Ophthalmology. 2011 Jan;118(1):168-75. Epub 2010 Aug 14.
Atlas of fluorescein angiographic findings in eyes undergoing laser for retinopathy of prematurity.
Lepore D, Molle F, Pagliara MM, Baldascino A, Angora C, Sammartino M, Quinn GE.
Source Department Ophthalmology and Dept Anesthesiology, Catholic University of Sacred Heart, Rome, Italy.
Abstract
PURPOSE:
We sought to examine the clinical features of severe retinopathy of prematurity (ROP) using fluorescein angiography (FA).
DESIGN:
Retrospective case series of eyes with severe acute-phase ROP that underwent FA at the time of laser photocoagulation.
PARTICIPANTS:
We included 22 eyes of 11 infants that developed ROP stage 3 in zone 1 with plus disease, 8 eyes of 4 infants classified as ROP stage 3 in zone 1 without plus disease, and 21 eyes of 11 infants that developed ROP stage 3 in zone 2 with plus disease. All eyes underwent laser photocoagulation. A total of 51 sets of digital images including FA were obtained immediately before treatment.
METHODS:
RetCam (Clarity, Pleasanton, CA) fundus images and video digital FAs were performed under general anesthesia right before laser treatment. A 10% solution of fluorescein was intravenously administered as a bolus at a dose of 0.1 ml/kg, followed by an isotonic saline flush.
MAIN OUTCOMES MEASURES:
Fluorescein angiograms were examined retrospectively to catalog different retinal and choroidal findings
RESULTS:
In eyes with severe ROP, FA clearly shows extreme variability in both retinal circulation and choroidal filling pattern. Different patterns of vessels branching at the junction between vascular and avascular retina (V-Av junction) are noted. Posterior to the V-Av junction, hypoperfused retinal areas with or without hyperfluorescent "cotton-wool-like" or "popcorn-like" lesions due to dye
leakage are documented by FA. Focal dilatation of capillaries, capillary tufts formations, and rosary-bead-like hyperfluorescent lesions inside the vessels were seen; sometimes all 3 are noted. Various macular abnormalities are noted including absence of foveal avascular area and significant exudative component.
CONCLUSIONS:
Fluorescein angiography was useful to distinguish the deceptively featureless zone 1 junction between the vascularized and nonvascularized retina. Further studies are needed to understand the role of vascular abnormalities observed in zone 1 vascularized retina.
Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier
Inc. All rights reserved.
Atlas of fluorescein angiographic findings in eyes undergoing laser for retinopathy of prematurity.
Lepore D, Molle F, Pagliara MM, Baldascino A, Angora C, Sammartino M, Quinn GE.
Source Department Ophthalmology and Dept Anesthesiology, Catholic University of Sacred Heart, Rome, Italy.
Abstract
PURPOSE:
We sought to examine the clinical features of severe retinopathy of prematurity (ROP) using fluorescein angiography (FA).
DESIGN:
Retrospective case series of eyes with severe acute-phase ROP that underwent FA at the time of laser photocoagulation.
PARTICIPANTS:
We included 22 eyes of 11 infants that developed ROP stage 3 in zone 1 with plus disease, 8 eyes of 4 infants classified as ROP stage 3 in zone 1 without plus disease, and 21 eyes of 11 infants that developed ROP stage 3 in zone 2 with plus disease. All eyes underwent laser photocoagulation. A total of 51 sets of digital images including FA were obtained immediately before treatment.
METHODS:
RetCam (Clarity, Pleasanton, CA) fundus images and video digital FAs were performed under general anesthesia right before laser treatment. A 10% solution of fluorescein was intravenously administered as a bolus at a dose of 0.1 ml/kg, followed by an isotonic saline flush.
MAIN OUTCOMES MEASURES:
Fluorescein angiograms were examined retrospectively to catalog different retinal and choroidal findings
RESULTS:
In eyes with severe ROP, FA clearly shows extreme variability in both retinal circulation and choroidal filling pattern. Different patterns of vessels branching at the junction between vascular and avascular retina (V-Av junction) are noted. Posterior to the V-Av junction, hypoperfused retinal areas with or without hyperfluorescent "cotton-wool-like" or "popcorn-like" lesions due to dye
leakage are documented by FA. Focal dilatation of capillaries, capillary tufts formations, and rosary-bead-like hyperfluorescent lesions inside the vessels were seen; sometimes all 3 are noted. Various macular abnormalities are noted including absence of foveal avascular area and significant exudative component.
CONCLUSIONS:
Fluorescein angiography was useful to distinguish the deceptively featureless zone 1 junction between the vascularized and nonvascularized retina. Further studies are needed to understand the role of vascular abnormalities observed in zone 1 vascularized retina.
Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier
Inc. All rights reserved.
Oftalmologia. 2011;55(1):84-9.
[Prognostic factors for laser treatment in retinopathy of prematurity]. [Article in Romanian]
Talu S, Cormos D, Zaharia G, Stefanut C, Popa M, Lucaci DI.
Abstract
PURPOSE: The paper aims to determine the anatomical results of the eyes treated by laser photocoagulation for "threshold" retinopathy of prematurity (ROP) and to identify the potential risk factors for the unfavorable outcomes.
MATERIAL/METHOD: A retrospective study including all the consecutive ROPs that were treated by laser photocoagulation between January the 1st 2006 and September the 1st 2009 has been conducted. The followed criteria has been the anatomical result after the laser treatment. The outcomes have been correlated with: the gestational ages, the birth weights, the moment of treatment (postnatal and post-conceptional ages), the sex of the premature infants, the stage and zone of ROR. RESULTS The total number of prematurely newborns that met the screening criteria for ROP in the above-mentioned period has been 474. Of these, 350 (74%) presented no ROP and the remaining 124 (26%) developed various stages of the disease. Within the ROP group, 54 patients required laser therapy (44% of the retinopathies, representing 11% of all the prematures). The anatomical outcome has been favorable in 84% of the treated eyes, the remaining 16% presenting the progression of ROP The results of the treatment depended on the type of ROP, being significantly better in the classic disease as in the agressive posterior disease (APD) (p < 0.05). The gender also influenced the outcome: the results were better in girls as compared with
boys (p < 0.05). The precocity of the laser treatment (evaluated by the postnatal and postconceptional age) has positively influenced the ROP evolution (p < 0.05).
CONCLUSIONS:
Laser photocoagulation has proved its efficacy in the treatment of ROP on our cases. The factors that have negatively influenced the postlaser outcome were: the aggressive posterior disease, the delayed moment of the laser therapy and the male gender.
[Prognostic factors for laser treatment in retinopathy of prematurity]. [Article in Romanian]
Talu S, Cormos D, Zaharia G, Stefanut C, Popa M, Lucaci DI.
Abstract
PURPOSE: The paper aims to determine the anatomical results of the eyes treated by laser photocoagulation for "threshold" retinopathy of prematurity (ROP) and to identify the potential risk factors for the unfavorable outcomes.
MATERIAL/METHOD: A retrospective study including all the consecutive ROPs that were treated by laser photocoagulation between January the 1st 2006 and September the 1st 2009 has been conducted. The followed criteria has been the anatomical result after the laser treatment. The outcomes have been correlated with: the gestational ages, the birth weights, the moment of treatment (postnatal and post-conceptional ages), the sex of the premature infants, the stage and zone of ROR. RESULTS The total number of prematurely newborns that met the screening criteria for ROP in the above-mentioned period has been 474. Of these, 350 (74%) presented no ROP and the remaining 124 (26%) developed various stages of the disease. Within the ROP group, 54 patients required laser therapy (44% of the retinopathies, representing 11% of all the prematures). The anatomical outcome has been favorable in 84% of the treated eyes, the remaining 16% presenting the progression of ROP The results of the treatment depended on the type of ROP, being significantly better in the classic disease as in the agressive posterior disease (APD) (p < 0.05). The gender also influenced the outcome: the results were better in girls as compared with
boys (p < 0.05). The precocity of the laser treatment (evaluated by the postnatal and postconceptional age) has positively influenced the ROP evolution (p < 0.05).
CONCLUSIONS:
Laser photocoagulation has proved its efficacy in the treatment of ROP on our cases. The factors that have negatively influenced the postlaser outcome were: the aggressive posterior disease, the delayed moment of the laser therapy and the male gender.
Arch Ophthalmol. 2011 Jul;129(7):840-846.
Grating Visual Acuity Results in the Early Treatment for Retinopathy of Prematurity Study.
The Early Treatment for Retinopathy of Prematurity Cooperative Group.
Collaborators (6)Dobson V, Quinn GE, Summers CG, Hardy RJ, Tung B, Good WV.
Abstract
OBJECTIVE: To compare grating (resolution) visual acuity at 6 years of age in eyes that received early treatment (ET) for high-risk prethreshold retinopathy of prematurity (ROP) with that in eyes that underwent conventional management (CM).
METHODS:
In a randomized clinical trial, infants with bilateral, high-risk prethreshold ROP (n = 317) had one eye undergo ET and the other eye undergo CM, with treatment only if ROP progressed to threshold severity. For asymmetric cases (n = 84), the high-risk prethreshold eye was randomized to ET or CM. Main Outcome Measure Grating visual acuity measured at 6 years of age
by masked testers using Teller acuity cards.
RESULTS:
Monocular grating acuity results were obtained from 317 of 370 surviving children (85.6%). Analysis of grating acuity results for all study participants with high-risk prethreshold ROP showed no statistically significant overall benefit of ET (18.1% vs 22.8% unfavorable outcomes; P = .08). When the 6-year grating acuity results were analyzed according to a clinical algorithm (high-risk types 1 and 2 prethreshold ROP), a benefit was seen in type 1 eyes (16.4% vs 25.2%; P = .004) undergoing ET, but not in type 2 eyes (21.3% vs 15.9%; P = .29).
CONCLUSION:
Early treatment of eyes with type 1 ROP improves grating acuity outcomes, but ET for eyes with type 2 ROP does not. Application to Clinical Medicine Type 1 eyes should be treated early; however, based on acuity results at 6 years of age, type 2 eyes should be cautiously monitored for progression to type 1 ROP. Trial Registration clinicaltrials.gov
Identifier: NCT00027222.
Grating Visual Acuity Results in the Early Treatment for Retinopathy of Prematurity Study.
The Early Treatment for Retinopathy of Prematurity Cooperative Group.
Collaborators (6)Dobson V, Quinn GE, Summers CG, Hardy RJ, Tung B, Good WV.
Abstract
OBJECTIVE: To compare grating (resolution) visual acuity at 6 years of age in eyes that received early treatment (ET) for high-risk prethreshold retinopathy of prematurity (ROP) with that in eyes that underwent conventional management (CM).
METHODS:
In a randomized clinical trial, infants with bilateral, high-risk prethreshold ROP (n = 317) had one eye undergo ET and the other eye undergo CM, with treatment only if ROP progressed to threshold severity. For asymmetric cases (n = 84), the high-risk prethreshold eye was randomized to ET or CM. Main Outcome Measure Grating visual acuity measured at 6 years of age
by masked testers using Teller acuity cards.
RESULTS:
Monocular grating acuity results were obtained from 317 of 370 surviving children (85.6%). Analysis of grating acuity results for all study participants with high-risk prethreshold ROP showed no statistically significant overall benefit of ET (18.1% vs 22.8% unfavorable outcomes; P = .08). When the 6-year grating acuity results were analyzed according to a clinical algorithm (high-risk types 1 and 2 prethreshold ROP), a benefit was seen in type 1 eyes (16.4% vs 25.2%; P = .004) undergoing ET, but not in type 2 eyes (21.3% vs 15.9%; P = .29).
CONCLUSION:
Early treatment of eyes with type 1 ROP improves grating acuity outcomes, but ET for eyes with type 2 ROP does not. Application to Clinical Medicine Type 1 eyes should be treated early; however, based on acuity results at 6 years of age, type 2 eyes should be cautiously monitored for progression to type 1 ROP. Trial Registration clinicaltrials.gov
Identifier: NCT00027222.
Ophthalmology. 2011 Jul;118(7):1227-8.
Retinopathy of Prematurity in the Time of Bevacizumab: Incorporating the BEAT-ROP Results into Clinical Practice.
Moshfeghi DM, Berrocal AM.
Source
Palo Alto, California.
Retinopathy of Prematurity in the Time of Bevacizumab: Incorporating the BEAT-ROP Results into Clinical Practice.
Moshfeghi DM, Berrocal AM.
Source
Palo Alto, California.
