Exudative Retinal Detachment After ROP Laser Photocoagulation

被引:3
作者
Zou, Henry [1 ]
Fletcher-Morehouse, Lauren [2 ]
机构
[1] Michigan State Univ, Coll Human Med, Ophthalmol, Grand Rapids, MI 49503 USA
[2] Helen DeVos Childrens Hosp, Ophthalmol, Grand Rapids, MI USA
关键词
neurosensory retina; retinal pigment epithelium; laser photocoagulation; exudative retinal detachment; retinopathy of prematurity; RETINOPATHY; PREMATURITY; POSTERIOR;
D O I
10.7759/cureus.27891
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Exudative retinal detachment (ERD) can be a rare postoperative complication of laser photocoagulation surgery when used to treat type I retinopathy of prematurity (ROP). We present a case of bilateral ERD following ROP laser photocoagulation. A preterm male infant born at 24 weeks gestation and weighing 600 grams was diagnosed with stage 3/zone II/pre-plus ROP in both eyes. He was on oxygen therapy for 92 days due to chronic lung disease and was treated with laser photocoagulation at 40 weeks postmenstrual age. Initial laser settings (in use for over 15 years) were 300 mW power, 300 ms duration, and 300 ms intervals. Due to strong laser absorption, power was decreased to 250 mW for most of the procedure. He was prescribed prednisolone acetate drops four times per day for postoperative care. One week later, he developed complete ERD in both eyes. The patient was monitored in the neonatal intensive care unit (NICU) for three weeks and prednisolone acetate drops were increased to every two hours and tapered over one month. Complete resolution of ERD with residual peripheral exudate bilaterally was observed eight weeks after surgery. This case suggests that even after the settings of an ROP laser have been used safely for 15 years, it is important to tailor settings for each individual patient utilizing the least power and duration for laser application as possible. Furthermore, this case highlights the importance of titrating laser power in response to spot blanching throughout the procedure. However, near-complete resolution of post-ROP laser ERD is possible with minimal changes to standard postoperative management.
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页数:4
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