Visual outcomes after laser photocoagulation for threshold retinopathy of prematurity

Objective: To determine the long-term visual acuity after diode laser photocoagulation for threshold retinopathy of prematurity. Design: Retrospective, noncomparative case series. Intervention: Photocoagulation of the peripheral avascular retina with a diode laser indirect ophthalmoscope. Main Outcome Measures: The principal outcome evaluated was best-corrected visual acuity (BCVA). The most recent refractions for these eyes were also collected for analysis. Participants: Thirty-five infants with threshold retinopathy of prematurity treated with laser photocoagulation from 1991 to 1996. Results: After bilateral laser treatment, 14 (56%) of 25 patients who were capable of accurate visual acuity testing had 20/50 or better BCVA in at least 1 eye with 11 (44%) of 25 patients having at least 20/50 BCVA in both eyes. After unilateral treatment, four (40%) of ten had 20/50 or better BCVA in the treated eye while five (50%) of ten laser-treated eyes had a BCVA at least equal to the untreated fellow eye. Compared to eyes with 4 or more diopters (D) of myopia, those with less than 4 D of myopia were 6.4 times more likely to achieve 20/50 or better BCVA (95% confidence interval, 1.7- 22.7). The average age at follow-up was 3.7 years. Conclusions: After laser photocoagulation for threshold retinopathy of prematurity, 29 (48%) of 60 eyes had 20/50 or better visual acuity. Eyes with 4 or more D of myopia were significantly less likely to achieve 20/50 or better visual acuity than eyes with less than 4 D of myopia.