Visual field outcomes and refractive status of retinopathy of prematurity after laser treatment_Chinese Journal of Ocular Fundus Diseases

Authors：

Yao Yuou ,  Yin Hong , Li Xiaoxin , Zhao Mingwei , Liang Jianhong

Department of Ophthalmology, Peking University People’s Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100044, China;

Corresponding author：

Yin Hong, Email: yh6386@126.com

Keywords：

Retinopathy of prematurity/ therapy; Laser coagulation/adverse effects; Visual fields; Refractive errors

DOI：

10.3760/cma.j.issn.1005-1015.2017.02.009

Video：

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Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation. Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group. There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group, with an average age of (7.0±1.28) years. The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks, the birth weight (BW) of (1402.33±369.61) g and the number of laser burns was (517.86±277.40). The control group included 7 females (13 eyes) and 6 males (12 eyes), with an average age of (7.17±0.96) years. The age (t=0.691) and gender (χ²=1.425) were comparable between the two groups (P=0.491, 0.233). The data of patients and controls were retrospectively analyzed including best corrected visual acuity, refractive examination, automated perimetry test. The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed. ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB), mild VF loss group (MD≤6 dB) and moderate VF loss group (MD＞6 dB) according to the results of automated perimetry test, the differences of gestational age (GA), PA, BW, number of laser burns and SE between these groups were comparatively observed. Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27±3.34 dB, respectively; the difference between the two groups was statistically significant (t=–4.01,P＜0.001). The subgroup analysis showed that BW, number of laser burns, and SE were significantly different between no VF loss group and VF loss group (t=2.074, –1.996, –2.162;P=0.042, 0.026, 0.034); while the GA was not significantly different between these two groups (t=1.973,P=0.052). The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002). For refractive outcomes, the BW and ROP stage correlated with SE significantly (r=–0.304, –0.387;P=0.015, 0.002). The mean BCVA in ROP group was 0.84±0.23, and 59 eyes (91.2%) with BCVA better than 0.5. Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss, with good visual outcome.

Citation： Yao Yuou, Yin Hong, Li Xiaoxin, Zhao Mingwei, Liang Jianhong. Visual field outcomes and refractive status of retinopathy of prematurity after laser treatment. Chinese Journal of Ocular Fundus Diseases, 2017, 33(2): 148-152. doi: 10.3760/cma.j.issn.1005-1015.2017.02.009 Copy

1.	White JE, Repka MX. Randomized comparison of diode laser photocoagulation versus cryotherapy for threshold retinopathy of prematurity: 3-year outcome[J]. J Pediatr Ophthalmol Strabismus, 1997, 34(2): 83-87.
2.	Mintz-Hittner HA, Kennedy KA, Chuang AZ, et al. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity[J]. N Engl J Med, 2011, 364(7): 603-615. DOI: 10.1056/NEJMoa 1007374.
3.	Hwang CK, Hubbard GB, Hutchinson AK, et al. Outcomes after intravitreal bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis[J]. Ophthalmology, 2015, 122(5): 1008-1015. DOI: 10.1016/j.ophtha. 2014.12.017.
4.	Isaac M, Mireskandari K, Tehrani N. Treatment of type 1 retinopathy of prematurity with bevacizumab versus laser[J]. J AAPOS, 2015, 19(2): 140-144. DOI: 10.1016/j.jaapos.2015.01.009.
5.	Mueller B, Salchow DJ, Waffenschmidt E, et al. Treatment of type I ROP with intravitreal bevacizumab or laser photocoagulation according to retinal zone[J/OL]. Br J Ophthalmol, 2016, 2016: E308375[2016-06-14]. . DOI: 10.1136/bjophthalmol-2016-308375. [published online ahead of print].
6.	An International Classification of Retinopathy of Prematurity.The committee for the classification of retinopathy of prematurity[J]. Arch ophthalmol, 1984, 102(8): 1130-1134.
7.	International Committee for the Classification of Retinopathy of Prematurity.The International Classification of Retinopathy of Prematurity revisited[J]. Arch Ophthalmol, 2005, 123(7): 991-999.
8.	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(12): 1684-1694.
9.	陈晓明.自动视野计检查结果分析的基本知识[J]. 中华眼底病杂志, 2003, 19(5): 313-316.Chen XM. Elementary knowledge of results analysis of automatic perimeter[J]. Chin J Ocul Fundus Dis, 2003, 19(5): 313-316.
10.	Mills RP, Budenz DL, Lee PP, et al. Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease [J]. Am J Ophthalmol, 2006, 141(1): 24-30.
11.	Quinn GE, Dobson V, Hardy RJ, et al. Visual field extent at 6 years of age in children who had high-risk prethreshold retinopathy of prematurity[J]. Arch Ophthalmol, 2011, 129(2): 127-132. DOI: 10.1001/archophthalmol.2010.360.
12.	Holm M, Msall ME, Skranes J, et al. Antecedents and correlates of visual field deficits in children born extremely preterm[J]. Eur J Paediatr Neurol, 2015, 19(1): 56-63. DOI: 10.1016/j.ejpn. 2014.10.002.
13.	Larsson E, Martin L, Holmström G. Peripheral and central visual fields in 11-year-old children who had been born prematurely and at term[J]. J Pediatr Ophthalmol Strabismus, 2004, 41 (1): 39-45.
14.	Parrish RK 2nd, Gedde SJ, Scott IU, et al. Visual function and quality of life among patients with glaucoma[J]. Arch Ophthalmol, 1997, 115(11): 1447-1455.
15.	Gutierrez P, Wilson MR, Johnson C, et al. Influence of glaucomatous visual field loss on health-related quality of life[J]. Arch Ophthalmol, 1997, 115(6): 777-784.
16.	Quinn GE, Dobson V, Davitt BV, et al. Progression of myopia and high myopia in the early treatment for retinopathy of prematurity study: findings to 3 years of age[J]. Ophthalmology, 2008, 115(6): 1058-1064. DOI: 10.1016/j.ophtha.2007.07.028.
17.	Geloneck MM, Chuang AZ, Clark WL, et al. Refractive outcomes following bevacizumab monotherapy compared with conventional laser treatment: a randomized clinical trial[J]. JAMA Ophthalmol, 2014, 132(11): 1327-1333. DOI: 10.1001/jamaophthalmol. 2014.2772.
18.	Shalev B, Farr AK, Repka MX. Randomized comparison of diode laser photocoagulation versus cryotherapy for threshold retinopathy of prematurity: seven-year outcome[J]. Am J Ophthalmol, 2001, 132(1): 76-80.
19.	Fallaha N, Lynn MJ, Aaberg TM Jr, et al. Clinical outcome of confluent laser photoablation for retinopathy of prematurity[J]. J AAPOS, 2002, 6(2): 81-85.
20.	Yang CS, Wang AG, Sung CS, et al. Long-term visual outcomes of laser-treated threshold retinopathy of prematurity: a study of refractive status at 7 years[J]. Eye (Lond), 2010, 24(1): 14-20. DOI: 10.1038/eye.2009.63.
21.	Report of a WHO Study Group.The prevention of blindness[J]. World Health Organ Tech Rep Ser, 1973, 518: 1-18.
22.	McLoone E, O'Keefe M, McLoone S, et al. Long term functional and structural outcomes of laser therapy for retinopathy of prematurity[J]. Br J Ophthalmol, 2006, 90(6): 754-759.
23.	Axer-Siegel R, Maharshak I, Snir M, et al. Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes[J]. Retina, 2008, 28(6): 839-846. DOI: 10.1097/IAE.0b013e 318169faee.
24.	Sims LM, Stoessel K, Thompson JT, et al. Assessment of visual-field changes before and after focal photocoagulation for clinically significant diabetic macular edema[J]. Ophthalmologica, 1990, 200(3): 133-141.

1. White JE, Repka MX. Randomized comparison of diode laser photocoagulation versus cryotherapy for threshold retinopathy of prematurity: 3-year outcome[J]. J Pediatr Ophthalmol Strabismus, 1997, 34(2): 83-87.
2. Mintz-Hittner HA, Kennedy KA, Chuang AZ, et al. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity[J]. N Engl J Med, 2011, 364(7): 603-615. DOI: 10.1056/NEJMoa 1007374.
3. Hwang CK, Hubbard GB, Hutchinson AK, et al. Outcomes after intravitreal bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis[J]. Ophthalmology, 2015, 122(5): 1008-1015. DOI: 10.1016/j.ophtha. 2014.12.017.
4. Isaac M, Mireskandari K, Tehrani N. Treatment of type 1 retinopathy of prematurity with bevacizumab versus laser[J]. J AAPOS, 2015, 19(2): 140-144. DOI: 10.1016/j.jaapos.2015.01.009.
5. Mueller B, Salchow DJ, Waffenschmidt E, et al. Treatment of type I ROP with intravitreal bevacizumab or laser photocoagulation according to retinal zone[J/OL]. Br J Ophthalmol, 2016, 2016: E308375[2016-06-14]. . DOI: 10.1136/bjophthalmol-2016-308375. [published online ahead of print].
6. An International Classification of Retinopathy of Prematurity.The committee for the classification of retinopathy of prematurity[J]. Arch ophthalmol, 1984, 102(8): 1130-1134.
7. International Committee for the Classification of Retinopathy of Prematurity.The International Classification of Retinopathy of Prematurity revisited[J]. Arch Ophthalmol, 2005, 123(7): 991-999.
8. 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(12): 1684-1694.
9. 陈晓明.自动视野计检查结果分析的基本知识[J]. 中华眼底病杂志, 2003, 19(5): 313-316.Chen XM. Elementary knowledge of results analysis of automatic perimeter[J]. Chin J Ocul Fundus Dis, 2003, 19(5): 313-316.
10. Mills RP, Budenz DL, Lee PP, et al. Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease [J]. Am J Ophthalmol, 2006, 141(1): 24-30.
11. Quinn GE, Dobson V, Hardy RJ, et al. Visual field extent at 6 years of age in children who had high-risk prethreshold retinopathy of prematurity[J]. Arch Ophthalmol, 2011, 129(2): 127-132. DOI: 10.1001/archophthalmol.2010.360.
12. Holm M, Msall ME, Skranes J, et al. Antecedents and correlates of visual field deficits in children born extremely preterm[J]. Eur J Paediatr Neurol, 2015, 19(1): 56-63. DOI: 10.1016/j.ejpn. 2014.10.002.
13. Larsson E, Martin L, Holmström G. Peripheral and central visual fields in 11-year-old children who had been born prematurely and at term[J]. J Pediatr Ophthalmol Strabismus, 2004, 41 (1): 39-45.
14. Parrish RK 2nd, Gedde SJ, Scott IU, et al. Visual function and quality of life among patients with glaucoma[J]. Arch Ophthalmol, 1997, 115(11): 1447-1455.
15. Gutierrez P, Wilson MR, Johnson C, et al. Influence of glaucomatous visual field loss on health-related quality of life[J]. Arch Ophthalmol, 1997, 115(6): 777-784.
16. Quinn GE, Dobson V, Davitt BV, et al. Progression of myopia and high myopia in the early treatment for retinopathy of prematurity study: findings to 3 years of age[J]. Ophthalmology, 2008, 115(6): 1058-1064. DOI: 10.1016/j.ophtha.2007.07.028.
17. Geloneck MM, Chuang AZ, Clark WL, et al. Refractive outcomes following bevacizumab monotherapy compared with conventional laser treatment: a randomized clinical trial[J]. JAMA Ophthalmol, 2014, 132(11): 1327-1333. DOI: 10.1001/jamaophthalmol. 2014.2772.
18. Shalev B, Farr AK, Repka MX. Randomized comparison of diode laser photocoagulation versus cryotherapy for threshold retinopathy of prematurity: seven-year outcome[J]. Am J Ophthalmol, 2001, 132(1): 76-80.
19. Fallaha N, Lynn MJ, Aaberg TM Jr, et al. Clinical outcome of confluent laser photoablation for retinopathy of prematurity[J]. J AAPOS, 2002, 6(2): 81-85.
20. Yang CS, Wang AG, Sung CS, et al. Long-term visual outcomes of laser-treated threshold retinopathy of prematurity: a study of refractive status at 7 years[J]. Eye (Lond), 2010, 24(1): 14-20. DOI: 10.1038/eye.2009.63.
21. Report of a WHO Study Group.The prevention of blindness[J]. World Health Organ Tech Rep Ser, 1973, 518: 1-18.
22. McLoone E, O'Keefe M, McLoone S, et al. Long term functional and structural outcomes of laser therapy for retinopathy of prematurity[J]. Br J Ophthalmol, 2006, 90(6): 754-759.
23. Axer-Siegel R, Maharshak I, Snir M, et al. Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes[J]. Retina, 2008, 28(6): 839-846. DOI: 10.1097/IAE.0b013e 318169faee.
24. Sims LM, Stoessel K, Thompson JT, et al. Assessment of visual-field changes before and after focal photocoagulation for clinically significant diabetic macular edema[J]. Ophthalmologica, 1990, 200(3): 133-141.

Chinese Journal of Ocular Fundus Diseases

Visual field outcomes and refractive status of retinopathy of prematurity after laser treatment

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