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

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.

Download Full-text

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.

Download Full-text

Intravitreal Bevacizumab to Treat Retinopathy of Prematurity in 865 Eyes: a Study to Determine Predictors of Primary Treatment Failure and Recurrence

10.21203/rs.3.rs-876613/v1 ◽

2021 ◽

Author(s):

Kaveh Fadakar ◽

Mohammadreza Mehrabi Bahar ◽

Hamid Riazi-Esfahani ◽

Afsaneh Azarkish ◽

Afsar Dastjani Farahani ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Treatment Failure ◽

Retinopathy Of Prematurity ◽

Intravitreal Bevacizumab ◽

Primary Treatment ◽

Anti Vegf ◽

History Of ◽

Mean Time

Abstract Purpose: This study aimed To evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).Methods: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal Bevacizumab from 2012 to 2019. Medical records of patients were evaluated.Results: Mean gestational age (GA) and birth weight of patients were 28±2 weeks and 1121±312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64±13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97 %) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). Presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factor predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.Conclusion: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Attention to risk factors accompanied by special care to patterns of treatment failure and recurrence helps to achieve early detection of treatment failure and vigilant follow up for recurrence.

Download Full-text

Retinopathy of prematurity in preterm babies in a local medical college and hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20201343 ◽

2020 ◽

Vol 8 (4) ◽

pp. 1463

Author(s):

Shantisena Mishra ◽

Anjali Saji ◽

Saiprasanna Behera ◽

Sridhar Mohanty

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Mode Of Delivery ◽

Multiple Gestation ◽

Maternal Risk ◽

Preterm Babies

Background: Retinopathy of prematurity is a multifactorial vasoproliferative retinal disease that increases in incidence with decreasing gestational age and is one of the leading causes of preventable childhood blindness in India. Advances in neonatology have led to dramatic increase in survival of preterm neonates and in turn, to the risk of developing ROP. Since most of the risk factors associated with ROP mentioned above arise in the neonatal intensive care unit (NICU) itself and most of them are avoidable, cautious monitoring of the risk factors, early screening, follow up and surgical intervention have been shown to reduce the incidence and improve the outcome of ROP.Methods: This was a prospective observational study conducted for a period of 2 years. A total of 151 infants admitted in NICU /SNCU who satisfied the inclusion criteria were enrolled in this study. Initial and follow up screening was conducted in three phases the results were documented in proforma after ethical clearance.Results: Comparison of risk factors between eyes with and without ROP was done using Chi-square test. A p-value of<0.05 was considered to be statistically significant. Incidence of ROP in centre is found to be 33.8%. Among maternal risk factors, multiple gestation and PROM/PPROM is found to be significant in the development of ROP from this study. However, mode of delivery and gestational hypertension, were found to be not significant in ROP. Among neonatal risk factors, low birth weight, lower gestational age, prolonged oxygen exposure, blood transfusion, mechanical ventilation, sepsis, phototherapy was found to be significant in this study.Conclusions: ROP, being an emerging cause for potentially blinding visual disability, needs to be diagnosed early. Due to the advancements in neonatology and better survival of preterm babies, timely screening, regular follow up, early detection and intervention is mandatory. A multidisciplinary approach is required in diagnosis and treatment of the disease. Proper counselling and motivation for parents of preterm and low birth weight babies for regular follow up is also essential.

Download Full-text

Efficacy of intravitreal conbercept injection in the treatment of retinopathy of prematurity

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311662 ◽

2018 ◽

Vol 103 (4) ◽

pp. 494-498 ◽

Cited By ~ 4

Author(s):

Yichen Bai ◽

Huanjie Nie ◽

Shiyu Wei ◽

Xiaohe Lu ◽

Xiaoyun Ke ◽

...

Keyword(s):

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Primary Outcome ◽

Safety And Efficacy ◽

Postmenstrual Age ◽

Zone Ii ◽

The Mean ◽

Secondary Outcomes ◽

Number Of Injections

BackgroundTo evaluate the safety and efficacy of intravitreal conbercept (IVC) injection in the treatment of retinopathy of prematurity (ROP).MethodsPatients with ROP who underwent IVC injection in Zhujiang Hospital from June 2015 to July 2016 were studied retrospectively. The primary outcome was defined as the regression of plus disease. The secondary outcomes were defined as the presence of recurrence, number of injections and the final regression of disease.ResultsA total of 48 eyes of 24 patients with ROP were included. Among them, 9 eyes of 5 patients had zone I ROP, 35 eyes of 18 patients had zone II ROP and 4 eyes of 2 patients had aggressive posterior ROP. The mean gestational age was 28.5±1.6 weeks, the mean birth weight was 1209.6±228.6 g, the mean postmenstrual age of first injection was 34.2±1.9 weeks and the mean follow-up period was 31.0±4.7 weeks. Forty of 48 eyes (83.3%) received IVC only once, and the regression of plus disease occurred at an average of 3.5±1.5 weeks after the first injection of conbercept. For eight recurrent eyes (16.7%), four eyes received a second IVC and the remaining four eyes received laser photocoagulation, and the regression of plus disease occurred in 3 weeks. No lens opacity, vitreous haemorrhage, entophthalmia or retinal detachment was observed during follow-up.ConclusionIVC injection is an effective treatment for ROP.

Download Full-text

A study of risk factors and their correlation with severity of retinopathy of prematurity: a prospective study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204039 ◽

2020 ◽

Vol 7 (10) ◽

pp. 1984

Author(s):

Bhuvaneshwari C. Yelameli ◽

Ramesh V. Neelannavar ◽

Kiruthika Das

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Survival Rates ◽

Wide Field ◽

Maternal Risk ◽

Medical College ◽

Stage 4 ◽

A Prospective Study

Background: Recent advances in neonatal care in the last decade and improved survival rates have resulted in an apparent increase in the incidence of retinopathy of prematurity (ROP), which is the most important cause of preventable blindness in infants. This study was done to identify the risk factors which predispose to ROP and to assess its correlation with severity of ROP.Methods: A total of 140 neonates with gestational age ≤34 weeks, birth weight ≤2000 grams who were admitted at NICU, S. N. Medical College and HSK Hospital, Bagalkot from December 2018 to May 2019 were considered. Babies were assessed and recorded for the risk factors of ROP in a predesigned proforma. ROP screening was performed using wide-field digital imaging on a retcam shuttle (Clarity MSI, USA).Results: A total of 140 babies were examined, and an overall incidence of ROP was 52 (37.1%). 17 (32.7%) had stage 3, 3 (5.8%) had stage 4, and 1 (1.9%) had stage 5. Among the 52 babies with ROP, 19 (51.3%) underwent laser photoablation. Risk factors like gestational age, birth weight, maternal risk factors, apnea, intrauterine growth restriction (IUGR), hypoglycaemia, respiratory distress syndrome (RDS), sepsis, coronary heart disease (CHD), blood transfusion and oxygen requirement duration were significantly associated with ROP. Delay in the establishment of feeds has been associated with ROP (p<0.001).Conclusions: Screening should be intensified in the presence of risk factors which can reduce the incidence of severe stages of ROP as highlighted by this study.

Download Full-text

Retinopathy of Prematurity in A Tertiary Care Hospital in Eastern Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.213 ◽

2008 ◽

Vol 47 (169) ◽

Author(s):

Srijana Adhikari ◽

B P Badhu ◽

N K Bhatta ◽

R S Rajbhandari ◽

B K Kalakheti

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Screening Criteria

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening

Download Full-text

Retinopathy of Prematurity among Very-Low-Birth-Weight Infants in Korea: Incidence, Treatment, and Risk Factors

Journal of Korean Medical Science ◽

10.3346/jkms.2015.30.s1.s88 ◽

2015 ◽

Vol 30 (Suppl 1) ◽

pp. S88 ◽

Cited By ~ 26

Author(s):

Jong Hee Hwang ◽

Eun Hee Lee ◽

Ellen Ai-Rhan Kim

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Retinopathy Of Prematurity ◽

Very Low Birth Weight ◽

Low Birth Weight Infants

Download Full-text

Abstract 14575: Implantable Cardiac Defibrillator in the Setting of Tetralogy of Fallot: Long-Term Follow-Up of a French National Multicenter Retrospective Registry

Circulation ◽

10.1161/circ.132.suppl_3.14575 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Abdeslam Bouzeman ◽

Maxime De Guillebon ◽

Guillaume Duthoit ◽

Magalie Ladouceur ◽

Raphael Martins ◽

...

Keyword(s):

Risk Factors ◽

Ventricular Tachycardia ◽

Primary Prevention ◽

Secondary Prevention ◽

Tetralogy Of Fallot ◽

Primary And Secondary Prevention ◽

Long Term Follow Up ◽

Appropriate Therapy

Background: Tetralogy of Fallot (TOF) is the most frequent form of congenital heart disease managed by EP physicians for potential ICD. However, few studies have reported long-term outcomes of TOF patients with ICD. Methods: Between 2005 and 2014, all TOF patients with ICD in 17 French centers were enrolled in a specific evaluation aiming to determine characteristics at implantation as well as outcomes (overall mortality, appropriate ICD therapies, and device-related complications). Results: Overall 78 patients (45±13 years, 64% males) were enrolled. A majority of patients were implanted in the setting of secondary prevention (73%), whereas the remaining (27%) in primary prevention. Among the latest group, known risk factors for sudden cardiac death were: severe pulmonary regurgitation (30%,) prior palliative shunt (50%), syncope with unknown origin (25%), inducible ventricular tachycardia (45%), QRS duration ≥180ms (18%), non-sustained ventricular tachycardia (25%), and documented sustained supra ventricular tachycardia (45%).Overall, patients implanted in the setting of primary prevention presented with a mean of 3.1±1.4 risk factors. After a mean follow-up of 4.9±3.8 years, 35 patients (45%) experienced at least one appropriate therapy (25% in the primary prevention group compared to 53% in the secondary prevention group), giving annual-incidences of 6.9% (95%CI 0.14-13.7) and 21.3% (12.4-30.3) respectively (P=0,01). The mean time between ICD implantation and the first appropriate therapy was 2.2±3.2 years, without significant differences between primary and secondary prevention. Overall, ≥one ICD-related complication occurred in 30 patients (38%), including inappropriate shock (n=9), major pocket hematoma (n=1), lead dysfunction (n=12), infection (n=4), shoulder algodystrophia (n=2), device failure or dislodgement needing reintervention (n=2). Eventually, four patients were transplanted (5%), and six patients (8%) died during the course of follow-up. Conclusions: Considering relatively long-term follow-up, patients with TOF and ICDs experience high rates of appropriate ICD therapies, in both primary and secondary prevention. Major ICD-related complications remain, however, high.

Download Full-text