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March 2000

A Macular Lesion Simulating an Aberrant Cryotherapy Lesion in Retinopathy of Prematurity

Arch Ophthalmol. 2000;118(3):438-439. doi:10.1001/archopht.118.3.438

RETINAL PIGMENT epithelial disruption is a well-recognized entity in the spectrum of posterior pole pathologic traits in patients who have been treated with cryotherapy for threshold retinopathy of prematurity (ROP).1 In 1982, Hindle2,3 applied the term macular pigment epitheliopathy to macular lesions in infants treated with cryotherapy. He postulated that macular pigment epitheliopathy was the result of serous effusion or a subtle serous retinal detachment extending into the macula, possibly potentiated by compression of the eye during treatment. Saito et al4 described colobomalike macular lesions in a series of patients treated with cryotherapy applied to both the ridge extraretinal fibrovascular proliferative complex and anterior avascular retina. They speculated that the dispersion of retinal pigment epithelial cells during cryotherapy with subsequent migration and ectopic proliferation played a role in this maculopathy. Even inadvertent application of the cryoprobe to the macula during treatment has been suggested as one possible cause of these lesions. We describe an eye of a child who did not receive any form of ablation therapy yet developed a discrete retinal pigment epithelial lesion in the macula.

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