We evaluated long-term visual outcome in 28 patients (52 eyes) with
retinopathy of prematurity after
Xenon photocoagulation and/or cryocautery. The visual outcome was roughly classified into two groups: visual acuity of 0.6 or better and that of 0.2 or worse. The poor visual outcome resulted from
macular degeneration, and risk factors for its development were small
birth weight (Mann-Whitney's U test, p = 0.03), retinopathy plus disease (chi 2 test, p = 0.041), treatment of a large area of the fundus (Mann-Whitney's U test, p = 0.035) and the inside of the vascular arcade (Mann-Whitney's U test, p = 0.0034), and treatment by cryocautery (chi 2 test, p = 0.032).
Macular degeneration occurred either as an isolated small focus extending circumferentially around the fovea or as a result of extension from the temporal degeneration caused by
photocoagulation. These results suggest that intensive treatment for
retinopathy of prematurity, in addition to the prematurity by itself, caused the development of
macular degeneration. Overtreatment should be carefully avoided in
retinopathy of prematurity complicated by disease in which
photocoagulation needs to be done in the area posterior to the ridge.