Association of systemic risk factors with the progression of laser-treated retinopathy of prematurity to retinal detachment.

PURPOSE

To identify systemic risk factors associated with treatment failure of diode laser photocoagulation for threshold or prethreshold retinopathy of prematurity (ROP).

METHODS

Consecutive infants treated with laser at our institution and infants referred from outside centers with progression to stage 4 or 5 ROP after laser treatment were included in this retrospective study. Two groups were identified: those with regression of ROP after laser (LT group; 196 eyes of 98 infants) and those with progression to stage 4 or 5 ROP after laser (ST group; 134 eyes of 80 infants).

RESULTS

Using a multiple logistic regression model, there was a statistically significant association for progression of treated ROP to retinal detachment (RD) with history of sepsis (P < 0.001), oxygen therapy (P = 0.003), mechanical ventilation (P = 0.003), respiratory distress syndrome (RDS; P = 0.005), and patent ductus arteriosus (PDA; P = 0.042). On the other hand, jaundice (P = 0.563), anemia (P = 0.599), thrombocytopenia (P = 0.689), and blood transfusion (P = 0.878) did not show a statistically significant association with failure of laser treatment and progression of ROP to stage 4 or 5 disease.

CONCLUSIONS

Premature infants with a history sepsis, oxygen therapy, mechanical ventilation, RDS, and PDA may be at a higher risk for progression of ROP despite diode laser treatment.