Incidence of Retinopathy of Prematurity in Extremely Premature Infants

Purpose. To investigate the incidence and the severity of retinopathy of prematurity (ROP) in extremely preterm infants born before 28 weeks of gestation in southeastern Turkey. Methods. A retrospective chart review was performed for infants born before 28 weeks of gestation. The following data were reviewed: gender, gestational age (GA), birth weight (BW), zone and stage of ROP, presence of plus disease, and treatment for ROP if needed. Infants were divided into 2 groups according to GA as follows: group 1 included infants of GAs 25 weeks and under; group 2 included infants of GAs less than 28 weeks and over 25 weeks. Results. The incidence of any ROP in the whole cohort, in group 1, and in group 2, was 66.0%, 95.5%, and 58.6%, respectively. Incidence of any ROP was significantly associated with BW and GA (P=0.014 and P=0.002, resp.). The overall incidence of type 1 ROP was 35.8% (59.1% in group 1 and 29.9% in group 2). Development of type 1 ROP was independently associated with GA. Conclusion. Any ROP was significantly associated with BW and GA. Extremely premature infants with lower GA were found to be more likely to develop type 1 ROP. BW cannot predict the development of type 1 ROP.

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Refractive Error in Patients with Retinopathy of Prematurity after Laser Photocoagulation or Bevacizumab Monotherapy

Ophthalmologica ◽

10.1159/000439182 ◽

2015 ◽

Vol 234 (4) ◽

pp. 211-217 ◽

Cited By ~ 14

Author(s):

Hsi-Kung Kuo ◽

I-Ting Sun ◽

Mei-Yung Chung ◽

Yi-Hao Chen

Keyword(s):

Refractive Error ◽

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Group 4 ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Type 1 Rop ◽

Group 1

Purpose: To evaluate the refractive development of premature infants with retinopathy of prematurity (ROP) after treatment with laser photocoagulation or intravitreal injection of bevacizumab (IVB). Methods: The medical records of patients with ROP treated between 2003 and 2012 who underwent yearly follow-ups were retrospectively reviewed. Patients with residual ROP abnormalities were excluded. The cycloplegic refraction at 3 years of age, assessed using an autorefractometer, was recorded. Results: In total, 54 eyes from 54 patients were enrolled. Patients were divided into 4 groups: group 1, including 14 eyes of 14 patients treated with laser therapy; group 2, 15 eyes of 15 patients treated with IVB; group 3, 13 eyes of 13 patients with non-type 1 ROP under conservative follow-up, and group 4, 12 eyes of 12 premature patients without ROP. The mean spherical equivalent at 3 years of age was -1.71 ± 1.27 dpt in group 1, -1.53 ± 2.20 dpt in group 2, 0.63 ± 1.37 dpt in group 3, and 0.41 ± 1.95 dpt in group 4. The mean refractive error differed significantly among the 4 groups (p < 0.001). Patients in groups 1 and 2 were more prone to myopia compared with those in groups 3 and 4. Furthermore, patients with type 1 ROP treated by laser photocoagulation (group 1) and those treated by IVB (group 2) had similar refraction (p = 1). Conclusions: The results of this study suggest that treatment-demanding ROP eyes are susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP. In addition, the myopic status between laser and IVB treatment did not differ statistically.

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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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Drug-induced mydriasis in infants born at different gestation terms

Ophthalmology journal ◽

10.17816/ov11485-92 ◽

2018 ◽

Vol 11 (4) ◽

pp. 85-92

Author(s):

Elvira I. Saidasheva ◽

Svetlana V. Biyanovskaya ◽

Fedor V. Kovshov ◽

Marina S. Petrachkova ◽

Olga S. Dolgova ◽

...

Keyword(s):

Side Effects ◽

Retinopathy Of Prematurity ◽

Full Term ◽

Eye Drops ◽

Drug Induced ◽

Term Infants ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Term Newborns ◽

Group 2

Background. At the present time, the problem of choice of eye drops to achieve adequate mydriasis with minimal side effects for retinopathy of prematurity screening remains an urgent challenge. Purpose. To estimate the clinical efficacy of combination mydriatic eye drops Fenicamide in infants born at different gestation terms. Materials and methods. Under observation, there were 75 newborns (150 eyes) and babies aged from 1 day to 3 months (average, 38.2 ± 32.2 days). Patients were distributed into 3 groups depending on gestational age: group 1 consisted of 25 full-term infants; group 2 – of 25 premature babies, and group 3 – of 25 extremely preterm infants. To achieve mydriasis, 1 drop of combination eye drops (5% phenylephrine and 0.8% tropicamide) was instilled. Dynamics of pupil diameter change in each group of patients was registered within 4 hours, and side effects were recorded within 24 hours. The quality of fundus visualization was estimated using a pediatric retinal camera RetCam 3. Results. Maximal pupil dilation (average, 6.5 ± 0.5 mm) was reached to 60 ± 14 min after instillation on average; pupil remained dilated within 1 hour, its diameter became normal in 4 hours. Mydriasis varied from 5.9 mm in extremely premature infants to 7 mm in the full-term newborns (p > 0.05), and allowed a full and high quality examination of the fundus in all patients, including the visualization of peripheral zones of the retina for retinopathy of prematurity screening. It was established that drug side effects were absent in 76% (57) of infants, they were present in 24% (18) of infants, mostly as local reaction. Conclusion. Fenicamide eye drops are an effective mydriatic medication, with a convenient instillation regimen, have minimal side effects, and can be recommended for retinopathy of prematurity screening and monitoring.

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Validity and reliability of ROPScore scoring method to predict the severity of retinopathy of prematurity in premature infants

10.22541/au.161515047.77230490/v1 ◽

2021 ◽

Author(s):

Samet Gulkas ◽

Yasin Ozcan ◽

Huseyin GUMUS

Keyword(s):

Birth Weight ◽

Premature Infants ◽

Retinopathy Of Prematurity ◽

Scoring System ◽

Very Low Birth Weight ◽

Validity And Reliability ◽

Predictive Values ◽

Scoring Model ◽

Type 1 Rop

Abstract Purpose: To assess the accuracy and efficacy of ROPScore scoring system an ancillary method to predict the severity of retinopathy of prematurity (ROP) in very low birth weight (VLBW) premature infants. Methods: The medical records of 131 premature babies having a birth weight  1500 gram and gestational age (GA) ≤ 30 weeks were included in this study. The ROPScore was calculated for each baby at six weeks of life using an Excel spreadsheet (Microsoft®). Area under curve (AUC) analysis was used in both any stage of ROP and type-1 (severe) ROP to ascertain the cut-off points for the scoring model. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of the scoring system with the calibrated cut-off points were analyzed. Results: The sensitivity of the ROPScore scoring system was 88.5% ( 95% CI 79-94) and 100% (95% CI 82-100) was for predicting any stage and type-1 retinopathy of prematurity, respectively. The PPV and NPV of the models were 62% and 74.1% for any stage of ROP and those of were 50% and 100% for type-1 ROP, respectively. In ROC analysis, the mean AUCs of ROPScore model was statistically significant compared than BW and GA for predicting type -1 ROP (p < 0.001). Conclusion: This study indicated that ROPScore scoring model with customized cutoff levels might be a useful method for early prediction of premature retinopathy, particularly in type-1 (severe) ROP. In addition, this model may also reduce the number of eye examinations which are essential for detecting the retinopathy of prematurity

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Preferences and Trends in Practices Caring Premature Infants for Retinopathy of Prematurity (ROP): A Web-based Survey

Current Trends in Ophthalmology ◽

10.18314/ctoy.v1i1.1247 ◽

2018 ◽

Vol 1 (1) ◽

pp. 49-61

Author(s):

Swati Agarwal-Sinha ◽

Sarina Amin ◽

Amanda Way

Keyword(s):

Premature Infants ◽

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Practice Patterns ◽

Treatment Preferences ◽

Web Survey ◽

Web Based ◽

Type 1 Rop

Objectives: To study preferences in treatment, follow-up and conclusion of examination in infants treated with and without bevacizumab (IVB) and/or laser photocoagulation for retinopathy of prematurity (ROP).Methods: A 22 question web survey was administered to physicians to understand practice patterns for treatment of type1 ROP, determine timeframe of conclusion of examinations with and without IVB/laser, and to approximate incidence of ROP recurrence post-treatment.Results: The survey revealed that 73% pediatric ophthalmologists reported not personally performing injections and 54.1% reported not performing laser. In infants with persistent avascular retina without pre-threshold disease, 54.2% continued examination > 50 weeks PMA, 23.3% discontinued at 50 weeks PMA, 3.2% preferred prophylactic laser and 5.1% fluorescein angiography and laser prior to concluding exams. 46.3% of physicians preferred IVB as primary monotherapy, 37.3% laser, and 16.4% both IVB and laser in type 1 ROP. Of those who preferred IVB, 20.4% concluded examination at ? 55 weeks PMA, whereas 79.6% continued evaluation >55 weeks PMA (60 to ? 80 weeks). Of those who preferred both IVB and laser, 50.6% concluded examination at ? 50 weeks PMA, whereas 49.4% continued > 50 weeks (60 to ? 80 weeks). 21.1 % of respondents reported recurrence with IVB and 8.8% with dual therapyConclusions: Treatment preferences and conclusion of examination in ROP varies considerably without and with treatment. Though a longer follow-up is recommended with IVB, this survey reveals extended examinations beyond 50 weeks PMA in infants with persistent avascular retina requiring no treatment and in the laser treated subgroup. The survey highlights low rates of performing treatments personally by pediatric ophthalmologists, and distinctlyvariable practice patterns in ROP care

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Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316401 ◽

2020 ◽

pp. bjophthalmol-2020-316401

Author(s):

Qian Yang ◽

Xiaohong Zhou ◽

Yingqin Ni ◽

Haidong Shan ◽

Wenjing Shi ◽

...

Keyword(s):

Cohort Study ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Predictive Performance ◽

Screening Guideline ◽

Postmenstrual Age ◽

The Mean ◽

Type 1 Rop ◽

Rop Screening

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.ResultsOf the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.ConclusionsThe incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

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Percutaneous posteroanterior screw fixation for Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture: Operative technique and randomized clinical results

Journal of Orthopaedic Surgery ◽

10.1177/2309499021997996 ◽

2021 ◽

Vol 29 (1) ◽

pp. 230949902199799

Author(s):

Tianming Yu ◽

Jichong Ying ◽

Jianlei Liu ◽

Dichao Huang ◽

Hailin Yan ◽

...

Keyword(s):

Screw Fixation ◽

Malleolar Fracture ◽

Malleolar Fractures ◽

Posterior Malleolar Fracture ◽

Post Traumatic ◽

Group 2 ◽

Traumatic Arthritis ◽

Group 1

Purpose: The study described a novel surgical treatment of Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture and patient outcomes at intermediate period follow-up. Methods: All patients from January 2015 to December 2017 with tri-malleolar fracture of which posterior malleolar fractures were Haraguchi type 1, were surgically treated in this prospective study. Lateral and medial malleolar fractures were managed by open reduction and internal fixation through dual incision approaches. 36 cases of Haraguchi type 1 posterior malleolar fractures were randomly performed by percutaneous posteroanterior screw fixation with the aid of medial exposure (group 1). And 40 cases were performed by percutaneous anteroposterior screw fixation (group 2). Clinical outcomes, radiographic outcomes and patient-reported outcomes were recorded. Results: Seventy-six patients with mean follow-up of 30 months were included. There were no significant differences in the mean operation time (81.0 ± 11.3 vs. 77.2 ± 12.4), ankle function at different periods of follow-up, range of motions and visual analog scale (VAS) at 24 months between the two groups ( p > 0.05). However, the rate of severe post-traumatic arthritis (Grade 2 and 3) and the rate of step-off rather than gap in radiological evaluation were lower in group 1 than that in group 2 ( p < 0.05). Conclusion: Using our surgical technique, more patients had good outcome with a lower rate of severe post-traumatic arthritis, compared with the group of percutaneous anteroposterior screw fixation. Percutaneous posteroanterior screw fixation can be a convenient and reliable alternative in treating Haraguchi type 1 posterior malleolar fracture.

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Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

Medicina ◽

10.3390/medicina57050420 ◽

2021 ◽

Vol 57 (5) ◽

pp. 420

Author(s):

Claudia Ioana Borțea ◽

Florina Stoica ◽

Marioara Boia ◽

Emil Radu Iacob ◽

Mihai Dinu ◽

...

Keyword(s):

Risk Factors ◽

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Univariate Analysis ◽

Significant Risk ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Surfactant Administration ◽

Stage 1

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

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