scholarly journals THE DIAGNOSTIC SIGNIFICANCE OF FLUORESCENCE ANGIOGRAPHY FOR THE EARLY DETECTION AND PROGNOSTICATION OF THE DEVELOPMENT OF ACTIVE RETINOPATHY OF PREMATURITY IN THE INFANTS BORN ON THE DEADLINES OF GESTATION

2017 ◽  
Vol 12 (1) ◽  
pp. 17-22 ◽  
Author(s):  
E. I Saidasheva ◽  
V. A Lyubimenko ◽  
S. V Buyanovskaya ◽  
F. V Kovshov
Keyword(s):  
Early Detection ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Diagnostic Value ◽  
Retinal Blood Flow ◽  
Fluorescence Angiography ◽  
Diagnostic Significance ◽  
Extremely Preterm ◽  
Group 2 ◽  
Preterm Born

Aim. The objective of the present study was to elucidate the fluorescent angiographic characteristics, such as the features of retinal and choroidal microcirculation, depending on the duration of the active course of retinopathy of prematurity in the infants born on the deadlines of gestation (the gestational age of 21-26 weeks). Materials and methods. The study included 65 patients presenting with retinopathy of prematurity. A total of 102 sessions of fluorescence angiography (FA) of the retina were carried out, with 40% of the sessions being performed in duplicate. The gestational age of the infants ranged from 22 to 26 (mean 24.9+-1.0) weeks, their body weight at birth varied from 490 to 1,400 (mean BW 774.8+-152.6) g. All the patients were subdivided into 4 groups. Group 1 was comprised of 8 (12.3%) children at the initial stages of retinopathy of prematurity, group 2 consisted of 28 (43.1%) children presenting with threshold retinopathy of prematurity, group 3 was composed of 20 (30.8%) children with the recurring disorder, and group 4 involved 9 (13.8%) children experiencing induced regression of this pathology. The photographs of the fundus and digital video FA images were obtained with the use of the RetCam3 pediatric retinal camera (“Clarity”, USA). The 10% fluorescein solution was administered intravenously in the form of bolus injections at a dose of 7.5 mg/kg. Results. The present study has revealed some characteristic fluorescent and angiographic features of active retinopathy of prematurity in the extremely preterm born infants including instability of the retinal blood flow, variability in the filling of the choroid, various types of pathological branching of the blood vessels at the boundary between vascularized and avascular retina, etc. The comparative analysis of the angiograms and colour images of the fundus obtained with the use of the RetCam3 camera gave evidence of the high diagnostic value of the fluorescence angiography technique that provides the possibility for the early objective visualization and registration of the pathological changes in the retinal vasculature characteristic of the initial and threshold stages of the disease as well as for the reliable detection of the signs of its relapse (the local sites of re-proliferation) and regression of the pathology being considered. Conclusion. The application of the fluorescence angiography technique for the examination of the markedly prematurely born infants provides a safe and efficient tool allowing to greatly optimize both the early detection and prognostication of the development of active retinopathy of prematurity in the infants born on the deadlines of gestation.

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

Medicina ◽  
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.

scholarly journals The modified protocol of transesophageal atrial pacing in stress echocardiography as an alternative way to increase the information value of the method for detection of ischemic wall motion abnormalities

Kardiologiia ◽  
2021 ◽  
Vol 61 (3) ◽  
pp. 71-76
Author(s):  
M. A. Saidova ◽  
J. V. Botvina ◽  
V. N. Shitov ◽  
L. S. Atabaeva
Keyword(s):  
Coronary Angiography ◽  
Stress Echocardiography ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Information Value ◽  
Atrial Pacing ◽  
Circumflex Artery ◽  
Diagnostic Significance ◽  
Coronary Insufficiency ◽  
Group 2

Aim    To develop a new, modified protocol for transesophageal atrial electric stimulation (TEAES), which would significantly enhance the diagnostic value of stress echocardiography and reduce the duration of the test in patients with ischemic heart disease (IHD).Material and methods    This study included 101 patients (80 men and 21 women aged 55±9 years) with suspected or documented diagnosis of IHD who were divided into two homogenous groups. Group 1 (51 patients) underwent stress echocardiography (stress-EchoCG) according to a standard protocol (SP) for TEAES and group 2 (50 patients), underwent stress-EchoCG according to a modified protocol (MP). In addition to stress-EchoCG with TEAES, selective coronary angiography was performed for all patients. The development of the new method for evaluating occult coronary insufficiency was based on comparison of SP and MP for TEAES with stress-EchoCG with data of coronary angiography.Results    In both groups, significant differences in values of systolic and diastolic blood pressure were absent. However, the values of achieved heart rate were significantly different: 141±11 (TEAES SP) and 155±10 (TEAES MP) bpm (p=0.01). There was also a difference in the duration of the TEAES protocols: 15±3 and 5±2 min, respectively (p=0.006). The use of the modified TEAES protocol for detecting transient disorders of left ventricular myocardial local contractility increased the sensitivity, specificity and accuracy of the test from 76 %, 87 %, and 80 % to 83 %, 92 %, and 86 %, respectively. The most significant differences were found in the area supplied by the circumflex artery: the SP and MP sensitivities were 63 % and 75 %, respectively (p<0.05) and the SP and MP accuracies were 81 % and 90 %, respectively (p<0.05).Conclusion    Evaluation of occult coronary insufficiency by stress-EchoCG with the TEAES MP as compared to the TEAES SP provides a gentler procedure regimen for the patient due to a shorter duration of the test and at the same time improves the diagnostic significance of this method in IHD patients.

scholarly journals Validation of WINROP algorithm as a screening tool for retinopathy of prematurity in a northern Spanish cohort

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Raúl Fernández-Ramón
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Predictive Value ◽  
Predictive Values ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Sensitivity Specificity ◽  
Spanish Cohort

Introduction: WINROP (Weight, Insulin-like growth factor 1, Neonatal Retinopathy of Prematurity) is a computer-based ROP risk which correlate postnatal weight gain with the developed of treatment-requiring ROP. The purpose of this study was to evaluate the ability of the WINROP algorithm to detect severe (Type 1 or Type 2) ROP in a Spanish cohort of infants. Methods: Birth weight, gestational age, and weekly weight measurements of preterm infants (>23 and <32 weeks gestation) born between 2015 and 2017 were retrospectively collected and entered in WINROP algorithm. Infants were classified according alarm activation and compared with ROP screening outcomes. Sensitivity, specificity, and predictive values were calculated. Results: A total of 109 infants were included. The mean gestational age was 29.37 ± 2.26 weeks and mean birth weight was 1178 ± 320 g. Alarm occurred in 47.7 % (52/109) of neonates, with a mean time from birth to alarm of 1.9 ± 1.4 weeks. WINROP had a sensitivity of 100% (CI 95%, 59-100), a specificity of 55.9% (CI 95%, 45.7-65.7), a positive predictive value of 13.5% (CI 95%, 11.1-16.2) and a negative predictive value of 100% (CI 95%, 93.7-100) for predicting severe ROP. Conclusion: The WINROP algorithm has proven to be a useful tool in the detection of severe ROP in our cohort. Nevertheless, in extremely preterm infants (GA <28 weeks) the results should be taken with caution and an optimization of WINROP can be necessary to improve its utility in other populations.

scholarly journals Drug-induced mydriasis in infants born at different gestation terms

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.

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.

scholarly journals Achieved oxygen saturations and retinopathy of prematurity in extreme preterms

2019 ◽  
Vol 105 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Marie G Gantz ◽  
Waldemar A Carlo ◽  
Neil N Finer ◽  
Wade Rich ◽  
Roger G Faix ◽  
...  
Keyword(s):  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Late Onset ◽  
Significant Risk ◽  
Research Network ◽  
Severe Illness ◽  
Oxygen Supplementation ◽  
Increased Risk ◽  
Extremely Preterm ◽  
Postmenstrual Age

ObjectiveTo identify achieved oxygen saturations (SpO2) associated with increased risk of severe retinopathy of prematurity (ROP).DesignThis is a secondary analysis of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT)randomised controlled trial. SpO2 was recorded up to 36 weeks’ postmenstrual age. Saturations through 9 postnatal weeks were explored graphically, and logistic regression models were created to predict severe ROP.Setting20 centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.Patients984 surviving infants of 24–27 weeks’ gestational age born in 2005–2009.InterventionsSUPPORT targeted SpO2 to a lower (85%–89%) or higher (91%–95%) range through 36 weeks’ postmenstrual age or off respiratory support.Main outcome measuresSevere ROP defined as threshold ROP, ophthalmological surgery or bevacizumab treatment.ResultsThere were statistically significant interactions between duration of oxygen supplementation and percentage of time in certain achieved saturation ranges. Specifically, for infants who spent at least 2 weeks on oxygen in postnatal weeks 1–5, a higher percentage of time at 91%–96% SpO2 was associated with increased odds of severe ROP. For infants who spent at least 3 weeks on oxygen in postnatal weeks 6–9, a higher percentage of time at 97%–100% SpO2 was associated with increased odds of severe ROP. Other significant risk factors were lower gestational age and birth weight, non-Hispanic white versus black race, prospectively defined severe illness, late-onset sepsis or meningitis, and clinical centre.ConclusionsAmong extremely preterm survivors to discharge, the association between SpO2 and severe ROP depended on the timing and duration of oxygen supplementation.

scholarly journals Prevalence and Risk Factors of Retinopathy of Prematurity in Iran

2019 ◽  
Author(s):  
Mohammad Zarei ◽  
Fatemeh Bazvand ◽  
Nazanin Ebrahimiadib ◽  
Ramak Roohipoor ◽  
Reza Karkhaneh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Extremely Low Birth Weight ◽  
Increased Risk ◽  
Extremely Preterm ◽  
History Of

Purpose: The present study aimed to evaluate the frequency and risk factors of retinopathy of prematurity (ROP) among Iranian infants. Methods: A retrospective cohort study was conducted on infants who had undergone screening for ROP at Farabi Eye Hospital, between March 2016 and March 2017. Data were analyzed based on the presence of extreme prematurity (gestational age ≤ 28 weeks), extremely low-birth-weight (≤ 1000 g), and multiplegestation (MG) infants. Results: The prevalence of ROP was 27.28% (n = 543) among all screened infants, 74.4% for extremely preterm (EP) infants, 77.5% for extremely low birth weight (ELBW) babies, and 27.25% for infants from MG pregnancies. On multivariate analysis, gestational age, birth weight, and history of transfusion (P < 0.0001, P < 0.0001, and P = 0.04, respectively) were found to be significantly associated with ROP. More advanced stages of ROP (P < 0.0001) were observed in EP and ELBW infants. Birth weight (P = 0.088), history of transfusion (P = 0.066), and intubation (P = 0.053) were not associated with increased risk of ROP in EP infants, while gestational age (P = 0.037) and history of transfusion (P = 0.040) were significant risk factors for ROP in ELBW infants. Gestational age (P < 0.001) and birth weight (P = 0.001) were significantly associated with ROP in infants from MG pregnancies in multivariate analysis. Conclusion: ROP remains a commonly encountered disease, especially in ELBW and EP infants. The history of transfusion may have a role in stratifying the risk for ROP and guiding future screening guidelines.

scholarly journals Are The Neutrophil-to-lymphocyte, Platelet-to-lymphocyte And Monocyte-to-lymphocyte Ratios Predictive Factors For The Retinopathy Of Prematurity?

2019 ◽  
Author(s):  
Adem Uğurlu ◽  
Erel İçel ◽  
Nurdan Gamze Taşlı ◽  
Hayati Yılmaz ◽  
Turgay Uçak ◽  
...  
Keyword(s):  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Independent Predictor ◽  
Inclusion Criteria ◽  
Independent Risk Factors ◽  
The Mean ◽  
Group 2 ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Group 1

Abstract Purpose: In this study, we aimed to evaluate the possible relationship between the neutrophil-to-lymphocyte, monocyte-to-lymphocyte and platelet-to-lymphocyte ratio and retinopathy of prematurity (ROP). Method: The data of 348 patients who applied to Erzincan University Ophthalmology Unit for screening the retinopathy of prematurity were analyzed retrospectively. One hundred sixty seven patients who were collected CBC samples within the first 72 hours after delivery and who met the inclusion criteria were included in the study. Infants with a gestational age of ≤35 week were screened for ROP. Pateints were divided into two groups. Group 1 was involved the patients with the diagnosis of ROP and group 2 was involved the normal patients (no ROP). The levels of NLR, PLR and MLR were determined in two groups. Results: Fifty nine patients who were detected ROP are in group 1 and 108 patients who were not seen ROP are in group 2 in the study. The mean gestational age at birth of the patients was 30,4 ± 2,1 [26-34] weeks in group 1 and 33,7 ± 1,7 [27-35] weeks in group 2.( P =0.004) The mean gestational weigth at birth was 1927,2 ± 158,4 [1690-2300] gram in group 1 and 2169,1 ± 283,1 [1750-3100] gram in group 2. ( P <0.001) With the result of logistic regression analysis, gestational age [Odds Ratio(OR): 0.531, 95%CI: 0.388-0.726, P <0.001], NLR [OR:34.849, 95%CI: 2.091-580.779, P :0.013] and PLR [OR: 1.067, 95%CI: 1.034-1.110, P <0.001] were detected the independent risk factors for ROP. Conclusion: Our study revealed that higher NLR and PLR which are evaluated with in first 72h after birth is an independent predictor of ROP.

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