Purpose: The purpose of this study was to review the anatomic and functional outcomes of aggressive posterior retinopathy of prematurity occurring at the authors' institution. Methods: This is a retrospective chart review of inborn infants developing aggressive posterior retinopathy of prematurity from January 2004 through January 2008. Birth histories, interventions, and outcomes were reviewed. Results: Twenty-two infants were identified as having aggressive posterior retinopathy of prematurity. All eyes underwent peripheral laser ablation. Seven infants (14 eyes) required a second session of laser. Five infants (eight eyes) progressed to retinal detachment that was successfully repaired by lens-sparing vitrectomy. Seven eyes developed stage 4a detachments, and 1 eye developed a stage 4b detachment. Forty-three eyes (43 of 44) demonstrated a good anatomic outcome with minimal posterior pole distortion. Conclusion: The management of aggressive posterior retinopathy of prematurity requires frequent screening examinations and timely intervention as outlined in the Early treatment Retinopathy of Prematurity Study. Eyes progressing to retinal detachment may still have a good structural outcome with lens-sparing vitrectomy.
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