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Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India

PURPOSE: The main purpose is to study the treatment outcomes of zone 1 retinopathy of prematurity (ROP). MATERIALS AND METHODS: A retrospective analysis was done of infants diagnosed with zone 1 ROP with any stage with or without plus disease who were treated with either laser photocoagulation and/o...

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Autores principales: Sen, Parveen, Abraham, Sharanya, Jain, Smriti, Gopal, Lingam, Bhende, Pramod
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947749/
https://www.ncbi.nlm.nih.gov/pubmed/31942431
http://dx.doi.org/10.4103/tjo.tjo_62_18
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author Sen, Parveen
Abraham, Sharanya
Jain, Smriti
Gopal, Lingam
Bhende, Pramod
author_facet Sen, Parveen
Abraham, Sharanya
Jain, Smriti
Gopal, Lingam
Bhende, Pramod
author_sort Sen, Parveen
collection PubMed
description PURPOSE: The main purpose is to study the treatment outcomes of zone 1 retinopathy of prematurity (ROP). MATERIALS AND METHODS: A retrospective analysis was done of infants diagnosed with zone 1 ROP with any stage with or without plus disease who were treated with either laser photocoagulation and/or intravitreal injection of antivascular endothelial growth factor (anti-VEGF) agents and/or underwent surgery according to their stage at presentation. The retinal outcome at the final visit was analyzed. A favorable outcome was characterized by an attached retina at the posterior pole with regression of ROP (regression of plus disease as well as new vessels) while an unfavorable outcome was detached retina at posterior pole in spite of treatment. RESULTS: Seventy-eight eyes of 39 infants presented with zone 1 ROP in various stages with plus disease in 50% cases. About 60 eyes underwent treatment. Forty eyes (66.6%) had an attached retina at the final follow-up. Thirty-three eyes (55%) underwent monotherapy with 14 eyes (23.3%) showing regression of ROP with laser alone. Nineteen (31.6%) eyes were treated only by surgery. Of these, a favorable outcome was seen in four eyes (44.4%) with Stage 4 disease and three eyes (30%) with Stage 5 disease. None of the eyes received anti-VEGF as monotherapy. A combination of two or more modalities was required in the remaining 27 eyes (45%). Six eyes (10%) needed anti-VEGF injections in addition to laser and six eyes needed surgery in addition to laser to achieve a favorable outcome. Six eyes (10%) required surgery in addition to both laser and anti-VEGF therapy, and one eye (1.6%) required surgery in addition to anti-VEGF therapy for a favorable final outcome. Among the eyes undergoing treatment, 66.6% had a favorable outcome with 92.9% of eyes in Stage 3, 59% in Stage 4, and 33% in Stage 5 showing regression of disease and attached retina. CONCLUSION: In spite of the aggressive nature of zone 1 ROP, favorable outcome is possible as was seen in 66.6% of our cases. A multipronged approach using a combination of laser, intravitreal anti-VEGF agents with or without surgery may be necessary for the management of these eyes.
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spelling pubmed-69477492020-01-15 Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India Sen, Parveen Abraham, Sharanya Jain, Smriti Gopal, Lingam Bhende, Pramod Taiwan J Ophthalmol Original Article PURPOSE: The main purpose is to study the treatment outcomes of zone 1 retinopathy of prematurity (ROP). MATERIALS AND METHODS: A retrospective analysis was done of infants diagnosed with zone 1 ROP with any stage with or without plus disease who were treated with either laser photocoagulation and/or intravitreal injection of antivascular endothelial growth factor (anti-VEGF) agents and/or underwent surgery according to their stage at presentation. The retinal outcome at the final visit was analyzed. A favorable outcome was characterized by an attached retina at the posterior pole with regression of ROP (regression of plus disease as well as new vessels) while an unfavorable outcome was detached retina at posterior pole in spite of treatment. RESULTS: Seventy-eight eyes of 39 infants presented with zone 1 ROP in various stages with plus disease in 50% cases. About 60 eyes underwent treatment. Forty eyes (66.6%) had an attached retina at the final follow-up. Thirty-three eyes (55%) underwent monotherapy with 14 eyes (23.3%) showing regression of ROP with laser alone. Nineteen (31.6%) eyes were treated only by surgery. Of these, a favorable outcome was seen in four eyes (44.4%) with Stage 4 disease and three eyes (30%) with Stage 5 disease. None of the eyes received anti-VEGF as monotherapy. A combination of two or more modalities was required in the remaining 27 eyes (45%). Six eyes (10%) needed anti-VEGF injections in addition to laser and six eyes needed surgery in addition to laser to achieve a favorable outcome. Six eyes (10%) required surgery in addition to both laser and anti-VEGF therapy, and one eye (1.6%) required surgery in addition to anti-VEGF therapy for a favorable final outcome. Among the eyes undergoing treatment, 66.6% had a favorable outcome with 92.9% of eyes in Stage 3, 59% in Stage 4, and 33% in Stage 5 showing regression of disease and attached retina. CONCLUSION: In spite of the aggressive nature of zone 1 ROP, favorable outcome is possible as was seen in 66.6% of our cases. A multipronged approach using a combination of laser, intravitreal anti-VEGF agents with or without surgery may be necessary for the management of these eyes. Wolters Kluwer - Medknow 2019-12-13 /pmc/articles/PMC6947749/ /pubmed/31942431 http://dx.doi.org/10.4103/tjo.tjo_62_18 Text en Copyright: © 2019 Taiwan J Ophthalmol http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Sen, Parveen
Abraham, Sharanya
Jain, Smriti
Gopal, Lingam
Bhende, Pramod
Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India
title Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India
title_full Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India
title_fullStr Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India
title_full_unstemmed Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India
title_short Treatment outcomes of zone 1 retinopathy of prematurity: A study from a tertiary eye care center in South India
title_sort treatment outcomes of zone 1 retinopathy of prematurity: a study from a tertiary eye care center in south india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947749/
https://www.ncbi.nlm.nih.gov/pubmed/31942431
http://dx.doi.org/10.4103/tjo.tjo_62_18
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