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Laser fetoscopy ablation for twin–twin transfusion syndrome may reduce the risk of ROP

[PDF] Artículo publicado en Open access en Acta Ophthalmologica (433.8Kb)
Identificadores
URI: https://hdl.handle.net/10481/86538
DOI: doi: 10.1111/aos.16608.
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Autor
García-Serrano, José Luis; Fernández Marín, Elisabeth; Domech Serrano, Teresa; Stevens, Benjamin Robert; Uberos Fernández, José
Editorial
Wiley
Materia
Avascular retina
 
Twin–twin transfusion syndrome
 
Retinopathy of prematurity
 
Monochorionic twins
 
Laser therapy
 
Fecha
2023-12-26
Referencia bibliográfica
García-Serrano JL, Fernández-Marín E, Domech-Serrano T, Stevens BR, Uberos Fernández J. Laser fetoscopy ablation for twin-twin transfusion syndrome may reduce the risk of ROP. Acta Ophthalmol. 2023 Dec 26. doi: 10.1111/aos.16608. Epub ahead of print. PMID: 38146930.
Patrocinador
Universidad de Granada aporta fondos para publicación del artículo en acceso abierto (Funding for open access charge): Universidad de Granada /CBUA. Acuerdo Universidad de Granada con Wiley 2023.
Resumen
Purpose: Twin–twin transfusion syndrome (TTTS) is a condition wherein monochorionic twins share a common placenta with placental anastomoses between the two foetal circulations. Most infants who survive TTTS are born prematurely. This study aimed to determine whether fetoscopic laser ablation (FLA) can reduce the risk of retinopathy of prematurity (ROP) and whether TTTS was a risk factor for ROP. Methods: This single-centre, retrospective, comparative study included 32 monochorionic twins with TTTS matched for gestational age, birthweight and sex to premature twins and singletons without TTTS (n = 68; twins, n = 34; and singletons, n = 34) born between 2003 and 2022. A single ophthalmologist recorded the fundus findings. FLA was performed using Solomon's technique to separate the vascular systems of the twins with TTTS. Results: The gestational age and weight of premature infants with TTTS treated with FLA were significantly higher than those of untreated infants (p = 0.001 and p = 0.001, respectively); however, the hyaline membrane grade was lower (p = 0.004). A significant increase in weight (g/day) (p = 0.002) and lesser avascular area in the peripheral temporal retina (p = 0.045) was observed at postnatal week 4. The risk of ROP in the FLA group was 2.6 times (13.3% vs. 35.3%) lower than that in the non-FLA group; however, this difference was not significant. The incidence of any stage of ROP (25% vs. 18%) and treatment for ROP type 1 (6.25% vs. 5.9%) did not differ significantly between monochorionic twins with TTTS and premature infants without TTTS. Conclusion: The gestational age of premature infants with TTTS treated with FLA was higher than that of untreated infants. Moreover, a reduction in complications of prematurity was also observed. Laser fetoscopy in twin–twin transfusion syndrome may reduce the risk of ROP, but the difference was not statistically significant in this small study.
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