Effect of retinal hemorrhage on laser photocoagulation in patients with retinopathy of prematurity_Chinese Journal of Ocular Fundus Diseases

Authors：

Tian Ruyin ,  Zhang Guoming , He Honghui , Wu Zhenquan , Zhao Jinfeng

Shenzhen Eye Hospital Affiliated to Jinan University, Key Laboratory of Ophthalmology in Shenzhen, Shenzhen 518040, China;

Corresponding author：

Zhang Guoming, Email: 13823509060@163.com

Keywords：

Retinopathy of prematurity/therapy; Retinal hemorrhage; Laser coagulation

DOI：

10.3760/cma.j.issn.1005-1015.2018.05.011

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ObjectiveTo observe the effect of retinal hemorrhage on the treatment of retinopathy of prematurity (ROP) by laser photocoagulation.MethodsRetrospective case analysis. Screening and diagnosis of 134 eyes in 67 patients with ROP in Zone Ⅱ Stage 3+ were included in the study. Among them, 32 patients were male and 35 patients were female. The average birth gestational age was 27.80±2.55 weeks. The average birth weight was 1060±320 g. All children underwent binocular indirect ophthalmoscopy and RetCam Ⅲ. Of the 134 eyes, 38 eyes (28%) with anterior, ridge or vitreous hemorrhage (group A); 96 eyes (72%) without hemorrhage. Retinal avascular photocoagulation was performed within 72 hours after diagnosis by intravenous sedative combined with ocular surface anesthesia with 810 nm laser. Follow-up was performed at 1, 4, 8 and 12 weeks after treatment, and then every 6 months thereafter. The same equipment and methods before treatment were used to examine and document the regression and progression of ROP. The number of eyes with lesions after photocoagulation in the two groups was compared by χ² test. The t-test was used to compare the gestational age and birth weight.ResultsAmong 134 eyes, lesions completely resolved in 125 eyes (93.3%), progressed in 9 eyes (6.7%). In group A, 7 eyes were progressive (18.4%). In group B, 2 eyes were progressive (2.1%). There was a statistically significant difference in the number of eyes with lesions after laser treatment in group A and B (χ²=9.14, P=0.003). There was no significant difference in birth gestational age and birth weight (t=0.85, 0.25; P=0.40, 0.80).ConclusionThe laser photocoagulation is safe and effective in the treatment of ROP. The preretinal, ridge or vitreous hemorrhage is related to the progression of the lesion after laser photocoagulation.

Citation： Tian Ruyin, Zhang Guoming, He Honghui, Wu Zhenquan, Zhao Jinfeng. Effect of retinal hemorrhage on laser photocoagulation in patients with retinopathy of prematurity. Chinese Journal of Ocular Fundus Diseases, 2018, 34(5): 467-470. doi: 10.3760/cma.j.issn.1005-1015.2018.05.011 Copy

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1. lencowe H, Lawn JE, Vazquez T, et al. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and globalevels for 2010[J]. Pediatr Res, 2013, 74(1): 35-49. DOI: 10.1038/pr.2013.205.
2. 陈宜, 李方烃, 邓洵, 等. 早产儿视网膜病变阈值前1型激光光凝的疗效观察[J]. 中华眼科杂志, 2015, 51(11): 814-817. DOI: 10.3760/cma.j.issn.0412-4081.2015.11.004.Chen Y, Li FT, Deng X, et al. The efficiency of 810 nm diode laser photocoagulation for type1 retinopathy of prematurity[J]. Chin J Ophthalmol, 2015, 51(11): 814-817. DOI: 10.3760/cma.j.issn.0412-4081.2015.11.004.
3. Hu Q, Bai Y, Chen X, et al. Recurrence of retinopathy of prematurity in zone Ⅱ stage 3+ after ranibizumab treatment: aretrospective study[J/OL]. J Ophthalmol, 2017, 2017: 5078565[2017-04-09]. https://doi.org/10.1155/2017/5078565. DOI: 10.1155/2017/5078565.
4. 中华医学会. 早产儿治疗用氧和视网膜病变防治指南[J]. 中华医学杂志, 2005, 85(10): 661-662. DOI: 10.3760/j.issn.0376-2491.2005.10.005.Chinese Medical Association. Guidelines for the treatment of oxygen and retinopathy in preterm infants[J]. Natl Med J China, 2005, 41(4): 661-662. DOI: 10.3760/j.issn.0376-2491.2005.10.005.
5. 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. DOI: 10.1001/archopht.123.7.991.
6. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results[J]. Arch Ophthalmol, 1988, 106(4): 471-479. DOI: 10.1001/archopht.1988.01060130517027.
7. Kim JE, Lee AC. Demographic changes and response to laser treatmentin threshold retinopathy of prematurity: 10-year experience[J]. J Pediatr Ophthalmol Strabismus, 2010, 47(4): 231-235. DOI: 10.3928/01913913-20090918-08.
8. Gotz-Wiekowska A, Rydlewska-Fojut M, Siennicka A, et al. The analysis of failure diode laser treatment of active phase of retinopathy of prematurity[J]. Klin Oczna, 2006, 108(1-3): 39-42.
9. Talu S, Cormos D, Zaharia G, et al. Prognostic factors for laser treatment in retinopathy of prematurity[J]. Oftalmologia, 2011, 55(1): 84-89.
10. 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. DOI: 10.1001/archopht.121.12.1684.
11. Pieh C, Agostini H, Buschbeck C, et al. VEGF-A, VEGFR-1, VEGFR-2 and Tie2 levels in plasma of premature infants: Relationship to retinopathy of prematurity[J]. Br J Ophthalmol, 2008, 92(5): 689-693. DOI: 10.1136/bjo.2007.128371.
12. Kim MJ, Kim S, Yu YS. The risk for retinal detachment associated with hemorrhages pre and Postlaser treatment in retinopathy of prematurity[J]. Retina, 2008, 28(10): 1451-1457.
13. Sanghi G, Dogra MR, Katoch D, et al. Aggressive posterior retinopathy of prematurity: risk factors for retinal detachment despite confluent laser photocoagulation[J]. Am J Ophthalmol, 2013, 155: 159-164. DOI: 10.1016/j.ajo.2012.07.012.

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