Evaluation of Outcomes and Regression after Neovascularization Treatment for Non-type 1 Retinopathy of Prematurity
Yothin Titawattanakul1, *
Identifiers and Pagination:Year: 2023
E-location ID: e187436412303020
Publisher ID: e187436412303020
Article History:Received Date: 18/7/2022
Revision Received Date: 30/1/2023
Acceptance Date: 14/2/2023
Electronic publication date: 04/05/2023
Collection year: 2023
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
To study the unfavorable outcomes and regression after neovascularization treatment for non-type 1 retinopathy of prematurity (ROP) in a tertiary care facility in Thailand.
A retrospective study was done of all infants undergoing screening and treatment for ROP at a tertiary referral center between July 2018 and June 2021 with follow-up for 60 weeks postmenstrual ages (PMA). The outcomes measured were unfavorable outcomes, including macula involving posterior retinal folds, macula involving retinal detachment, retrolental cicatrix formation, or a mass obscuring the view of the posterior pole, and the regression of ROP after treatment. The infants received neovascularization treatment (stage 3 ROP) within 72 h of diagnosis. The study also compared the unfavorable outcomes and regression between neovascularization in type 1 ROP and non-type 1 ROP subgroups.
There were 58 eyes of 31 infants that received neovascularization treatment that were included in the study. Of these 58 eyes, 41 had non-type 1 ROP, and 17 had type 1 ROP. 92.68% of the eyes treated for non-type 1 ROP had stage 3 ROP in zone II with pre-plus disease and 74.47% of the eyes treated for type 1 ROP had stage 3 ROP in zone II with plus disease. The mean gestational age and birth weight of the enrolled infants were 28.48 ± 1.99 weeks and 1165.32 ± 394.57 g, respectively. Unfavorable outcomes after neovascularization treatment occurred in three eyes (17.65%) in the type 1 ROP group, but there were no unfavorable outcomes in the non-type 1 ROP group (p=0.022); these three eyes were treated with laser indirect ophthalmoscopy (LIO) combined with Intravitreal bevacizumab (IVB). The non-type 1 ROP treated with laser LIO alone group had 100% regression, whereas type 1 ROP treated with LIO or combined LIO and IVT bevacizumab group had 82.35% regression. Progression after treatment without regression occurred in five eyes (29.41%) with type 1 ROP, but no progression occurred in eyes with non-type 1 ROP (p=0.001).
Neovascularization treatment in non-type 1 ROP is useful for preventing unfavorable outcomes and achieving the regression of neovascularization, especially for diseases less severe than type 1 ROP. Moreover, neovascularization treatment in non-type 1 ROP can reduce the progression of ROP disease.