Arch Ophthalmol. Aug;(8) Multicenter Trial of Cryotherapy for Retinopathy of Prematurity: ophthalmological outcomes at 10 years. Cryotherapy . The most effective proven treatments for ROP are laser therapy or cryotherapy. Laser therapy “burns away” the periphery of the retina, which has no normal. are discussed. Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.’2 Cryotherapy was first used in the treatment of this condition in the.

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However, in some instances, physicians may recommend treatment to try to prevent further advancement of the retinal detachment stage V. The study identified the zone 1 eyes to have the worst prognosis both with and without xryo.

Clinical investigations in ROP confront major barriers to study related to the age and relative immaturity of the subjects, the acute nature and rapid course of the disease, and the associated medical and developmental consequences of prematurity. The most important early visual function outcome reported was visual measurement using forced preferential looking tests of grating resolution Teller Acuity Card procedure.

Many children who develop stage II improve with no treatment and eventually develop normal vision. Other measurements of visual function also showed significant benefit in treated eyes, including contrast sensitivity and visual fields. Ro; 17, ; final revision received November 9, ; accepted November 18, However, some patients presented with asymmetric involvement, requiring a different randomization scheme, randomizing to treatment or no treatment in the single randomized eye.

Results of U.S. randomized clinical trial of cryotherapy for ROP (CRYO-ROP).

Ethical concerns also complicated the development of this study design. The outcome of greatest interest, long-term visual function, cannot be measured until years after treatment.

Copyright American Medical Association. Patient Selection and Randomization. Scientists believe that the periphery of cgyo retina then sends out signals to other areas of the retina for nourishment. What the primary outcomes did not demonstrate, but what has become clearer as the trial subjects have been followed up to an age when functional vision testing is possible, is that some ro; with anatomically favorable outcomes still have poor vision.


Treatment of acute retrolental fibroplasias by cryopexy. Stage V — Completely detached retina and the end stage of the disease.

The difficulty in precisely measuring visual acuity and the effect of nonocular visual pathway abnormalities in these children limit the interpretation of vision as a secondary outcome. Xryo a free personal account to make a comment, download free article PDFs, sign up for alerts and more. The purpose of the proposed gop is to examine the long-term structural and functional effects of cryotherapy as a treatment for severe retinopathy of prematurity ROP.

Results of U.S. randomized clinical trial of cryotherapy for ROP (CRYO-ROP).

Create a free personal account to download free article PDFs, sign up for alerts, and more. The natural history cohort has provided unique, well-documented information about the course of eyes with advanced acute ROP without treatment.

The early results of the trial also showed what had become apparent clinically to the ophthalmologists with experience with cryotherapy: The CRYO-ROP study was also very influential among ophthalmologists managing pediatric vision problems in adopting the Teller Acuity Card procedure, which is now used in many pediatric eye clinics to quantify visual function in preverbal children.

Post hoc analysis of enrollment suggests possible overrepresentation of black infants, multiple births, and boys. The initial conclusion of the expedited early publications and 3- and month primary outcomes crho that cryotherapy for threshold ROP is safe and effective when used in one eye.

This important finding led to the development of the ETROP and revised treatment recommendations for earlier treatment of patients with involvement of zone 1. These technical and logistical limitations caused compromises in the design of the CRYO-ROP study related to recruitment and randomization, treatment, choice of outcomes to be measured, ethical factors, and statistical analysis. Measurement of visual function of children with associated developmental, neurological, and ophthalmic complications of their premature birth is very difficult and complex.

Get free access to newly published articles Create a personal account or sign in to: The very high rate of testability and the precision of the test results when compared with optotype recognition provided a major validation of the Teller Acuity Card procedure, 18 which has subsequently become widely used as a practical clinical tool and clinical research tool in pediatric ophthalmology. It is difficult to overestimate the impact of this well-designed trial in taking the concept of ablative treatment from controversial to near universal acceptance within a short period of time.


It is possible that laser may be associated with less peripheral visual field constriction, less pathological myopia, and lower risk of macular retinopathy, 1314 but it is unlikely that a large-scale comparative trial would be feasible because of the almost universal adoption of laser photocoagulation.

Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. In the initial phase of the study, eyes with 5 contiguous or 8 total clock hours of stage 3 plus ROP, in infants with birth weights less than g.

This involves placing a silicone band around the eye and tightening it. Currently in the U. Some of this caution was removed in the conclusions of the 3-month interval publication. The present study proposes to follow patients in the randomized group and a relatively small subgroup 67 of potentially high risk patients from the Natural History study through age 10 years, to determine whether the reduction in the benefit of cryotherapy seen between ages 12 and 42 months continues into mid-childhood.

This causes a retinal detachment. Skip to main content. Influence of the study on clinical practice in management of rop. Abstract Funding Institution Related projects Comments.

It led to the publication of 50 or more manuscripts directly and has influenced many more publications and studies indirectly.