DIODE-LASER PHOTOCOAGULATION FOR ZONE-1 THRESHOLD RETINOPATHY OF PREMATURITY

We used the diode-laser indirect ophthalmoscope in the treatment of 17 (30 eyes) infants with zone 1 (a circle centered on the optic disk wi th a radius of twice the distance from the disk to the fovea) threshol d retinopathy of prematurity (at least five continuous or eight cumula tive 30-degree sectors [clock hours] of ridge with extraretinal fibrov ascular proliferation in the presence of plus disease). Mean follow-up was 31.2 weeks. Two eyes (6.7%) required retreatment of missed areas that had persistent plus disease (enlarged posterior veins and tortuou s arterioles). A favorable outcome was attained in 25 eyes (83.3%). Fi ve eyes (16.7%) developed retinal detachments, three of which remained stable at Stage 4A (extrafoveal retinal detachment) and two of which ultimately progressed to Stage 5 (total retinal detachment). Both eyes that went on to Stage 5 had severe posterior pole hemorrhages at the time of treatment. Two eyes that developed retinal detachments (one, s tage 4A and one, stage 5) had rhegmatogenous components. Among 14 infa nts followed up for more than three months, four developed nystagmus, and six developed strabismus. In contrast to cryoablation, diode-laser photoablation of the peripheral retina was found to be an effective t reatment for threshold retinopathy of prematurity located in zone 1. P ortability and ease of use of the laser system, precision of treatment , and minimal postprocedural adnexal inflammation are further advantag es of this therapeutic modality.