Effect of diode laser retinal ablative therapy for threshold retinopathy of prematurity on the visual field: results of goldmann perimetry at a mean age of 11 years

Abstract

Purpose: To assess the peripheral visual field in premature children who received diode laser photocoagulation for threshold retinopathy of prematurity (ROP) and in a comparison group with subthreshold ROP that had regressed spontaneously without laser treatment.

Patients and methods: Eleven patients (18 eyes) were treated with laser, and nine patients (16 eyes) with subthreshold untreated ROP were recalled for assessment at a mean follow-up of 11 years. All children underwent Goldmann visual field testing using the II4e and V4e stimuli. Distance visual acuity measurement, dilated fundal examination, and cycloplegic autorefraction were also performed.

Results: The visual field extent in treated eyes was 3% to 4% smaller for the V4e target and 7% to 10% smaller for the II4e target than in the comparison eyes. For the II4e stimulus, the right eye visual field extent of the laser-treated children did not differ significantly from that of the untreated comparison group (P = .11), but the left eyes showed a borderline significant reduction (P = .046). For the larger V4e stimulus, no significant differences were noted (right eye, P = .41; left eye, P = .30).

Conclusions: This is the first study to assess the effect of diode laser therapy on the peripheral visual field in eyes with threshold ROP using Goldmann perimetry. Laser-treated eyes showed a slight constriction of peripheral visual fields compared with untreated subthreshold eyes. It is uncertain whether this was due to the laser treatment itself or to the more severe ROP in the laser group. However, the limited reduction in visual field extent is comparable to that reported for cryotherapy and is unlikely to be of functional significance.