UNC study may help predict premature infants at risk of total...( These treatments help reduce the risk...),Health

Not all stage 4 ROP progresses to retinal detachment, Hartnett added, and the surgery poses risks such as infection, bleeding and surgical trauma. "So, this study sought to determine which infants, who had laser treatment for severe ROP and who didn't have regression of disease, needed to have surgery to prevent progressive stage 4 ROP and subsequent risk of blindness."

The researchers reviewed the retinal eye exam charts of infants who had been treated with laser but still developed stage 4 ROP. They found that the infants had specific features within the eyes two weeks before the development of progressive stage 4 ROP that should tell the surgeon to consider surgery: an increased extent of elevated tissue at the junction of the normal retinal blood vessels and the area of retina without blood vessels, dilated blood vessels in half the retina or more (called plus disease), and increasing vitreous cloudiness.

The extent of the abnormal blood vessels growing into the vitreous previously had always been considered an indication of disease progression. Surprisingly, this study did not support that feature as predictive of later retinal detachment.

"Instead, if unwanted intravitreous angiogenesis is found, that should clue the surgeon into looking for areas missed during the laser treatment and to treating these areas," Hartnett said.

"The findings in this study need to be confirmed with a larger prospective study, if that is possible, given that stage 4 ROP is not a very common condition. For now, this study provides guidance to the ophthalmologist monitoring infants who received laser treatment for severe ROP as to when surgery may
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Contact: L.H. Lang
llang@med.unc.edu
919-843-9687
University of North Carolina School of Medicine
7-May-2004