scholarly journals Oxygen care and treatment of retinopathy of prematurity in ocular and neurological prognosis

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Hyun Goo Kang ◽  
Eun Young Choi ◽  
Hyuna Cho ◽  
Min Kim ◽  
Christopher Seungkyu Lee ◽  
...  

AbstractThis retrospective cohort study aimed to investigate the effects of neonatal oxygen care and retinopathy of prematurity (ROP) treatment on ROP-related ocular and neurological prognoses. We included premature infants treated for ROP at a tertiary referral center between January 2006 and December 2019. Demographic and clinical data were collected from electronic medical records. Odds ratios (ORs) of oxygen care- and ROP treatment-related factors were calculated for ocular and neurological comorbidities 3 years after ROP treatment, after adjusting for potential confounders. ROP requiring treatment was detected in 171 eyes (88 infants). Laser treatment for ROP (OR = 4.73, 95% confidence interval [CI] 1.64–13.63) and duration of invasive ventilation (OR = 1.02, 95% CI 1.00–1.03) were associated with an increase in ocular comorbidities, along with a history of neonatal seizure (OR = 28.29, 95% CI 5.80–137.95) and chorioamnionitis (OR = 32.13, 95% CI 5.47–188.74). No oxygen care- or ROP treatment-related factors showed significant odds for neurological comorbidities. Shorter duration of invasive oxygen supply during neonatal care (less than 49 days) and anti-vascular endothelial growth factor injection as the primary treatment for ROP are less likely to cause ocular comorbidities. No association was identified between ROP treatment modalities and the risk of neurological comorbidities.

Ophthalmology ◽  
2017 ◽  
Vol 124 (5) ◽  
pp. 619-633 ◽  
Author(s):  
Deborah K. VanderVeen ◽  
Michele Melia ◽  
Michael B. Yang ◽  
Amy K. Hutchinson ◽  
Lorri B. Wilson ◽  
...  

2020 ◽  
Vol 20 (4) ◽  
pp. 216-220
Author(s):  
O.V. Zhukova ◽  
◽  
I.A. Mal’tseva ◽  
A.V. Zolotarev ◽  
◽  
...  

The article addresses current treatment modalities for threshold retinopathy of prematurity (ROP) and aggressive posterior retinopathy of prematurity (APROP), in particular, intravitreal administration of vascular endothelial growth factor (VEGF) inhibitors. The results of multicenter clinical trials evaluating pegaptanib, bevacizumab, and ranibizumab are discussed. The clinical effect of intravitreal anti-VEGF drugs was compared to the efficacy of laser retinal photocoagulation. In children with ROP, anti-VEGF drugs are equal or even superior to the conventional laser retinal photocoagulation in terms of clinical efficacy. No negative effects of anti-VEGF drugs on ocular tissues or vasculature development in premature children were demonstrated. Moreover, several studies show the potential efficacy of intravitreal anti-VEGF drugs plus avascular zone photocoagulation for APROP. Finally, our experience with intravitreal ranibizumab for threshold ROP and plus disease in a patient who was followed-up for subsequent 9 years is described.Keywords: retinopathy of prematurity, plus disease, aggressive posterior retinopathy of prematurity, anti-VEGF drugs, ranibizumab.For citation: Zhukova O.V., Mal’tseva I.A., Zolotarev A.V. Vascular endothelial growth factor inhibitors for retinopathy of prematurity. Russian Journal of Clinical Ophthalmology. 2020;20(4):216–220. DOI: 10.32364/2311-7729-2020-20-4-216-220.


2020 ◽  
pp. bjophthalmol-2020-317284
Author(s):  
Yung-Sung Lee ◽  
Wee-Min Teh ◽  
Hsiao-Jung Tseng ◽  
Yih-Shiou Hwang ◽  
Chi-Chun Lai ◽  
...  

AimsTo determine longitudinal differences in foveal thickness in preschool-aged patients with or without a history of type I retinopathy of prematurity (ROP).MethodsA study of 201 eyes, including 32 laser±intravitreal bevacizumab (IVB)-treated eyes, 37 IVB-treated eyes, 14 spontaneously regressed ROP eyes, and 118 age-matched controls were enrolled in this study. The retinal thicknesses (full, inner and outer) were measured in the foveal area at 6-month intervals four consecutive times by optical coherence tomography.ResultsThe foveal thicknesses among the four groups were similar at all four visits (all p>0.05) after gestational age (GA) adjustment and remained similar with no differences after the full retinal thickness was divided into inner and outer thicknesses (all p>0.05). The full and outer foveal thicknesses of premature children increased over time (0.17 μm/month and 0.17 μm/month; p=0.0001 and 0.0003, respectively), but the inner foveal thickness remained unchanged with time (0.002 μm/month; p=0.09). Moreover, the positive correlation with best-corrected visual acuity was stronger for outer foveal thickness than for inner foveal thickness (γ=0.281, p<0.0001 and γ=0.181, p<0.0001, respectively).ConclusionThe thickness of fovea in laser±IVB-treated, IVB-treated, regressed ROP and preterm eyes showed no difference after GA adjustment. The whole and outer foveal thicknesses increased with time in preschool-aged children over a 1.5-year follow-up period, but the inner foveal thickness remained unchanged with time.


2021 ◽  
Author(s):  
Hande Celiker ◽  
Ozlem Sahin

Abstract Purpose: To report the effects of anti-vascular endothelial growth factor (VEGF) treatment in vascular development for cases of acute retinopathy of prematurity (ROP) using fluorescent angiography (FA) and to present the results of our observational approach to retinal sequelae.Methods: A total of 31 eyes in 19 patients with a history of treatment with anti-VEGF agents for classic type 1 ROP and aggressive posterior ROP who underwent FA between March 2014 to February 2020 were reviewed. Angiograms of retinal developmental features of patients aged 4 months to 6 years were examined. Results: The patients mean gestational age were 26.06±1.90 weeks and the mean birth weight were 837.68±236.79g. All cases showed various abnormalities at the vascular and avascular retina, and the posterior pole. All but one case showed a peripheral avascular area on FA evaluation during the follow-up period. We did not apply prophylactic laser treatment to these avascular retina. On the final examination, except one case, we did not observe any late reactivation in any patients. Conclusion: FA is an important tool for assessing vascular maturation in infants. Every leakage should not be assumed to be evidence of late activation, as some leaks may be related to vascular immaturity. Retinal vascularization may not be completed in all patients, however this does not mean that all these patients need prophylactic laser application. Our observational approach may be more daring than the reports frequently encountered in the literature, but it should be noted that unnecessary laser treatment will also eliminate all the advantages of anti-VEGF treatment.


2021 ◽  
Author(s):  
Jeany Q. Li ◽  
Ulrich Kellner ◽  
Birgit Lorenz ◽  
Andreas Stahl ◽  
Tim U. Krohne

Zusammenfassung Hintergrund Durch Verbesserungen in der neonatologischen Versorgung von Frühgeborenen und die Entwicklung neuer Behandlungsmöglichkeiten der Frühgeborenenretinopathie („retinopathy of prematurity“ [ROP]) haben sich die Anforderungen an das ROP-Screening seit der Veröffentlichung der letzten Fassung der deutschen Leitlinie zum ROP-Screening im Jahr 2008 verändert. Auf Grundlage aktueller Studiendaten wurde die Leitlinie in 2020 grundlegend überarbeitet und in einer aktualisierten Fassung veröffentlicht. Ziel Dieser Artikel fasst die wichtigsten Änderungen in der neuen Leitlinie zusammen. Ergebnisse Die Altersgrenze für einen Screeningeinschluss wurde für Kinder ohne zusätzliche Risikofaktoren auf ein Gestationsalter von unter 31 Wochen gesenkt. Die Mindestdauer für eine Sauerstoffsupplementation, die einen Einschluss in das Screening bei Frühgeborenen erforderlich macht, wurde auf über 5 Tage angehoben. Eine Behandlung bei ROP in Zone II kann nun schon bei jedem Stadium 3 mit Plus-Symptomatik unabhängig von der Anzahl der betroffenen Uhrzeiten erfolgen. Für die Nachkontrollen nach Anti-VEGF („vascular endothelial growth factor“)-Therapie wurden Kriterien zur Frequenz und Dauer definiert. Das verbindliche Dokument für diese und weitere neue Empfehlungen ist die Leitlinie selber. Schlussfolgerungen Die Empfehlungen der Leitlinie ermöglichen eine zuverlässige Identifikation von Kindern mit ROP-Risiko für den Einschluss in das Screening und eine rechtzeitige Erkennung fortgeschrittener Krankheitsstadien für die Therapieeinleitung, um so Erblindung durch ROP zu verhindern.


Retina ◽  
2017 ◽  
Vol 37 (4) ◽  
pp. 694-701 ◽  
Author(s):  
Wei-Chi Wu ◽  
Chia-Pang Shih ◽  
Reyin Lien ◽  
Nan-Kai Wang ◽  
Yen-Po Chen ◽  
...  

Author(s):  
Khalid Najm Nadheer ◽  
Zohreh Zahraei ◽  
Hussein Al-Hakeim

Preeclampsia (PE) is characterized by a series of clinical features such as hypertension and proteinuria associated with endothelial dysfunction and the impairment of placenta vascular endothelial integrity. This study aimed to investigate the effect of serum copper (Cu) level on some angiogenesis-related factors including vascular endothelial growth factor-A (VEGF-A), soluble Fms-like tyrosine kinase-1 (sVEGF-R1), soluble endoglin (sEng) and cerruloplasmin (Cp) in Iraqi women with preeclampsia (PE) and control pregnant women. Therefore, 60 women with PE in addition to 30 healthy pregnant women were enrolled in the study. Serum concentration of sEng, VEGF-A, sVEGF-R1, and Cu in PE group significantly increased (p&lt;0.05) in the PE group compared with that in the control group. Increased production of antiangiogenic factors, soluble VEGF-A and sEng contribute to the pathophysiology of PE, indicating the involvement of these parameters in the angiogenic balance in patients with PE. Tests for between-subject effects showed that the circulating angiogenesis factors and Cu were significantly associated with the presence of PE. Serum Cu level was significantly correlated with VEGF- A and VEGF-R1 levels but not with sEng. Multiple regression analysis revealed that only Cp and BP can significantly predict the complications in women with PE. In conclusion, serum Cu has a role in the angiogenesis in women with PE and may be a new drug target in the prevention or treatment of PE.


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