Early Laser Treatment for Advanced Retinopathy of Prematurity

嚴重早產兒視網膜病變之早期網膜雷射治療

吳嘉敏(Chia-Min Wu) ； 王嘉康(Jia-Kang Wang)

《中華民國眼科醫學會雜誌》 49卷2期 (2010/06) Pp. 154-161

https://doi.org/10.30048/ACTASOS.201006.0006

摘要

Background and Objective: To investigate the clinical outcome of early laser treatment for advanced retinopathy of prematurity (ROP) in Taiwan. Materials and Methods: From December 2003 to July 2008, we performed fundus examination during postnatal 4-week period for infants with gestational age (GA) less than 36 weeks or birth body weight (BBW) less than 2000 g at Far Eastern Memorial Hospital. Peripheral retinal avascular-area ablation with diode laser in nearly confluent pattern was done in infants with threshold ROP and type 1 ROP, according to the guidelines of Early Treatment for Retinopathy of Prematurity (ETROP) trial.
Results: We included 168 cases (336 eyes) in our study. There were 21 cases (42 eyes) (12.5%) compatible with criteria for laser treatment. Ten cases were categorized as type 1 ROP, with the other 11 categorized as threshold ROP. There was statistically significant difference in GA and BBW between type 1 and threshold ROP (p ＜ 0.05). Laser treatment was administered in type 1 ROP at postconceptual age 35.9 ± 1.6 weeks, which was younger than 37.5 ± 1.3 weeks in threshold ROP (p = 0.02). After single session of laser treatment, all of the cases had regressed ROP without any unfavorable structural outcome.
Conclusion: The ETROP trial provided practical guidelines for treatment of advanced ROP among infants in Taiwan. Infants with type 1 ROP had significantly younger GA, less BBW, and younger postconceptual age in which laser was performed than those with threshold ROP.

並列摘要

Background and Objective: To investigate the clinical outcome of early laser treatment for advanced retinopathy of prematurity (ROP) in Taiwan. Materials and Methods: From December 2003 to July 2008, we performed fundus examination during postnatal 4-week period for infants with gestational age (GA) less than 36 weeks or birth body weight (BBW) less than 2000 g at Far Eastern Memorial Hospital. Peripheral retinal avascular-area ablation with diode laser in nearly confluent pattern was done in infants with threshold ROP and type 1 ROP, according to the guidelines of Early Treatment for Retinopathy of Prematurity (ETROP) trial.
Results: We included 168 cases (336 eyes) in our study. There were 21 cases (42 eyes) (12.5%) compatible with criteria for laser treatment. Ten cases were categorized as type 1 ROP, with the other 11 categorized as threshold ROP. There was statistically significant difference in GA and BBW between type 1 and threshold ROP (p ＜ 0.05). Laser treatment was administered in type 1 ROP at postconceptual age 35.9 ± 1.6 weeks, which was younger than 37.5 ± 1.3 weeks in threshold ROP (p = 0.02). After single session of laser treatment, all of the cases had regressed ROP without any unfavorable structural outcome.
Conclusion: The ETROP trial provided practical guidelines for treatment of advanced ROP among infants in Taiwan. Infants with type 1 ROP had significantly younger GA, less BBW, and younger postconceptual age in which laser was performed than those with threshold ROP.

並列關鍵字

diode laser ； retinopathy of prematurity ； early treatment ； threshold disease ； gestational age ； birth body weight