Clinical profile and management outcomes of posterior zone 1 retinopathy of prematurity

Background To analyse the varied clinical profile and treatment outcomes of posterior zone 1 retinopathy of prematurity (ROP). Methods This retrospective case-series included 54 eyes of 27 infants of posterior zone 1 ROP treated at our centre from January 2018 to June 2019. Three clinical patterns were observed at presentation - Posterior zone 1 ROP without detachment (group 1), with subtotal detachment (group 2) and total detachment (group 3) of the vascularised retina. Their profile, treatment options and outcomes were studied. Results The mean birth weight was 1204 ± 262 gm and mean gestational age was 28.8 ± 2 weeks. Clinical presentation as per group 1, 2 and 3 was seen in 33/54 (61.1%), 9/54 (16.6%) and 12/54 (22.2%) eyes, respectively. All the eyes received intravitreal ranibizumab as primary intervention. In group 1, 25/33 (75.7%) eyes had laser and 8/33 (24.2%) had surgery whereas, in group 2, 2/9 (22.2%) eyes had laser and 7/9 (77.7%) underwent surgery as a second intervention. In group 3, only 3 /12 (25%) eyes had second intervention (surgery). Surgical outcomes of group 1 and 2 were better than group 3. At last follow-up, macular vascularisation was noted in 33/54 (61.1%) eyes. Conclusion A customised and multifaceted treatment approach is required to treat posterior zone 1 ROP.