Early Experience with Diode Laser Combined with Systemic Steroid Therapy for Severe Stages of Retinopathy of Prematurity

Aims: To study the efficacy of diode laser-systemic steroid therapy in extremely and very-low-birth-weight prematures with severe Retinopathy of Prematurity (ROP). Methods: 36 eyes of 18 prematures, mean gestational age 25.67 weeks (SD ± 1.28) and 811, 83 g birth weight (SD ± 299.08) with aggressive-posterior ROP (AP-ROP) and threshold 3 ROP with plus sign and Extraretinal Fibrovascular Proliferation (EFP) were enrolled. Indirect diode laser combined with intravenous course of Dexamethason was applied. Analyzed risk factors were correlated with the same ones received in cohort treated only with laser. Shapiro-Wilk, t-Student, U Mann-Whitney tests were involved in the statistical analysis (significance levels at p<0.05). Results: Favorable anatomical results after mean 11.29 (SD ± 2.29) days of therapy were noted in 32 eyes (88.88% ), ROP 5 developed in four eyes, but this difference was statistically non-significant (p=0.0612). Transient cortisol decreasing, hyperglycemia and partial adrenal fatigue were noted in some babies. During therapy, arterial systolic and diastolic pressures rose (p<0.05; p<0.01), significantly, which were related with severity of ROP, such as, C-reactive protein, erythrocyte and hematocrit, ventilation duration and number of transfusion (p<0.01). Conclusion: Laser-steroid treatment might be additional effective alternative for severe ROP. Short- and long-term complications should be taken into account when starting this type of therapy