Demographic Changes and Response to Laser Treatment in Threshold Retinopathy of Prematurity: 10-Year Experience

Purpose:To evaluate the outcome of indirect diode laser treatment for threshold retinopathy of prematurity (ROP) and to report demographic changes observed over 10 years. Methods: Retrospective chart review and statistical analysis of 111 eyes of 61 infants treated for threshold ROP between 1991. and 2001 at a single academic institution. Results: Ninety-six of 111 (86%) eyes showed regression of neovascularization after laser treatment. Fourteen (13%) eyes had zone 1 disease and 97 (87%) eyes had zone 2 disease. Thirty-six percent of eyes with zone 1 disease progressed to stage 4 or 5 disease despite treatment, whereas 10% of the zone 2 eyes progressed. Based on multivariate logistic regression, zone and female gender were found to be predictive of progression, whereas birth weight was predictive of zone. Between 1991 and 2001, a significant trend toward lower mean gestational age at time of birth (Pearson correlation = -0.36, P = .005) and mean birth weight (Pearson correlation = -0.35, P = .0041) was found. However, progression rates to stage 4 and 5 disease following laser treatment were similar for infants born before and after 1997 (P = .0796). Conclusion: Regression of neovascularization was noted in 86% of eyes following laser treatment for threshold ROP. Zone was predictive of progression to stage 4 or 5 despite treatment. Premature infants being treated for threshold ROP tended to be born at an earlier gestational age and with lower birth weights over time, but progression rates to more severe stages did not increase following laser treatment, suggesting that optimal treatment can yield favorable ocular outcomes.