What's new AAPOS 2008 - The Private Eye Clinic

ROP
Retinopathy of Prematurity: the relationship between the Pediatric
Ophthalmologist and the Hospital.
JPOS 2007; 44: 145-149.
Across the United States, the care of premature infants with retinopathy of prematurity
(ROP) is becoming increasingly complex, often involving multiple specialists in multiple
clinical settings. Adding to this complexity are the legal ramifications of poor outcomes
for these tiny infants and the potential for high dollar litigation. The central role of the
Pediatric Ophthalmologist in this maze is discussed by a panel of experts in a report
generated at the 2006 AAO meeting.
Effect of Diode Laser Retinal Ablative therapy for Threshold Retinopathy of
Prematurity on the Visual field: Results of Goldman Perimetry at a Mean Age of
11 Years.
JPOS 2007; 44:170-173.
The peripheral visual field in premature children who received diode laser
photocoagulation for threshold ROP was compared with a group of children with
subthreshold ROP that had regressed spontaneously without laser treatment. The
mean followup was eleven years. Goldman visual field testing using the II4e and V4e
stimulus was utilized. Laser treated eyes showed a slight constriction of peripheral
visual fields compared with untreated subthreshold eyes. This may have been due to
either the laser therapy or the more severe ROP in the laser group. However, the
limited reduction in visual field extent is comparable to that reported for cryotherapy and
is unlikely to be of functional significance.
Severe visual impairment in children with mild or moderate retinal residua
following regressed threshold retinopathy of prematurity.
Siatkowski RM, Dobson V., et al.
J AAPOS 2007; 11: 148-152.
CRYO-ROP 10-year follow-up exam and data was used to identify 16 of the 247
patients examined who had retinal outcomes of no ROP residua, no straightened
temporal vessels, and no macular heterotropia in at least one eye, but with a visual
acuity less than 20/200 in both eyes. The authors discuss the anterior, posterior, or
combined visual pathway conditions that can occur in these rare patients.
3