Correlation of retinopathy of prematurity in fellow eyes in the cryotherapy for retinopathy of prematurity study. The Cryotherapy for Retinopathy of Prematurity Cooperative Group.

OBJECTIVE: To examine the similarity of extent (sectors) and severity (stage) of acute-phase retinopathy of prematurity (ROP) between fellow eyes and the concordance of cicatricial outcomes at age 1 year of eyes that did not develop threshold disease. METHODS: Four thousand ninety-nine infants with birth weights of less than 1251 g who participated in a natural history segment of the Cryotherapy for Retinopathy study underwent biweekly eye examinations from 4 to 6 weeks after birth until retinal vasculature was complete or until ROP regressed or reached threshold severity. Eyes were categorized as follows: (1) no ROP, (2) less than prethreshold ROP, (3) prethreshold ROP, (4) threshold ROP, and (5) unable to determine. The presence and stage of ROP residua in fellow eyes were evaluated at 12 months. RESULTS: Acute-phase ROP status between 32 and 42 weeks postconceptional age showed a high degree of correspondence between fellow eyes in severity (stage) and location (zone) of ROP, presence of plus disease, and sectors of stage 3 retinopathy. More variability between eyes was seen when cicatricial status at age 1 year was examined. This higher variability was evident even though results from patients with threshold ROP (many of whom underwent cryotherapy) were excluded. CONCLUSION: The usual course of ROP during its acute phase is for fellow eyes to be very similar in ROP status. However, asymmetry between eyes is not unusual in eyes with posterior pole residua of ROP.

Congenital retinoblastoma: a case report.

Retinoblastoma is usually diagnosed during the first three years of life, with an average age of diagnosis of 18 months. It is almost never found at birth except when there is a positive family history which prompts an early fundus examination. We report a case of unilateral nonfamilial retinoblastoma which was so advanced at birth that it had already produced a perforated globe. Despite enucleation, radiation, and chemotherapy, massive orbital recurrence developed which necessitated a modified orbital exenteration. In spite of this aggressive therapy the child died of metastatic retinoblastoma at age eight months.

Prognostic factors in the natural course of retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group.

BACKGROUND: There exists no reliable information that allows the ophthalmologist to predict with any degree of certainty a particular infant's chances of requiring surgical treatment for retinopathy of prematurity (ROP) or of reaching an unfavorable outcome on the basis of the retinal findings at the time of the nursery examination. METHODS: In the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP), 4099 infants weighing less than 1251 g at birth underwent eye examinations that began at 4 to 6 weeks after birth and subsequently continued at 2-week intervals. Independent variables in the population were studied using multiple logistic regressions. RESULTS: An increased risk of reaching threshold ROP was found associated with lower birth weights, younger gestational age, white race, multiple birth, and being born outside a study center nursery. For infants who developed ROP (66%), corresponding probabilities are presented for developing severe ("threshold") ROP or of having an unfavorable macular outcome. The risk of an unfavorable macular outcome was increased with zone 1 ROP, "plus" disease, the severity of the stage, and the amount of circumferential involvement. A higher risk also was associated with a rapid rate of progression of ROP to prethreshold disease but not with the postconceptional age at which ROP was first noted. CONCLUSION: The findings indicate that the ocular characteristics of ROP, along with some easily identifiable and available basic systemic and demographic information about an infant, can assist the ophthalmologist in understanding variations in an individual baby's chance for a good or poor macular outcome.