 eyes (22%) experienced dragging of the temporal vessels. Those with zone 1 disease were 13.7 times more likely to experience temporal dragging compared with zone 2 eyes (95% confidence interval, 3.3-57.2). Conclusions. After laser photocoagulation for threshold retinopathy of prematurity, 91% of eyes had a favorable anatomic outcome. Compared with zone 2 eyes, zone 1 eyes may be more likely to have temporal dragging of the retinal vessels. Laser therapy is effective in the treatment of threshold retinopathy of prematurity.