Confluent laser photocoagulation for the treatment of retinopathy of prematurity.

PURPOSE: To describe the efficacy, outcomes, and complications of confluent laser technique in a cohort of premature infants with threshold retinopathy of prematurity. Laser photocoagulation has a good treatment outcome in the management of retinopathy of prematurity; however, the number and density of laser spots remains debatable. Laser treatment can be done in a scattered pattern, a near-confluent pattern, or a confluent treatment pattern. METHODS: A retrospective chart review of patients with threshold retinopathy of prematurity treated between 2003 and 2006 was conducted. Confluent laser treatment was applied anterior to the ridge extending to the ora serrata 360 degrees . Rate of progression, frequency of retreatment, postoperative complications, structural outcomes, and refractive error were evaluated. RESULTS: A total of 100 eyes from 51 patients were included. Mean gestational age was 28 weeks (range: 23 to 32 weeks) and mean birth weight was 1,065 g (range: 477 to 1,905 g). Patients had a mean follow-up of 13 months (range: 6 to 50 months). Progression to stage 4 or 5 occurred only in a total of 6 eyes (6%). Postoperative complications included cataract, vitreous hemorrhage, corneal edema, and macular dragging. Mean spherical equivalent at the last follow-up visit was -3.80 diopters (range: -19.00 to+4.00 diopters). CONCLUSION: Patients treated with confluent laser photocoagulation had a low rate of progression to stage 4 or 5 retinopathy of prematurity. Also, the need for additional laser treatment was small, with rates of complications and structural outcomes comparable to previous reports using a nonconfluent laser pattern.

Pegaptanib sodium for the treatment of proliferative diabetic retinopathy and diabetic macular edema.

Diabetes mellitus is a growing health concern world-wide. Patients with this disease present with a variety of health conditions, including a number of sight-threatening ocular pathologies. Proliferative diabetic retinopathy (PDR) and diabetic macula edema (DME) are common diseases that cause substantial vision impairment in diabetic patients. There has been a strong focus on studying the epidemiology and treatment of these diseases. The recent discovery of vascular endothelial growth factor (VEGF) and its role in the development of proliferative disease, has led to a movement towards treating PDR and DME with anti-angiogenic medications in conjunction with the standard of care. In this review we present a summary of the origination and progression of PDR and DME. This will be followed by a review of clinical data surrounding new anti-angiogenic treatment modalities.