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

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

Systemic conbercept pharmacokinetics and VEGF pharmacodynamics following intravitreal injections of conbercept in patients with retinopathy of prematurity

2021 ◽  
pp. bjophthalmol-2021-319131
Author(s):  
Yong Cheng ◽  
Shuang Sun ◽  
Xun Deng ◽  
Xuemei Zhu ◽  
Dandan Linghu ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Intravitreal Injections ◽  
Vascular Endothelial ◽  
Randomised Study ◽  
Limit Of Quantitation ◽  
Significant Difference ◽  
Endothelial Growth Factor ◽  
Type 1 Rop

BackgroundData on serum vascular endothelial growth factor (VEGF) and drug levels in patients with retinopathy of prematurity (ROP) following intravitreal injections of conbercept (IVC) are lacking.MethodsMulticentre, prospective, non-randomised study of patients with aggressive posterior retinopathy of prematurity (APROP) or type 1 ROP who had not received other treatment. All infants received therapy in both eyes plus intravitreal IVC 0.25 mg/0.025 mL in one eye and had at least 6 months of follow-up. Blood samples were collected before and 1 week and 4 weeks after IVC. The main outcome measures were serum conbercept and VEGF concentrations.ResultsForty infants with APROP or type 1 ROP were enrolled. The mean serum VEGF at baseline and 1 week and 4 weeks after a total of 0.25 mg of IVC was 953.35±311.90 pg/mL, 303.46±181.89 pg/mL and 883.12±303.89 pg/mL, respectively. Serum VEGF 1 week after IVC was significantly lower (p<0.05) than baseline, and at 4 weeks after IVC, it was significantly higher (p<0.05) than at 1 week. There was no significant difference (p>0.05) between baseline and 4 weeks. Serum conbercept was below the limit of quantitation (BLOQ) at baseline and 4 weeks and was 19.81±7.60 ng/mL at 1 week.ConclusionSerum VEGF 1 week after IVC was significantly lower than baseline but returned to baseline at 4 weeks. Serum conbercept increased at 1 week and was BLOQ at 4 weeks.

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

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.

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

2015 ◽  
Vol 234 (4) ◽  
pp. 211-217 ◽  
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.

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

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

scholarly journals Incidence of Retinopathy of Prematurity in Extremely Premature Infants

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Alparslan Şahin ◽  
Muhammed Şahin ◽  
Fatih Mehmet Türkcü ◽  
Abdullah Kürşat Cingü ◽  
Harun Yüksel ◽  
...  
Keyword(s):  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Retrospective Chart Review ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Develop Type ◽  
Group 2 ◽  
Type 1 Rop ◽  
Group 1

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.

INTRAVITREAL RANIBIZUMAB INJECTION AS TREATMENT IN PATIENTS WITH TYPE 1 RETINOPATHY OF PREMATURITY

2021 ◽  
pp. 13-15
Author(s):  
Kalishankar Das ◽  
Athokpam Poireiton ◽  
Sneha Bhowmick
Keyword(s):  
Cohort Study ◽  
Intravitreal Injection ◽  
Retinopathy Of Prematurity ◽  
Positive Response ◽  
Primary Treatment ◽  
Intravitreal Ranibizumab ◽  
Response Group ◽  
Type 1 Rop

Aim: To investigate the anatomic outcomes of patients treated with intravitreal ranibizumab in the treatment of type 1 retinopathy of prematurity (ROP). A prospective cohort study was done including 100 eyes of Material And Method: 60 patients with type 1 ROP treated with intravitreal injection of ranibizumab (IVR) (0.25 mg/ 0.025 ml) as primary treatment from June 2018 to November 2019 over a period of 18 months. The anatomic outcomes were analyzed and follow-up were done upto 6 months. There were a Result: total of 94 eyes (94.0%) in the positive response group and 6 eyes (6.0%) in the negative/no response group after IVR. Within the positive response group, 49 eyes (52.13%) were in the regression without laser subgroup, and 45 eyes (47.87%) were in the regression with laser subgroup. Conclusion: Intravitreal injection of ranibizumab seemed to be effective in treating patients with type 1 ROP.

scholarly journals Foveal structure changes in infants treated with anti-VEGF therapy or laser therapy guided by optical coherence tomography angiography for retinopathy of prematurity

2022 ◽  
Vol 15 (1) ◽  
pp. 106-112
Author(s):  
Xun Deng ◽  
◽  
Xue-Mei Zhu ◽  
Dan-Dan Linghu ◽  
Hua Xu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Optical Coherence Tomography Angiography ◽  
Full Thickness ◽  
Anti Vegf ◽  
Laser Group ◽  
Type 1 Rop

AIM: To evaluate foveal vessel density (VD) and foveal thickness using optical coherence tomography angiography (OCTA) in retinopathy of prematurity (ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor (VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children. METHODS: This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes (14 patients) treated with anti-VEGF injection and twenty-nine eyes (17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina (centered on the fovea) using OCTA and cross-sectional OCT, respectively. RESULTS: Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation (P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina (P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group (P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study. CONCLUSION: In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70mo after the treatments.

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

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.

scholarly journals Evaluation of a deep learning image assessment system for detecting severe retinopathy of prematurity

2018 ◽  
Vol 103 (5) ◽  
pp. 580-584 ◽  
Author(s):  
Travis K Redd ◽  
John Peter Campbell ◽  
James M Brown ◽  
Sang Jin Kim ◽  
Susan Ostmo ◽  
...  
Keyword(s):  
Deep Learning ◽  
Retinopathy Of Prematurity ◽  
Predictive Value ◽  
Severity Score ◽  
Receiver Operating Curve ◽  
Fundus Photography ◽  
Image Analysis System ◽  
Reference Standard ◽  
Type 1 Rop

BackgroundPrior work has demonstrated the near-perfect accuracy of a deep learning retinal image analysis system for diagnosing plus disease in retinopathy of prematurity (ROP). Here we assess the screening potential of this scoring system by determining its ability to detect all components of ROP diagnosis.MethodsClinical examination and fundus photography were performed at seven participating centres. A deep learning system was trained to detect plus disease, generating a quantitative assessment of retinal vascular abnormality (the i-ROP plus score) on a 1–9 scale. Overall ROP disease category was established using a consensus reference standard diagnosis combining clinical and image-based diagnosis. Experts then ranked ordered a second data set of 100 posterior images according to overall ROP severity.Results4861 examinations from 870 infants were analysed. 155 examinations (3%) had a reference standard diagnosis of type 1 ROP. The i-ROP deep learning (DL) vascular severity score had an area under the receiver operating curve of 0.960 for detecting type 1 ROP. Establishing a threshold i-ROP DL score of 3 conferred 94% sensitivity, 79% specificity, 13% positive predictive value and 99.7% negative predictive value for type 1 ROP. There was strong correlation between expert rank ordering of overall ROP severity and the i-ROP DL vascular severity score (Spearman correlation coefficient=0.93; p<0.0001).ConclusionThe i-ROP DL system accurately identifies diagnostic categories and overall disease severity in an automated fashion, after being trained only on posterior pole vascular morphology. These data provide proof of concept that a deep learning screening platform could improve objectivity of ROP diagnosis and accessibility of screening.

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

2018 ◽  
Vol 103 (4) ◽  
pp. 494-498 ◽  
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.

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