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

Overview

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.