Zone‐I retinopathy of prematurity, progression and scheduling of treatment

Abstract Purpose To evaluate the progression celerity and scheduling of suitable treatment time for Zone‐I Retinopathy of Prematurity (ROP). Methods Records of 36 eyes (18 infants) with Zone‐I ROP, which were screened for ROP at the Neonatal Intensive Care Unit of Baskent University, Ankara, Turkey, between January 2004‐March 2009, were evaluated retrospectively. Birth weight ranged between 480‐1000g, gestational age ranged from 24‐28 weeks. First fundus examination was performed at 29‐31 weeks gestational age, and was repeated once or more per week. The first treatment was performed using laser photocoagulation and the progression criteria for laser photocoagulation treatment were: (1) Zone‐I ROP less than stage‐3 with plus disease (ETROP‐type 1); (2) Zone‐I stage 3 ROP with or without plus disease (ETROP‐type 1). Results Twenty eyes of 10 infants showed criterion (1) and 16 eyes of 8 infants criterion (2). Corneal opacity, pupillary rigidity, tunica vasculosa lentis and vitreous haze were observed until 31‐33 weeks gestational age. The time period for the progression of stage‐1 to stage‐3 retinopathy ranged between 0.7‐3.7 weeks. The mean age at the first treatment was 33 weeks (range 30‐35 weeks). The mean time between the development of stage‐1 retinopathy and the laser treatment was 9.8 days in mean (5‐23 days), and 69.3 % of the infants were treated within 12 days after the diagnosis of stage‐1 ROP. Additional treatments were performed in 7 eyes, scleral buckling+cryotherapy in 5 eyes, vitrectomy in 2 eyes.Thirty‐two eyes had favorable and 4 eyes had unfavorable outcomes. Conclusion The diagnosis of Zone‐I ROP requires close‐meshed follow‐up and immediate treatment.