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Kourous A. Rezai, MD; Dean Eliott, MD; Philip J. Ferrone, MD; Rubin W. Kim, MD

Arch Ophthalmol. 2005;123:621-626.

Objective  To evaluate the effect of a near confluent pattern of indirect laser photocoagulation in reducing the rate of progression and re-treatment of threshold retinopathy of prematurity.

Methods  This study examined a noncomparative interventional case series. We performed a retrospective review of the medical records of patients who underwent peripheral laser ablation by 1 surgeon for threshold retinopathy of prematurity from 1997 to 2002. A total of 58 eyes from 31 patients were treated, and 44 eyes of 23 patients were included in the study. Ten eyes of 5 infants had zone 1 disease, and 34 eyes of 18 infants had zone 2 disease. Laser spots were placed in a near confluent pattern in the peripheral avascular retina between the ridge of extraretinal proliferation and the ora serrata. The mean ± SD number of laser spots was 2534 ± 455 for zone 1 (range, 2100-3378) and 1850 ± 487 for zone 2 (range, 1030-2689).

Results  In 7 eyes of 4 infants with zone 1 disease, the retinopathy regressed and did not require any further treatment. Three eyes of 2 infants, however, progressed after laser treatment and required vitrectomy surgery. Progression was defined as the development of stage 4 or 5 disease. None of the patients with zone 2 disease had progression of retinopathy, and none of them needed more than 1 treatment. Patients tolerated the procedure well, and there were no complications at the time of the procedure or at follow-up visits.

Conclusions  A near confluent pattern of laser photocoagulation may reduce the rate of progression of threshold retinopathy of prematurity in zone 2 (0%). The near confluent pattern of treatment may also reduce the re-treatment rate of the disease (0%). Larger studies are needed to confirm our findings.

Author Affiliations: Kresge Eye Institute, Wayne State University, Detroit, Mich (Drs Rezai, Eliott, and Kim); Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Ill (Dr Rezai); and Long Island Vitreoretinal Consultants, Great Neck, NY (Dr Ferrone).