American Journal of Ophthalmology
Volume 140, Issue 2 , Pages 214-222, August 2005

Involution of Retinopathy of Prematurity After Laser Treatment: Factors Associated With Development of Retinal Detachment

  • David K. Coats, MD

      Affiliations

    • Cullen Eye Institute, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • Corresponding Author InformationCorresponding author: David K. Coats, MD, Texas Children’s Hospital, 6621 Fannin, Suite 640, Houston, TX 77030; fax: 713-796-8110;
    • ,
  • Aaron M. Miller, MD

      Affiliations

    • Cullen Eye Institute, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • ,
  • Mohamed A.W. Hussein, MD

      Affiliations

    • Cullen Eye Institute, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • ,
  • Kathryn M. Brady McCreery, MD

      Affiliations

    • Cullen Eye Institute, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • ,
  • Eric Holz, MD

      Affiliations

    • Cullen Eye Institute, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • ,
  • Evelyn A. Paysse, MD

      Affiliations

    • Cullen Eye Institute, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
    • Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas

Accepted 30 December 2004. published online 24 March 2005.

Purpose

To identify specific features during the process of involution of retinopathy of prematurity after treatment at threshold that are associated with development of a retinal detachment.

Design

Retrospective case series.

Methods

The evolution of retinal detachments over time was analyzed retrospectively in 262 treated eyes of 138 infants. Specific features hypothesized to be associated with development of a retinal detachment were analyzed, including vitreous organization defined as clinically important, active stage 3 disease and active plus disease more than 21 days after treatment, and vitreous hemorrhage defined as clinically important.

Results

A retinal detachment developed in 36 (13.7%) of 262 eyes. Vitreous organization meeting our clinically important definition was associated with a 31-fold (confidence interval [CI] 5.37–183.63; P < .0001) and 13-fold (CI 2.97–58.59; P < .0001) increase in the odds for retinal detachment for right and left eyes, respectively. Vitreous hemorrhage defined as clinically important was associated with a 38-fold (CI 2.69–551.19; P = .007) and 15-fold (CI 1.65–144.12; P = .02) increase in the odds for retinal detachment for right and left eyes, respectively. The timing of retinal detachment relative to vitreous hemorrhage was not determined. Prolonged activity of Stage 3 disease or plus disease more than 21 days after treatment was not associated with development of a retinal detachment.

Conclusions

Clinically important vitreous organization and vitreous hemorrhage were predictive for development of a retinal detachment. Evaluation of preemptive reintervention strategies for eyes at highest risk for developing a retinal detachment may be reasonable.

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 This study was supported in part by Knight’s Templer Foundation, Chicago, Illinois, and an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York.This manuscript is based on a thesis that was prepared in partial fulfillment of the requirements for membership in the American Ophthalmological Society.

PII: S0002-9394(05)00004-8

doi:10.1016/j.ajo.2004.12.106

American Journal of Ophthalmology
Volume 140, Issue 2 , Pages 214-222, August 2005

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