Diode laser photocoagulation for retinopathy of prematurity: A histopathologic study

Laser photocoagulation has largely supplanted cryotherapy as an effective t reatment for retinopathy of prematurity. This case describes the ocular his topathologic findings of a pair of eyes in a severely premature male infant treated with diode laser photocoagulation for bilateral stage 3 retinopath y of prematurity (ROP) for 360 degrees in zone 1 with severe plus disease. The right eye responded to treatment; the left eye developed persistent vit reous hemorrhage and total retinal detachment. The histopathologic examinat ion of laser burns in the right eye disclosed segmental areas of chorioreti nal scarring with retinal atrophy and gliosis, loss of RPE and extensive at rophy of the choroid and its vasculature, which involved both the choriocap illaris and larger vessels. The left eye had iris neovascularization, a chr onic organized vitreous hemorrhage and a totally detached retina. The histo pathologic findings in an eye of a premature infant with threshold ROP trea ted with diode laser photocoagulation resembled those reported after transs ceral cryotherapy. Diode laser photocoagulation may produce less severe cho rioretinal damage.