Laser fetoscopy ablation for twin–twin transfusion syndrome may reduce the risk of ROP
Metadata
Show full item recordAuthor
García-Serrano, José Luis; Fernández Marín, Elisabeth; Domech Serrano, Teresa; Stevens, Benjamin Robert; Uberos Fernández, JoséEditorial
Wiley
Materia
Avascular retina Twin–twin transfusion syndrome Retinopathy of prematurity Monochorionic twins Laser therapy
Date
2023-12-26Referencia 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.
Sponsorship
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.Abstract
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.