Aggressive posterior retinopathy of prematurity in Asian Indian babies: spectrum of disease and outcome after laser treatment.
OBJECTIVE
To analyze the spectrum of aggressive posterior retinopathy of prematurity and outcome after laser treatment.


METHODS
This is a retrospective review of 81 eyes of 44 consecutive infants diagnosed to have aggressive posterior retinopathy of prematurity and treated between September 2005 and March 2007 from a large tertiary care center in North India. Qualitative variables were tested for statistical significance using the chi-square test and independent samples with the student's t-test.


RESULTS
Mean birth weight and gestational age were 1,259.66 +/- 310.51 g (range, 660-2,000 g) and 29.75 +/- 2.35 weeks (range, 26-36 weeks), respectively. Twenty-one infants (47.72%) had a birth weight > 1,250 g. Thirty-three (40.74%) eyes had Zone 1, and 48 (59.26%) had posterior Zone 2 disease. All eyes underwent confluent laser photocoagulation at a mean postconceptional age of 34.58 +/- 2.19 weeks (range, 31-40.5 weeks). Mean follow-up was 12.8 months (range, 6-24 months). At the last follow-up visit, 55 (71.4%) of 77 eyes had a favorable outcome. Eighteen eyes (23.4%) had a localized (1-3 clock hours) partial peripheral tractional detachment (Stage 4a), which remained stable at last follow-up. Two eyes (2.6%) developed falciform fold involving the macular area, and 2 (2.6%) developed Stage 5 retinopathy of prematurity.


CONCLUSIONS
Aggressive posterior retinopathy of prematurity is encountered not only in low birth weight infants, but also in heavier and more mature Asian Indian infants. Early, aggressive confluent laser photocoagulation is necessary to maximize outcomes in these eyes.
Sanghi
Gaurav
G
Department of Ophthalmology, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Dogra
Mangat R
MR
Das
Pranab
P
Vinekar
Anand
A
Gupta
Amod
A
Dutta
Saurabh
S
D044466:Asian People / Q000208:ethnology; D001724:Birth Weight; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D017075:Laser Coagulation; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D012178:Retinopathy of Prematurity / Q000150:complications* / Q000208:ethnology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome