The results of diode Laser The results of diode Laser treatment for posterior treatment for posterior retinopathy of prematuresretinopathy of prematures

Piozzi E. Mazza M. Del Longo A.Piozzi E. Mazza M. Del Longo A.

Niguarda Hospital MILANNiguarda Hospital MILAN

S.C. Pediatric OphthalmologyS.C. Pediatric Ophthalmology

Chief E. Piozzi MDChief E. Piozzi MD

Laser photocoagulation is Laser photocoagulation is

the treatment of choice for the treatment of choice for treshold retinopathy of treshold retinopathy of prematurity (ROP)prematurity (ROP)

LASER treatmentLASER treatment

We treated 50 eyes of 25 babies We treated 50 eyes of 25 babies with diode Laser (810 nwith diode Laser (810 nµµ) or ) or green Laser (532 ngreen Laser (532 nµ) from July µ) from July 2000 to October 2005.2000 to October 2005.

44 eyes ROP stage 2-3 plus 44 eyes ROP stage 2-3 plus

6 eyes ROP zone I (AP-ROP)6 eyes ROP zone I (AP-ROP)

The International Classification of Retinopathy of Prematurity Revisited

An International Committee for the Classification of Retinopathy of Prematurity*

Arch Ophthalmol. 2005;123:991-999.

ROP plusROP plus

Different from classic ROPDifferent from classic ROP

AP-ROP

AP-ROPAP-ROP

Zone IZone I Flat network neovascularizationFlat network neovascularization Naked shuntsNaked shunts Early plusEarly plus No stages No stages Rapidly progressiveRapidly progressive

AP-ROPAP-ROP

Plus is indication to laserPlus is indication to laser

Laser TreatmentLaser Treatment

Parameters:Parameters:

Power 150-200 mWPower 150-200 mW

Duration 0.1-0.2 sec.Duration 0.1-0.2 sec.

Number 1500-2000 spotsNumber 1500-2000 spots

Laser treatmentLaser treatment

The pattern of Laser The pattern of Laser photocoagulationphotocoagulation

burns to the avascular retina is :burns to the avascular retina is :

-confluent or -confluent or

-near confluent -near confluent

to avoid skip areas.to avoid skip areas.

Laser treatmentLaser treatment

Laser photocoagulation was Laser photocoagulation was performed under general performed under general anesthesiaanesthesia

NN GAGA WW STAGESTAGE EVOLUTIONEVOLUTIONPGPG 2525 780780 OO st 3 plusOO st 3 plus OS 4 AOS 4 A

RSRS 31+431+4 12001200 OO st 2 zona II plusOO st 2 zona II plus FAVORABLEFAVORABLE

PLPL 25+525+5 650650 3 plus3 plus FAVORABLEFAVORABLE

MBMB 2525 630630 3 plus zona II-III3 plus zona II-III FAVORABLEFAVORABLE

NVNV 2525 850850 3 plus 3 plus FAVORABLEFAVORABLE

PPPP 24+424+4 710710 3 plus zona II3 plus zona II FAVORABLEFAVORABLE

PDPD 2626 850850 2 plus zona II2 plus zona II FAVORABLEFAVORABLE

TDTD 2929 10001000 2 plus zona II-II2 plus zona II-II FAVORABLEFAVORABLE

CCCC 2323 610610 AP-RopAP-Rop OD 4 A-OS 5OD 4 A-OS 5

GMGM 2626 750750 AP-ROPAP-ROP FAVORABLEFAVORABLE

LYLY 3030 930930 3 plus3 plus FAVORABLEFAVORABLE

PMPM 2525 730730 3 plus3 plus FAVORABLEFAVORABLE

PR PR 2626 750750 3 plus3 plus FAVORABLEFAVORABLE

GCGC 2626 720720 3 plus3 plus FAVORABLEFAVORABLE

CACA 2525 770770 2 zona II plus2 zona II plus FAVORABLEFAVORABLE

GAGA 2727 10001000 OD 2 plus OS 3 plusOD 2 plus OS 3 plus FAVORABLEFAVORABLE

SDSD 26+626+6 630630 2 plus zona 12 plus zona 1 OD 4 A-OS 5OD 4 A-OS 5

DSDS 2525 700700 3 plus zona 13 plus zona 1 FAVORABLEFAVORABLE

VNVN 2626 924924 2 plus zona 22 plus zona 2 FAVORABLEFAVORABLE

ZFZF 2424 665665 3 plus3 plus OD 4 AOD 4 A

GA GA 2626 953953 3 plus zona II3 plus zona II FAVORABLEFAVORABLE

FMFM 2424 620620 2 plus zona I-II2 plus zona I-II FAVORABLEFAVORABLE

CM CM 2525 760760 AP-ROPAP-ROP OO 5OO 5

SASA 2525 815815 3 plus3 plus FAVORABLEFAVORABLE

Only two eyes (4%) needed Only two eyes (4%) needed Supplemental Laser treatment.Supplemental Laser treatment.

RESULTSRESULTS

42 favorable outcome (84%)42 favorable outcome (84%)

4 eyes progress to stage 4 A4 eyes progress to stage 4 A

4 eyes progress to stage 54 eyes progress to stage 5

RESULTSRESULTS

6 eyes AP-Rop 6 eyes AP-Rop

2 favorable outcome (34%)2 favorable outcome (34%)

4 unfavorable (66%)4 unfavorable (66%)

CONCLUSIONSCONCLUSIONS

Laser photocoagulation is Laser photocoagulation is associated with a good anatomic associated with a good anatomic outcome.outcome.

ROP more posterior is difficult to ROP more posterior is difficult to treat successfully with ablative treat successfully with ablative therapy.therapy.

MOVIEMOVIE

Thank-youThank-youThank-youThank-you