Outcomes of Laser Photocoagulation for ROP in the Decade after Early Treatment for Retinopathy of Prematurity Trial (ETROP)
Nasrin N. Tehrani, MD; Seema Emami; Maram M. Isaac, MD; Kamiar K. Mireskandari, MD
The Hospital for Sick Children
Introduction: We report the structural, visual, and refractive outcomes following laser treatment for type 1 ROP at a Canadian centre in the decade after the publication of results of ETROP randomized trial.1
Methods: We reviewed charts for infants treated between 2004-2014. Patients with type 1 ROP and follow-up examination at 8-15 months corrected age (CA) and/or 3 years ±6 months were included. We report structural outcome as per ETROP criteria. Secondary outcomes were refractive error and visual acuity (VA), reported in spherical equivalent (SE) and logMAR, respectively.
Results: One hundred and seventeen infants (n=213 eyes) received laser in zone I (n=43), and zone II (n=170). Mean gestational age was 25.4±1.6 weeks. Mean birth weight was 758.5±272.1 grams. Four eyes (1.9%) demonstrated unfavorable structural outcome; three were in zone I. At 8-15 months CA, mean VA was 0.9±0.34 logMAR (range 0.00 to 2.12), and mean refractive error was -3.23±4.63 SE diopters (range -18.50 to +12.50). At 3 years, mean VA was 0.4±0.38 logMAR (range 0.00 to 1.90), with mean refractive error of -5.41±5.99 SE diopters (range -21.00 to +2.25).
Discussion: We observed lower rates of unfavorable structural outcomes compared to ETROP.1 Refractive error and VA findings are consistent with previous studies.2,3
Conclusion: Structural outcomes following laser may have improved since ETROP. Our results highlight the value of incorporating institutional data as well as published comparisons when obtaining consent for ROP treatment. This is particularly relevant when parents are offered a choice between laser and anti-VEGF treatment modalities.
References: 1. Early Treatment For Retinopathy Of Prematurity Cooperative G. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121(12):1684-1694.
2. Geloneck MM, Chuang AZ, Clark WL, et al. Refractive Outcomes at Age 2½ Years in the Bevacizumab Eliminates the Angiogenic Threat for Retinopathy of Prematurity Trial: A Randomized Clinical Trial. Journal of American Association for Pediatric Ophthalmology and Strabismus. 2013;17(1):e1-7.
3. Early Treatment for Retinopathy of Prematurity Cooperative G, Good WV, Hardy RJ, et al. Final visual acuity results in the early treatment for retinopathy of prematurity study. Arch Ophthalmol. 2010;128(6):663-671.