A clinical study on the clinical progress and treatment efficacy of aggressive posterior retinopathy of prematurity

Objective To describe the clinical progress and characteristics of aggressive posterior retinopathy ofprematurity(AP-ROP, and to access the efficacy of retinal photocoagulation and cryotherapy for AP-ROP to stop progression of retinal detachment. Methods Prospective, non-comparative, consecutive case series. Sixteen eyes (8 patients) with AP-ROP were included in this study. Each patient underwent retinal photocoagulation with or without cryotherapy within 24 hours after identification.Results AP-ROP, an unusual form of ROP, often rapidly progresses to a closed funnel of tractional retinal detachment within several weeks if left untreated. It is characterized by substantial dilation and tortuosity of the vessels of the posterior pole in Zone 1. Nine out of 16 (56.2%) eyes were stopped to progress to advanced ROP in our series. However, retinal detachment developed in 7/16 (43.8%) eyes. Conclusions These results suggest that early intervention with photocoagulation or cryotherapy is necessary and effective to stop ROP progression to Stage 5 in most cases; however, the prognosis is poor in parts of patients despite retreatment of poripheral retinal photocoagulation and cryotherapy. Clinicians looking for preterm infants must be vigilant in screening and providing appropriate intervention to avoid missing the "time window" of treatment. Key words: Aggressive posterior retinopathy of prematurity;  Retinal photoeoagulation;  Cryotherapy