Session Title: Free Paper Session 23: Vascular Diseases & Diabetic Retinopathy VI
Session Date/Time: Sunday 10/09/2017 | 08:00-09:30
Paper Time: 08:12
Venue: Room 120
First Author: : P.Volodin RUSSIA
Co Author(s): : A. Semenov I. Iablokova
Retinopathy of prematurity (ROP) is still one of the most severe ocular diseases affecting pre-term infants. Laser photocoagulation of avascular retina is the generally accepted approach for the treatment of threshold ROP. The purpose is to evaluate the efficacy and long-term outcomes of modified laser technique with multiple-spot photocoagulation comparing to the conventional laser in infants with severe 3 stage ROP.
The Academician S. Fyodorov Eye Microsurgery Federal state institution, Moscow, Russia
60 premature infants (120 eyes) with severe 3 stage threshold ROP: clinical signs of plus-disease, continuous (more than 8 clock hours) and high extraretinal proliferation - underwent transpupillary slit-lamp delivered laser photocoagulation. The gestational ages at birth ranged from 26 to 31 (mean 29 (27.30) weeks. Birth weight varied from 690 to 1560 g (990;1325.5). Mean post-conceptual age at the moment of laser treatment – 39 (38;41) weeks. All infants were divided in two groups. In the main group (30 babies, 60 eyes) we performed semi-automated pattern laser treatment with the use of Pascal photocoagulator (Optimedica). Laser burns were applied to the whole avascular zone and additionally – posterior to the ridge. Parameters were the following: matrix patterns (2×2 – 5×5 dots), laser fluence – 0.7-1.1 J/cm2, laser spot diameter – 400 microns, pulse duration – 0.03 sec and 0.25 φ spacing. In the control group (30 babies, 60 eyes) conventional laser was done.
In the main group of premature babies with severe 3 stage ROP the complete regression of the disease without clinically significant residual vitreoretinal changes was achieved in all cases as a result of modified multiple-spot laser coagulation with high density. In the control group the results were the following: in 11 eyes (19%) the continuous extraretinal fibrovascular proliferation growth was observed, which required additional posterior laser; in 9 eyes - partial regression occurred; in one eye lens-sparing vitrectomy was done due to the ROP progression to stage IVa. In the long-term follow-up (more than 36 months) in the main group the mean spherical equivalent was – 0.06 (-1.25;1.0) D and the mean axial length was 20.81 (20.33; 21.73) mm. In the control group the mean spherical equivalent was – 0.25(-0.5;1.0) D and the mean axial length was 20.9 (19.94;21.41) mm. The incidence of myopic refraction was 23.3% in the main group and 23,4% - in the control group, respectively.
The use of modified technique of multiple-spot laser photocoagulation in the treatment of premature babies with severe 3 stage retinopathy of prematurity provided good clinical and relatively favorable refractive outcomes.