title: Exudative retinal detachment following photocoagulation in older premature infants for retinopathy of prematurity: description and management.
abstract: OBJECTIVE
  To describe exudative retinal detachment following laser photocoagulation after 40 weeks of postmenstrual age (PMA) for retinopathy of prematurity in premature infants, its medical management, and outcomes.
  
  
  METHODS
  Two pediatric vitreoretinal surgeons at 2 different quaternary care institutions retrospectively identified children who received laser photocoagulation after 40 weeks of PMA and subsequently developed exudative detachment. Hospital course, management, and outcomes were identified.
  
  
  RESULTS
  Three infants were identified that developed exudative retinal detachments following laser photocoagulation for retinopathy of prematurity after 40 weeks of PMA. The average gestational age was 25 weeks with an average birth weight of 650 g. All babies were Zone II at initial examination and developed Stage 3 with pre-plus or plus disease after 40 weeks of PMA (average 42 weeks of PMA). Therapy consisted of topical cyclogyl (0.5%) and topical prednisolone acetate (1%) to the affected eyes and intravenous dexamethasone in all cases. The exudative retinal detachments resolved by 50 weeks of PMA in all infants. Hard exudates following resolution were found in all eyes. Two eyes demonstrated temporal macular dragging.
  
  
  CONCLUSIONS
  Premature infants who require laser photocoagulation for retinopathy of prematurity at >40 weeks of PMA may be predisposed to develop exudative retinal detachments. In the absence of identifiable traction, systemic corticosteroid use can be considered to achieve favorable anatomic outcomes.
authors.affiliation: *Department of Ophthalmology, Stanford University, Stanford, California; and †Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Darius M
authors.initials: DM
authors.lastname: Moshfeghi
authors.forename: Ruwan A
authors.initials: RA
authors.lastname: Silva
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
mesh_terms: D000287:Administration, Topical; D003519:Cyclopentolate / Q000627:therapeutic use; D005122:Exudates and Transudates; D005865:Gestational Age; D049690:History, Ancient; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D017075:Laser Coagulation / Q000009:adverse effects*; D009184:Mydriatics / Q000627:therapeutic use; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D012163:Retinal Detachment / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D012178:Retinopathy of Prematurity / Q000601:surgery*
chemical_list: D009184:Mydriatics; C009935:prednisolone acetate; D011239:Prednisolone; D003519:Cyclopentolate