Involution of retinopathy of prematurity after laser treatment: factors associated with development of retinal detachment.
OBJECTIVE
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.


METHODS
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.
Coats
David K
DK
Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, Houston 77030, USA. dcoats@bcm.tmc.edu
Miller
Aaron M
AM
Hussein
Mohamed A W
MA
McCreery
Kathryn M Brady
KM
Holz
Eric
E
Paysse
Evelyn A
EA
D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D017075:Laser Coagulation; D008297:Male; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000209:etiology*; D012178:Retinopathy of Prematurity / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014822:Vitreous Body / Q000473:pathology; D014823:Vitreous Hemorrhage / Q000150:complications