Amblyopia and myopic shift after unilateral laser diode treatment of retinopathy of prematurity

Abstract

Purpose: To consider the visual outcomes in the diode laser treated eyes compared to their fellow non-treated eyes in patients with asymmetrical retinopathy of prematurity (ROP). Method: A review was conducted of premature infants admitted to the Royal Brisbane and Women's Hospital neonatal intensive care unit between 1992 and 2013 who received unilateral treatment. Results: Of the 4507 screened for ROP, 1201 were diagnosed with ROP and 140 required laser treatment. Nine treated patients demonstrated asymmetrical disease so that only one eye qualified for treatment. Two patients were lost to follow up. The remaining seven had a mean gestational age of 27.6 weeks, birth weight of 924g and follow up of 7.7 years. Four patients developed amblyopia in their treated eye. These eyes also demonstrated a myopic shift with a mean final refraction of 6.63. Laser treatment received averaged 1128 spots per eye. Their fellow non-treated eyes had a mean refraction of +1.63 and visual acuities of 6/9.5 or better. The three non-amblyopic treated eyes received and average of 516 laser burns had a mean final refraction of +1.21 and visual acuities of 6/6 to 6/12 with almost identical outcomes in the non-treated eyes. The severity of ROP in the amblyopic eyes and non-amblyopic eyes was comparable. Conclusion: Unilateral laser for ROP has a high risk of anisomyopia and amblyopia. There was positive corre-lation between number of laser burns and the degree of subsequent myopia.L6201309612018-01-11 <br />