Anatomic outcomes of laser indirect ophthalmoscopy for retinopathy of prematurity in a tertiary referral center in the Philippines

Abstract

Objective: Laser/photocoagulation criteria for retinopathy of prematurity (ROP) are generally universal, with > 90% anatomic success reported in varied settings. Outcomes in the Philippines, a developing/lower-middle income nation, were examined. Results: This single-center retrospective chart review covered years 2014 and 2015. Of 214 infants screened, 64 had any ROP. Thirty-four were treated, and 20 had documented outcomes. Only 15 of 25 eyes (8 infants) with laser treatment-requiring ROP were successes (60%). All infants had Type 1 ROP except one with Aggressive Posterior ROP. Seven infants with bilateral "Milder than Type 1" ROP were treated successfully. Type 1 ROP treatment failures versus successes did not differ significantly in birth weight (1009 g vs. 1112.86 g, p =.5152), birth age of gestation (27.74 vs. 28.49 weeks, p =.3290), and, delay in first screening (6.74 vs. 5 weeks, p =.4649). Poorer outcomes of laser treatment-requiring ROP were documented here compared with elsewhere in the world. Variables/risk factors examined were limited and human error was not systematically considered. Subsequent studies validating this trend should incorporate other clinical (e.g. maternal/neonatal risk factors) and environmental differences that might drive pathology and treatment response in this multifactorial disease. Adherence to protocols gains importance given the widespread delay and early loss to follow-up observed.