Management of avascular peripheral retina in older prematurely born infants.

PURPOSE: To report on the authors' experience with presentation and management of prematurely born infants who do not fully vascularize after 45 weeks of postmenstrual age (PMA).

METHODS

Retrospective, noncomparative, consecutive case series consisting of premature infants with retinopathy of prematurity (ROP) who were treated with laser ablation after 45 weeks of PMA at a single tertiary referral institution.

RESULTS

A total of 370 premature infants with ROP were treated at this institution from January 1, 2006, to August 1, 2009. Eighteen eyes of 9 patients received laser photocoagulation after 45 weeks of PMA and were included in this series. The mean gestational age for this subgroup was 26 weeks and 2 days, and mean birth weight was 792 g. Type 1 ROP developed in 3 infants after 45 weeks of PMA and received laser treatment, and 6 infants without Type 1 ROP received laser treatment for an avascular peripheral retina, evidence of peripheral neovascularization, and/or ROP in Zone 3 with persistent plus disease.

CONCLUSION

This series represents the authors' experience in the management of prematurely born infants with ROP after 45 weeks of PMA. One may consider close observation or laser ablation for the management of infants who have incomplete peripheral retinal vascularization, peripheral neovascularization, and/or ROP in Zone 3 with persistent plus disease.