The risk for retinal detachment associated with hemorrhages pre- and postlaser treatment in retinopathy of prematurity.

PURPOSE: To determine the risk factors including retinal or vitreous hemorrhage for retinal detachment after laser photocoagulation in threshold or aggressive posterior retinopathy of prematurity.

METHODS

The medical records of 184 eyes of 94 consecutive infants who underwent diode laser photocoagulation for threshold or aggressive posterior retinopathy of prematurity between 1996 and 2006 were retrospectively reviewed. Eight clinical variables were included in the logistic regression analysis to assess the relationship between each variable and retinal detachment of 4A or greater.

RESULTS

The mean follow-up after laser photocoagulation was 25.06 +/- 23.59 months (range: 6-85 months). Sixteen (8.7%) eyes developed a retinal detachment. Pre and posttreatment retinal or vitreous hemorrhage was present in 30 (16.3%) eyes. Among 154 eyes without hemorrhage, 6 (3.9%) developed a retinal detachment, whereas 10 of 30 (33.3%) eyes with a hemorrhage developed a retinal detachment (P < 0.001). The logistic regression analysis showed that a pretreatment hemorrhage, vitreous organization, a persistent active element of plus disease after 21 days, and posttreatment hemorrhage were statistically associated with the development of a retinal detachment.

CONCLUSION

Pre and posttreatment hemorrhage was significantly associated with the progression to retinal detachment along with vitreous organization, a persistent plus disease activity 21 days after treatment.