Comparison of Refractive Error Changes in Retinopathy of Prematurity Patients Treated with Diode and Red Lasers

2016 ◽  
Vol 235 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Ramak Roohipoor ◽  
Reza Karkhaneh ◽  
Mohammad Riazi Esfahani ◽  
Fateme Alipour ◽  
Mahtab Haghighat ◽  
...  

Aim: To compare refractive error changes in retinopathy of prematurity (ROP) patients treated with diode and red lasers. Methods: A randomized double-masked clinical trial was performed, and infants with threshold or prethreshold type 1 ROP were assigned to red or diode laser groups. Gestational age, birth weight, pretreatment cycloplegic refraction, time of treatment, disease stage, zone and disease severity were recorded. Patients received either red or diode laser treatment and were regularly followed up for retina assessment and refraction. The information at month 12 of corrected age was considered for comparison. Results: One hundred and fifty eyes of 75 infants were enrolled in the study. Seventy-four eyes received diode and 76 red laser therapy. The mean gestational age and birth weight of the infants were 28.6 ± 3.2 weeks and 1,441 ± 491 g, respectively. The mean baseline refractive error was +2.3 ± 1.7 dpt. Posttreatment refraction showed a significant myopic shift (mean 2.6 ± 2.0 dpt) with significant difference between the two groups (p < 0.001). There was a greater myopic shift among children with zone I and diode laser treatment (mean 6.00 dpt) and a lesser shift among children with zone II and red laser treatment (mean 1.12 dpt). The linear regression model, using the generalized estimating equation method, showed that the type of laser used has a significant effect on myopic shift even after adjustment for other variables. Conclusion: Myopic shift in laser-treated ROP patients is related to the type of laser used and the involved zone. Red laser seems to cause less myopic shift than diode laser, and those with zone I involvement have a greater myopic shift than those with ROP in zone II.

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hemang K. Pandya ◽  
Lisa J. Faia ◽  
Joshua Robinson ◽  
Kimberly A. Drenser

Purpose. To report anatomic outcomes after early and confluent laser photocoagulation of the entire avascular retina, including areas in close proximity to the fovea, in patients with APROP. We aspire to demonstrate fundoscopic evidence of transverse growth and macular development following laser treatment in APROP.Methods. Retrospective review of 6 eyes with APROP that underwent confluent laser photocoagulation of the entire avascular retina. Photographic fundoscopic imaging was performed using the RetCam to compare outcomes after treatment.Results. Mean birth weight and gestational age were 704.8 g and 24.33 weeks, respectively. There were 2 females and 1 male. The average time to laser was 9.3 weeks after birth, with the mean postmenstrual age of 34 weeks. Two eyes had zone 1 and 4 eyes had posterior zone 2 disease. Three eyes developed 4A detachments, which were successfully treated. All 6 eyes experienced transverse growth, with expansion of the posterior pole and anterior displacement of the laser treatment.Conclusion. Confluent photocoagulation of the entire avascular retina, regardless of foveal proximity, should be the mainstay for treating APROP. Examination should be conducted within 5–10 days to examine areas previously hidden by neovascularization to ensure prudent therapy. Macular development involves both transverse and anterior-posterior growth.


2017 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Mohammod Shahidullah ◽  
Arjun Chandra Dey ◽  
Firoz Ahmed ◽  
Ismat Jahan ◽  
Sanjoy Kumer Dey ◽  
...  

<p>Retinopathy of prematurity is considered as an important cause of blindness. This prospective study was undertaken to document the frequency and the associated factors of retinopathy of prematurity among 97 preterm newborn weighing &lt;2000 g and/or with a gestation of &lt;35 weeks. The first eye examination was performed by an ophthalmologist at 4 weeks of postnatal age for the infants born at ≥30 weeks of gestation or birth weight ≥1200 g and at 3 weeks of postnatal age for the infants &lt;30 weeks of gestation or birth weight &lt;1200 g. The overall incidence of retinopathy of prematurity was 23.7%. Premature newborn with retinopathy was having significant low mean birth weight (p=0.001) and the mean gestational age (p=&lt;0.001) when compared with newborns without retinopathy of prematurity. Newborns with retinopathy of prematurity were requiring a longer duration of oxygen (p=0.005) than that of non-retinopathy of prematurity newborns. Logistic regression shows the duration of oxygen in the hospital and lower gestational age were independent risk factors of retinopathy of prematurity. Prematurity and longer duration of oxygen administration were the risk factors for the development of retinopathy of prematurity.</p>


2021 ◽  
Vol 43 (2) ◽  
pp. 173-178
Author(s):  
Amir Eftekhari ◽  
Vahideh Manouchehri ◽  
Farideh Mosavi ◽  
Mohammad Ali Jahanbani

Background: Since Retinopathy of prematurity (ROP) is a leading cause of childhood blindness, the identification of contributed risk factors is crucial. In recent years, great attention has been paid to maternal factors. The reason is that maternal factors can directly affect fetus via intrauterine hypoxia. However, the results of this studies are conflicting. The purpose of this study was to evaluate the effect of maternal factors on the development of ROP. Methods: In a prospective study, 150 premature infants with the gestational age of less than 32 weeks and birth weight of less than 1500 grams were examined. They divided into two groups based on ophthalmologic examination; those with ROP and those without ROP. Variables of study including maternal age, injection of corticosteroid in the last week of pregnancy, history of maternal diabetes mellitus, preeclampsia, hypertension, anemia, thyroid, renal, cardiovascular and rheumatologic diseases were compared between groups. Results: Forty-seven infants (31.33 %) had ROP. The mean age of gestational age was 27.89 weeks in ROP group and 29.06 weeks in non-ROP group. The mean birth weight was 1180.53 grams in ROP group and 1079.44 grams in non-ROP group. There were no statistically important differences regarding to maternal factors between two groups. Conclusion: The above mentioned maternal factors have no effect on the development of ROP.


Author(s):  
Kishan A. Makvana ◽  
Apurva H. Suthar

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.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2094430
Author(s):  
Ashwaq Bin Amro ◽  
Rawdha Alnuaimi ◽  
Tin Chan ◽  
Abeer Alali

In this case report, we discuss the presentation of retinopathy of prematurity in triplets born at 25 + 3 weeks gestational age of whom each had a different birth weight, weight gain and treatment requirements. Triplet A weighed 800 g and his retinopathy of prematurity had resolved with no intervention. Triplet B weighed 630 g at birth and he required bilateral intravitreal ranibizumab injection at 32 + 6 weeks. Triplet C weighed 520 g and required bilateral intravitreal ranibizumab injection at 36 weeks, but after 5 weeks he had recurrence which was treated with bilateral diode laser. Triplet C had the poorest weight gain. The main differences between the triplets are the birth weight and the weight gain. Furthermore, refraction was performed at 10 months; triplet A had a hyperopia of +1.25 spherical equivalent in both eyes, triplet B had mild myopia of −0.25 spherical equivalent and triplet C had a myopia of −3.00 spherical equivalent in the right eye and −2.75 spherical equivalent in the left eye.


2019 ◽  
Author(s):  
Ramesh Venkatesh ◽  
Prachi Abhishek Dave ◽  
Prachi Gurav ◽  
Manisha Agarwal ◽  
Mamta Jajoo ◽  
...  

Abstract Background To study and analyse the factors affecting the prevalence of prevalence of retinopathy of prematurity (ROP) between the urban and semi-urban regions in North India. Methods Retrospective, observational, cross-sectional study. All babies referred for ROP screening by paediatricians or other general ophthalmologists between 2013 – 2016 were included in the study. Demographic, clinical and treatment related findings were recorded. Results Five hundred and fifty-eight (467: urban & 91: semi urban) babies were screened for ROP. The mean birth weight in the urban and semi-urban setting was 1348.6 ± 395.21 gm and 1703.77 ± 401.76 gm respectively. The mean gestational age was 30.99 ± 2.93 weeks and 30.73 ± 2.08 weeks in the urban and semi-urban cohorts respectively. The average time for first ophthalmic examination following birth was 23.82 ± 13.69 days in the urban and 101.16 ± 238.26 days in the semi-urban setting. Prevalence of ROP in the urban cohort was 11.7% and in the semi-urban cohort was 31.9%. Statistically significance between the two groups was noted with birth weight, day of screening and prevalence but not with gender or gestational age. Conclusion The prevalence of ROP is found to be higher in the semi-urban setting due to delayed screening, higher drop-out rate and lack of basic treatment facilities like laser.


Author(s):  
Juan Carlos Romo-Aguas ◽  
Ana González-H.León ◽  
Miroslava Paolah Meraz-Gutiérrez ◽  
María A. Martínez-Castellanos

Abstract Aim The objective of this study is to report the incidence of retinopathy of prematurity (ROP) outliers that fall outside the screening guidelines of the American Academy of Ophthalmology (AAO) in our country. Methods A retrospective review of 503 records of newborns evaluated in our institution between January 2011 and March 2017. We analyzed the data by subgroups based on gestational age (GA), birth weight (BW) and stage, focusing on the outliers that don’t meet the criteria of the screening AAO guidelines (GA ≤ 30 weeks, BW ≤ 1500 g). Results Of the 503 records, 352 had some degree of ROP, 91.76% being bilateral, and 26.2% require treatment. The mean GA at delivery was 30.56 ± 2.33 weeks, and the mean BW was 1287.90 ± 338.52 g. For the current AAO/AAP ROP screening, 19.9% were outliers, of which (57%) had ROP diagnosis and (38%) required treatment. Conclusions ROP diagnosis in newborns of BW > 1500 g or GA > 30 weeks is not uncommon in Mexico, and it is important to take this into account to adjust the selection criteria on each population to reach all the infants at risk.


Author(s):  
Radha Annamalai ◽  
Krishnima Raghu ◽  
Meera Mohanakumar ◽  
M. Muthayya

Aim: This study was performed to determine profile of asymmetry, newer differences in postnatal risk factors and effects of current laser treatment on retinopathy of prematurity (ROP) progression in preterm twin pairs. Methods: A retrospective study was conducted on 250 infants (125 twin pairs) of premature birth, low weight or other infant risk factors at Sri Ramachandra hospital, a tertiary referral hospital in Chennai, India from May 2017 to April 2019. Indirect ophthalmoscopy with scleral indentation was performed on all babies under continuous monitoring of oxygen saturation using pulseoximeter in the presence of a neonatologist. Examination and analysis was done for stage and zone of ROP, systemic causes, spontaneous regression and need for treatment. Results: Among 125 twin pairs, 38twin pairs (30%) had ROP which was asymmetrical in 27% and symmetrical in 4%. Disparity developed before 35 weeks when both twins had ROP. Two stage differences occurred in 84%. Both were statistically significant (p<0.05). Spontaneous regression occurred after 35 weeks and majority regressed by 40 weeks. Laser treatment was required in 36%. Risk factors were most commonly respiratory distress, patent ductus arteriosus, apnoea, variation of birth weight and gestational age. Conclusion: Smaller gestational age is a good predictor of variability in progression of vascularization and along with birth weight and weight gain contributes to asymmetry. Respiratory distress has the highest risk. It is important to screen and follow up all twins irrespective of initial examination status and normal appearing retina in one twin, as transition from one stage to another can occur. Early detection with timely treatment will prevent irreversible visual loss.


2018 ◽  
Vol 103 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Yichen Bai ◽  
Huanjie Nie ◽  
Shiyu Wei ◽  
Xiaohe Lu ◽  
Xiaoyun Ke ◽  
...  

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.


2020 ◽  
Vol 7 (10) ◽  
pp. 1984
Author(s):  
Bhuvaneshwari C. Yelameli ◽  
Ramesh V. Neelannavar ◽  
Kiruthika Das

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.


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