Risk factors and rate of progression for zone I versus zone II type 1 retinopathy of prematurity

PURPOSE: To study the incidence of retinopathy of prematurity (ROP) in a neonatal intensive care unit in Croatia and obtain information on risk factors associated with ROP. There have been limited studies on ROP in Croatia where the screening for ROP and its treatment is still insufficient and not introduced in many intensive care units. MATERIAL AND METHODS: This retrospective study included 247 premature infants admitted to the neonatal intensive care unit of University Hospital Split, over a 5-year period between January 2012, and December 2016. In this paper the relationship between clinical risk factors and the development of ROP was analyzed. RESULTS: The overall incidence for ROP was 23,9 % (59 infants), for Type 1 ROP was 9,3% (23 infants); for Type 2 ROP was 14,6% (36 infants). Median gestational age (GA) and birthweight (BW) were significantly lower among infants with ROP versus those without ROP (29: 23-34 vs. 31: 23-34,p<0,001 and 1,180:630-2,000 vs. 1485:590-2000, p<0,001 respectively). Multivariate analysis showed that only BW (p=0,029) and small for gestational age (SGA) (p=0,045) predicted the development of ROP. CONCLUSION: Birth weight and small for gestational age were the most significant risk factors for developing ROP. In comparison with studies from highly developed countries, infants with a much wider range of gestational age and birth weights are developing Type 1 ROP.

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Differences in Risk Factors for Retinopathy of Prematurity Development in Paired Twins: A Chinese Population Study

The Scientific World JOURNAL ◽

10.1155/2014/212183 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Gordon S. K. Yau ◽

Jacky W. Y. Lee ◽

Victor T. Y. Tam ◽

Stan Yip ◽

Edith Cheng ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Retinopathy Of Prematurity ◽

Very Low Birth Weight ◽

Significant Risk ◽

The Mean ◽

Record Review ◽

Chinese Twins ◽

Retrospective Medical Record Review

Purpose.To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins.Methods.A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.Results.In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44,P=0.02), higher mean oxygen concentration (OR = 1.34,P=0.03), presence of thrombocytopenia (OR = 1429.60,P<0.0001), and intraventricular hemorrhage (OR = 18.67,P=0.03) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45,P=0.03) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis.Conclusion.In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP.

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Persistence of Retinopathy of Prematurity in an Infant with Tetralogy of Fallot

Case Reports in Pediatrics ◽

10.1155/2016/7070316 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Murat Gunay ◽

Taner Yavuz ◽

Gokhan Celik ◽

Gunay Uludag

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Tetralogy Of Fallot ◽

Retinopathy Of Prematurity ◽

Peripheral Retina ◽

Demarcation Line ◽

Probable Reason ◽

Zone Ii ◽

Index Subject

We report an infant with tetralogy of fallot (TOF) who was born at 35 weeks of gestation and of 1700 g birth weight and presented with persistent retinopathy of prematurity (ROP) at 6 months of age. Follow-up ophthalmic examinations were done at 2, 3, and 4 weeks of age. A demarcation line in Zone II was noticed on the first ocular examination done at 4 weeks of postnatal age. At 6 months of postnatal age, the infant still had an avascular peripheral retina with the demarcation line in Zone II. Even though this index subject did not have any typical risk factors for ROP, TOF seems to be the probable reason for developing as well as persistence of avascular retina.

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Prevalence and Risk Factors For Retinopathy of Prematurity Among Infants in Minilk-II Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study, 2020.

10.21203/rs.3.rs-148640/v1 ◽

2021 ◽

Author(s):

Emebet Berhane Woldemariam ◽

Hana Endale Aliyou ◽

Yosef Tsige Redi

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Medical Records ◽

Oxygen Therapy ◽

Maternal Education ◽

Cross Sectional ◽

Childhood Blindness ◽

Zone Ii ◽

The Impact

Abstract Background: Retinopathy of prematurity (ROP) is defined as a vaso-proliferative retinal disorder that leads to childhood blindness; and persists as the main cause of preventable childhood blindness. The impact of ROP in developing countries is heavier as term infants can develop ROP because of inadequate awareness of the disease development and the risk factors. Hence, the aim of the study is assessing the prevalence and risk factors for retinopathy of prematurity in the specific study area.Methodology: An institutional based cross-sectional retrospective study was conducted on 301 samples of the pediatrics out-patient eye clinic medical records, at Minilik II referral hospital, from March to April 2020. Study subjects were selected using systematic random sampling method. Data was collected from medical records of all infants visiting the hospital for eye problems from January 2018 to December 2019, using a structured check list. The collected data was entered and cleaned using Epi data 6.4.2.0 and then exported & analyzed using SPSS version 25. Bivariate and multivariate analysis was computed to distinguish the statistically significant factors. Result: The prevalence of ROP among infants in this study showed 39(13%). Of these, more than half (56.4%) were Zone II + Stage 1, followed by Zone II + stage-2, and Stage-5; 12.8% and 10.2% respectively. Birth weight, oxygen therapy and sepsis were the factors significantly associated with ROP [AOR= 39.28; 95% CI: 3.204- 481.658], [AOR= 5.317; 95% CI:1.009- 28.019] and [AOR=9.805; 95% CI:1.592- 60.388] respectively. Conclusions: the prevalence of ROP in the current study is (13%). Birth weight, oxygen therapy and sepsis were the determinant risk factors for development of ROP. Regular ANC, and maternal education may be important to reduce the risk of low-birth weight, and sepsis that results in long-term oxygen therapy leading to childhood blindness.

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Incidence, timing and risk factors of type 1 retinopathy of prematurity in a North American cohort

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317467 ◽

2020 ◽

pp. bjophthalmol-2020-317467

Author(s):

Yinxi Yu ◽

Lauren A Tomlinson ◽

Gil Binenbaum ◽

Gui-shuang Ying

Keyword(s):

Risk Factors ◽

Premature Infants ◽

Retinopathy Of Prematurity ◽

Characteristic Curve ◽

Time Windows ◽

Secondary Analysis ◽

Prenatal Factors ◽

The Mean ◽

Type 1 Rop

Background/AimsEarly detection and timely treatment of type 1 retinopathy of prematurity (ROP) can reduce the risk of blindness. To evaluate the incidence, timing and risk factors of type 1 ROP in a large, broad-risk cohort of premature infants.MethodsSecondary analysis of data from the two Postnatal Growth and Retinopathy of Prematurity studies. Main outcomes are the incidence and timing of type 1 ROP.ResultsAmong 11 463 infants (mean birth weight (BW), 1095 g; mean gestational age (GA), 28 weeks), 677 (5.9%, 95% CI 5.5% to 6.3%) developed type 1 ROP. Rate of type 1 ROP decreased with larger GA (28.8% for GA ≤23 weeks, 0.2% for GA of 31–32 weeks) and no infants with GA >32 weeks developed type 1 ROP. Type 1 ROP was first diagnosed at a median postmenstrual age (PMA) of 36 weeks (range 30–46 weeks) or postnatal age (PNA) of 11 weeks (range 5–21 weeks). The mean PMA at diagnosis of type 1 ROP increased with GA (35 weeks for GA of 22–24 weeks, 41 weeks for GA of 29–30 weeks), but the mean PNA at diagnosis of type 1 ROP was similar (11–13 weeks) across GA of 22–29 weeks. GA and BW dominate the association (area under the receiver operating characteristic curve=0.87, 95% CI 0.86 to 0.88).ConclusionsType 1 ROP developed in about 6% of premature infants over wide time windows in terms of both PMA and PNA. BW and GA are the dominant risk factors for type 1 ROP, while other prenatal factors add minimal predictive power for type 1 ROP.

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Functional and Structural Outcomes of Temporal Zone II-Sparing Laser Photocoagulation Combined with Intravitreal Bevacizumab in Retinopathy of Prematurity

Journal of Ophthalmology ◽

10.1155/2018/2376240 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Eoi Jong Seo ◽

Joo Yong Lee

Keyword(s):

Treatment Group ◽

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Combined Treatment ◽

Intravitreal Bevacizumab ◽

Late Complications ◽

Refractive Errors ◽

Retinal Vessels ◽

Zone Ii

Background/Aim. The aim of the study was to investigate the outcomes of temporal Zone II-sparing laser photocoagulation combined with intravitreal bevacizumab (IVB) in patients with Type 1 retinopathy of prematurity (ROP) in Zone I.Methods. Medical records of 74 eyes of 37 infants were analysed. Only infants with Type 1 ROP in Zone I were included. Thirty-two eyes were treated with temporal-sparing laser + IVB. Both Zone I and temporal Zone II were spared to minimise potential visual field loss. Forty-two eyes were treated with laser alone conventionally. Early treatment outcomes, late complications, and refractive errors were analysed.Results. The mean gestational age and birth weight of the enrolled patients were 25.7 ± 2.5 weeks and 798.8 ± 440.2 g, respectively. In the combined treatment group, plus sign regression was achieved faster (12.1 ± 6.2 days vs. 25.6 ± 21.3 days,p=0.011) and retreatment was required less (0% vs. 23.8%,p=0.004) than in the laser-alone group. Retinal/preretinal haemorrhages occurred more often in the laser-alone group (42.9% vs. 9.4%,p=0.002). Normal development of temporal retinal vessels was also observed in twelve eyes in the combined treatment group. No differences in late complications or refractive errors were observed between the groups.Conclusion. Temporal Zone II-sparing laser treatment combined with IVB showed good early treatment outcome and temporal retinal vessels development.

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Strukturelle, visuelle und refraktive Verläufe der intravitrealen Injektion von Aflibercept bei Hochrisiko-Frühgeborenen-Prethreshold-Retinopathie vom Typ 1

Karger Kompass Ophthalmologie ◽

10.1159/000438802 ◽

2015 ◽

Vol 1 (2) ◽

pp. 84-86

Keyword(s):

High Risk ◽

Retinopathy Of Prematurity ◽

Intravitreale Injektion ◽

Multizentrische Studie ◽

Refractive Outcomes ◽

Intravitreal Aflibercept ◽

Zone Ii

Zielsetzung: Untersuchung der strukturellen, visuellen und refraktiven Ergebnisse der intravitrealen Injektion von Aflibercept in Monotherapie bei Patienten mit Frühgeborenenretinopathie (retinopathy of prematurity; ROP) vom Typ 1 mit hohem Risiko und unterhalb der Therapieschwelle. Aufbau: Prospektive, nichtrandomisierte, interventionelle Fallserien-Studie. Patienten und Methoden: Patienten mit Hochrisiko-Prethreshold-Typ-1-ROP wurden mit 1 mg/0,025 ml Aflibercept intravitreal behandelt. Die betrachteten primären Endpunkte waren ein ungünstiger struktureller Verlauf, ungünstiger visueller Verlauf und ungünstiger refraktiver Verlauf. Die sekundären Endpunkte waren ausbleibende Rezidivierung, okulare und systemische Nebenwirkungen. Ergebnisse: In die Studie wurden 26 Augen aufgenommen; alle hatten eine Nachbeobachtung von 1 Jahr abgeschlossen. Das mittlere Geburtsgewicht betrug 991 ± 266 g (Bereich 875-1105 g); das mittlere Gestationsalter bei Entbindung betrug 26,33 ± 2,1 Wochen (Bereich 24-30 Wochen); bei 9 Augen wurde die ROP als Stadium 2+, Zone I eingestuft, bei 14 Augen lag Stadium 3+ in Zone II vor und bei 3 Augen Stadium 3 in Zone I. 25 Augen (96,2%) zeigten einen günstigen strukturellen und 21 (80,1%) einen günstigen visuellen Verlauf; die Fehlsichtigkeit lag nach 1 Jahr im Median bei 0,75 dpt (Bereich -9,5 bis +4). Schlussfolgerungen: Die intravitreale Injektion von Aflibercept als Monotherapie ist eine einfache, sichere und wirksame Therapieoption bei Hochrisiko-Prethreshold-ROP vom Typ 1. Eine weitere, multizentrische Studie mit längerem Nachbeobachtungszeitraum ist erforderlich. Übersetzung aus Salman AG, Said AM: Structural, visual and refractive outcomes of intravitreal aflibercept injection in high-risk prethreshold type 1 retinopathy of prematurity. Ophthalmic Res 2015;53:15-20 (DOI: 10.1159/000364809)

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Transscleral vs transpupillary diode laser photocoagulation for the treatment of zone II type 1 retinopathy of prematurity: Anatomical and refractive outcomes

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_1125_21 ◽

2022 ◽

Vol 70 (1) ◽

pp. 189

Author(s):

Nazanin Ebrahimiadib ◽

Ramak Roohipourmoallai ◽

Shahin Faghihi ◽

Hooshang Faghihi ◽

Ali Torkashvand ◽

...

Keyword(s):

Diode Laser ◽

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Refractive Outcomes ◽

Zone Ii

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Recurrence of Retinopathy of Prematurity in Zone II Stage 3+ after Ranibizumab Treatment: A Retrospective Study

Journal of Ophthalmology ◽

10.1155/2017/5078565 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Qinrui Hu ◽

Yujing Bai ◽

Xiaoli Chen ◽

Lvzhen Huang ◽

Yi Chen ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Retrospective Study ◽

Intravitreal Injection ◽

Retinopathy Of Prematurity ◽

Initial Treatment ◽

Univariate Analysis ◽

Outcome Data ◽

Zone Ii ◽

Ranibizumab Treatment

Objective. To determine the prevalence and risk factors for the recurrence of retinopathy of prematurity (ROP) in Zone II Stage 3+ after ranibizumab treatment.Methods. This was a retrospective, nonrandomized, noncontrolled study that excluded Zone I and aggressive posterior ROP (APROP) cases. Infants who developed Zone II Stage 3 ROP with plus disease and underwent initial intravitreal injection of ranibizumab (IVR) were recruited. Patients were divided into 2 groups based on the outcome after initial ranibizumab treatment: recurrence of ROP or favorable outcome. Data was collected and analyzed by SPSS 16.0.Results. Forty-two patients were included, and 80 eyes with Zone II Stage 3+ were subjected to IVR treatment. Eleven of 42 patients (26.2%, 18 eyes) had a recurrence of ROP after the initial treatment. On univariate analysis, preretinal hemorrhage before treatment was significantly different between the two groups (P=0.000). Multivariate analysis found that preretinal hemorrhage before treatment was the only factor associated with the recurrence of ROP in our study (P=0.004).Conclusions. The recurrence rate of ROP in Zone II Stage 3+ after initial ranibizumab treatment was notable and preretinal hemorrhage before treatment was associated with the recurrence of ROP in our study.

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Prevalence and Risk Factors of Retinopathy of Prematurity (ROP): A Cross-Sectional Study

Ophthalmology Research An International Journal ◽

10.9734/or/2021/v15i330212 ◽

2021 ◽

pp. 1-6

Author(s):

Kishan A. Makvana ◽

Apurva H. Suthar

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Delayed Diagnosis ◽

Developed Countries ◽

Preterm Neonates ◽

Cross Sectional ◽

The Mean

Background and Aim: Despite considerable progress made in the treatment of Retinopathy of prematurity (ROP), it is still a common cause of reduced vision in children in developed countries, and its prevalence is increasing. This is a preventable disease and responds to treatments appropriately if diagnosed at early stages, but in case of delayed diagnosis and treatment, it may lead to blindness. The aim of the present study is to describe the incidence, severity, and risk factors of ROP in a tertiary healthcare center. Material and Methods: This was a prospective, observational, nonrandomized study conducted in a tertiary-level neonatal intensive care unit (NICU) of a teaching hospital in Gujarat. A total of 130 preterm neonates admitted in the NICU during the study period were screened for ROP as per the guidelines of NNF of India. Screening was done under topical anesthesia, and findings were documented according to the International Classification for Retinopathy of Prematurity recommendations. The data were analyzed for gestational age, birth weight, and systemic factors predisposing to ROP. Results: Of the 130 neonates, 37 neonates were found to have ROP, with the incidence of ROP being 28.4%. The mean birth weight (1388 ± 312 g) and the mean gestational age (32.21 ± 2.50 wk) Out of the 37 neonates with ROP, 14 had a gestational age of > 32 weeks and/or birth weight of > 1500 g. ROP was classified into type 1 and type 2 as per the ETROP study, 14 (39.39%) neonates had type 1 or treatable ROP; there were no cases of APROP in our study; ROP regressed without any intervention in 13 neonates; 7 neonates were defaulters; and 11 neonates were treated with laser. Conclusion: ROP is strongly associated with smaller, more immature, and sicker neonates. However, in our study, about 40% of neonates who developed ROP were of higher gestation (> 32 wk) and birth weight (> 1500 g). The analysis of risk factors for ROP development will help to understand and predict it in severe preterm infants.

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