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Role of fluorescein angiography guided laser treatment in aggressive retinopathy of prematurity

Eye volume 37, pages 2130–2134 (2023)Cite this article

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Abstract

Purpose

To compare disease regression in cases of Fluorescein Angiography (FA) guided laser vs. conventional laser treatment in infants with Aggressive retinopathy of prematurity (AROP).

Methods

60 eyes of 30 infants of AROP were randomized into two groups. In both the group’s FA was done once. Montage of the fundus, FA images was created and the vascular area, avascular areas, and skip areas after laser treatment were demarcated and measured. In group 1, FA-guided laser treatment was done whereas in group 2 they were lasered without seeing FA. Infants were followed up every week to look for skip areas and disease regression.

Results

The mean vascular retinal area in group 1 and group 2 on fundus images was 302.7 sq. mm and 245.8 sq. mm respectively, while the same on FA was 285.2 sq. mm and 221.3 sq. mm respectively, suggesting overestimation of the vascular area on fundus imaging compared to FA which enabled more objective estimation of avascular loop areas. Retinal skip areas in group 1 and group 2 after 1st laser were 18.7 sq. mm and 73.1 sq. mm respectively (P = 0.001), after 2nd laser was 3.7 sq. mm and 19.2 sq. mm (P = 0.003), which suggests FA-guided laser led to significantly fewer skip areas. Infants had regression in 4.1 ± 0.3 wks and 4.2 ± 0.4 wks in groups 1 and 2, respectively.

Conclusion

FA-guided laser ensured lesser skip areas and more complete laser treatment, though regression was similar in both groups.

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Fig. 1: Combining fundus and FA images to assess laser treatment in group 2.
Fig. 2: Combining fundus and FA images to assess laser treatment in group 1.

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Data availability

The datasets generated during and/or analysed during the current study are not publicly available due patient privacy but are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Prashant Kumar, Parijat Chandra, Rohan Chawla & Rajpal Vohra

  2. Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Ramesh Agarwal

Authors
  1. Prashant Kumar
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  2. Parijat Chandra
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  3. Ramesh Agarwal
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  4. Rohan Chawla
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  5. Rajpal Vohra
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Contributions

Conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. PK PC. Drafting the work or revising it critically for important intellectual content PK PC RA RC RV. Final approval of the version to be published. PK PC RA RC RV. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. PK PC RA RC RV.

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Correspondence to Parijat Chandra.

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Institutional ethical committee (AIIMS, New Delhi).

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Kumar, P., Chandra, P., Agarwal, R. et al. Role of fluorescein angiography guided laser treatment in aggressive retinopathy of prematurity. Eye 37, 2130–2134 (2023). https://doi.org/10.1038/s41433-022-02302-0

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