Evaluation of Treatment Models in the Treatment of Retinopathy of Prematurity

Özet

Objectives: This study aims to evaluate the treatment modalities applied for retinopathy of prematurity (ROP) and to determinethe efficacy and results of treatment modalities.Methods: Premature babies, who needed treatment for ROP and followed-up in the Neonatal Intensive Care Unit (NICU) of ourhospital or external centers, were retrospectively evaluated between January 2012 and January 2017. According to the criteriadetermined by the International ROP committee, the zones and stages of the cases were recorded. In this study, patients wereevaluated in three groups. Group 1: plus disease with any stage in zone 1, group 2: plus disease in zone 2, together with stage 2 or 3,group 3: classified as aggressive posterior retinopathy (APROP). The birth weight, gestational age, treatment weeks and treatmentsthat were administered were recorded. Regression in plus disease, macular dragging and retinal detachment did not develop wereevaluated as successful treatment.Results: 1746 preterm babies were examined. 65 (3.7%) preterm babies were included in this study, 31 female and 34 male. 126eyes of preterm babies were intervened. The mean birth weight was 1159 (535-2200) grams, and the mean gestational age was28.4±2.5 (24-34) weeks. Group 1 had 33 eyes (26.1%), group 2 had 71 eyes (56.3%), and group 3 had 22 eyes (17.4%). 94 eyes(74.6%) were treated once, 26 eyes (20.6%) were treated twice, 6 eyes (4.8%) received treatment three times. The first treatmentwas applied at 36±2.4 (32-41) weeks. The first treatment was performed with intravitreal bevacizumab (IVB) in 75.8% of group 1and 95.5% of group 3, and with diode laser photocoagulation (LPC) in 78.9% of group 2. There was a significant correlation betweenbirth week and birth weight and first treatment week. Re-treatment was applied to 32,8% in LPC group and 19.2% in the IVBgroup due to recurrence. 5 eyes which were applied LPC+IVB did not need any re-treatment. Stage 4a retinal detachment developedin both eyes of 1 patient from group 1. Macular traction was developed in 2 eyes of 1 patient in group 2. After the treatments,success in 122 eyes (96.8%) was obtained.Conclusion: ROP can be controlled by convenient and effective treatment. Although conventional LPC is still the first treatmentoption for ROP, IVB alone or combination with LPC is a highly effective treatment option for zone 1 disease and APROP. IVB reducesthe number of ROP treatments.