Management of advanced retinopathy of prematurity in the older patient.

Abstract

The authors studied 11 eyes of 10 patients who complained of a recent decrease in vision and whose eyes had the clinical appearance of stage 5 retinopathy of prematurity (ROP) as diagnosed by the presence of a dense, opaque retrolenticular membrane. Patients ranged in age from 4 to 33 years, and birth weights ranged from 680 to 1077 g. All eyes underwent vitrectomy, lensectomy, and membrane peeling and were found intraoperatively to have areas of retina that were attached (stage 4B). Preoperatively, a reproducible visual-evoked potential waveform appeared to better predict this retinal configuration and potential retinal function than did the contact B scan ultrasound of the globe. Postoperatively, seven (63.6%) eyes demonstrated an improvement in vision. Vitreous surgery may be beneficial in selected eyes of older patients with advanced ROP to clear media opacities and to uncover areas of functional, attached retina, which may allow these patients to more effectively use the vision they possess.