Outcomes after laser therapy for threshold retinopathy of prematurity

Objective: To determine the anatomic outcomes of eyes treated with laser ph otocoagulation for threshold retinopathy of prematurity and to identify pot ential risk factors for unfavorable outcomes after treatment. Design: Retrospective, noncomparative case series. Intervention: Photocoagulation of the peripheral avascular retina with an a rgon or diode laser indirect ophthalmoscope. Participants., One hundred twenty eyes of 81 infants with threshold retinop athy of prematurity treated with laser photocoagulation from 1989 through 1 997 with at least 12 months of follow-up after treatment. Main Outcome Measures: The principal outcome was the presence of an unfavor able anatomic outcome defined as a retinal detachment, macular fold, or ret rolental tissue. Results: One hundred nine of 120 eyes (91%) had favorable outcomes. Eleven eyes (9%) had retinal detachments, and 1 of the 11 also had retrolental tis sue. Zone 1 eyes appeared to be 3.3 times more likely to have an unfavorabl e outcome compared with zone 2 eyes, but the 95% confidence interval (0.8-1 4.5) did not support this statistically. Twenty-four of 109 eyes (22%) expe rienced dragging of the temporal vessels. Those with zone 1 disease were 13 .7 times more likely to experience temporal dragging compared with zone 2 e yes (95% confidence interval, 3.3-57.2). Conclusions. After laser photocoagulation for threshold retinopathy of prem aturity, 91% of eyes had a favorable anatomic outcome. Compared with zone 2 eyes, zone 1 eyes may be more likely to have temporal dragging of the reti nal vessels. Laser therapy is effective in the treatment of threshold retin opathy of prematurity.