Our treatment results on retinopathy of prematurity

PURPOSE: To investigate and compare the results of treatment effectivess of argon laser photocoagulation (LFK), intravitreal injection of bevacizumab (IVB) and combined (LFK + IVB) applied on the treatment of retinopathy of prematurity infants at at Dicle University Faculty of Medicine, Department of Ophthalmology between January 2010 and December 2011. MATERIALS AND METHODS: We retrospectively investigated 76 premature infants who treated at the clinic. Patients' birth weight, gestational age at delivery, sex, duration of oxygen therapy, a history of multiple pregnancy, additional systemic diseases, phase of retinopathy of prematurity, treatment and outcome were investigated. Premature infants assembled into groups: LFK-treated patients in the first group, IVB-treated patients in the second group and patients treated with combination therapy in the third group. Groups are compared in terms of birth weight, gestational age, the findings of the anterior segment, posterior segment findings, phase of retinopathy of prematurity, illness zone and the presence of plus disease. The results of treatment and complications in three groups were evaluated with comparative analysis. FINDINGS: The mean gestational age at delivery was 27,8 ± 2,3 weeks and the mean birth weight was 1112,5 ± 272,9 grams. The mean duration of the oxygen therapy was 38,2 ± 20,6 days. Out of 76 patients, 24 patients had multiple pregnancy and 30 patients had a a history of previous systemic diseases. 150 eyes of 76 premature infants treated. The mean birth weight of the infants applied LFK was 1081,60 ± 266,94 grams, IVB was 1189,55 ± 263,77 and the combined treatment 1078,57 ± 332,13 was grams. Average gestational age at delivery appied LFK was 27.57 ± 2.47, IVB was 28.73 ± 1.75 and combination therapy was 26.86 ± 2.26 weeks. There was no difference between the groups in terms of birth weight and birth week. LFK applied respectively to 95 eye and 2 (%2) was in stage 1, 18 (%19) was in stage 2, 60 (%63) was in stage 3 and 15 (%16) was in AP-ROP. IVB applied respectively to 44 eye and 4 (%5) was in stage 1, 12 (%34) was in stage 2, 5 (%9) was in stage in 3 and 23 (%52) was in AP-ROP. Combined therapy applied respectively to 11 eyes and 7 (%64) was in stage 3 and 4 (36) was in AP-ROP. Plus disease was present in all patients. In anterior segment examination 16 eyes that applied LFK, 7 eyes that applied IVB and 7 eyes that applied the combined theraphy applied had iris, or the lens neovascularization. The vitreous hemorrhage was present in 5 eyes that LFK applied, 3 eyes that IVB applied and 1 eye that the combined therapy. Out of 95 eyes that applied LFK, 90 (%94,7) eye showed regression and 5 (%5,3) showed disease progression. Regression was observed in all 44 eyes that applied IVB as monotherapy. Out of 11 eyes that applied combined therapy, in 9 (%82) the retinopathy of prematurity regression and in 2 (%18) the progression seen. CONCLUSION: In retinopathy of prematurity, effective results have been obtained by applying LFK and IVB injection treatments. Due to treatment in some patients, disease progression development seen afterwards by applying combined treatment useful results obtained. In our study, the IVB injection for use as monotherapy or combination therapy with LFK is seen to be effective and promising.