ROP Treatment Indications

Highlights from the Hot Topics in Neonatology Conference in Washington , D.C.
December 12-14 , 2004

ROP Treatment Indications

REVISED INDICATIONS FOR THE TREATMENT OF RETINOPATHY OF PREMATURITY. Dale Phelps, M.D. University of Rochester Medical School. Arch Opththalmol. 2003;121:1684-1696

Objective: To determine whether earlier treatment using ablation of the vascular retina in high risk prethreshold ROP results in improved grating visual acuity and retinal structural outcomes compared with conventional treatment.

Methods: Babies with bilateral high risk prethreshold ROP had one eye randomized to early treatment with the fellow eye managed conventionally ( controlled eye ). In asymmetric cases, the eye with high-risk prethreshold ROP was randomized to early treatment or conventional management. Visual acuity was assessed at 2 months corrected age, and eyes were examined for structural outcomes at 6 and 9 months of age.

Conclusion: Early treatment of high-risk pre-threshold ROP significantly reduced unfavorable outcomes to a clinically important degree. Additional analyses led to modified recommendations for the use of peripheral retinal ablation in eyes with ROP. Long term follow-up is being conducted.

Comments: After the final analysis we may find ourselves performing surgery on even younger ELBW infants if stable. Though let’s wait for the long term follow-up results. EV.

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