scholarly journals Retinopathy of Prematurity – Bangladesh perspective

2021 ◽  
Vol 11 (2) ◽  
pp. 447-452
Author(s):  
Maksudur Rahman ◽  
Liton Chandra Saha ◽  
Md Mahbubul Hoque ◽  
M Monir Hossain ◽  
BH Nazma Yasmeen
Keyword(s):  
Developing Countries ◽  
Visual Impairment ◽  
Preterm Infants ◽  
Functional Impairment ◽  
Retinopathy Of Prematurity ◽  
Screening Program ◽  
Capital City ◽  
Medical College ◽  
Timely Referral ◽  
Rop Screening

Retinopathy of Prematurity (ROP) results in severe visual impairment and blindness in newborns. Now a days with the advancement of the technology to save preterm infants, its incidence is also increasing in both developed and developing countries. Appropriate and timely screening program can prevent ROP and reduces the functional impairment of eyes. Many countries have their guideline for ROP screening. Bangladesh national guideline is still in progress. Hope it will be published soon. In Bangladesh practically nationwide ROP screening was started in 2013. But still most of the screening program is limited to the capital city. Vast majority of neonates who stayed in peripheral districts are still out of screening program and failed to have timely referral. The current efforts of screening program are mainly driven by the private, NGO and the Gov’t professional bodies. Northern International Medical College Journal Vol.11 (2) Jan 2020: 447- 452

Outcomes of a uniformly active approach to infants born at 22–24 weeks of gestation

2021 ◽  
pp. fetalneonatal-2020-320486
Author(s):  
Fanny Söderström ◽  
Erik Normann ◽  
Maria Jonsson ◽  
Johan Ågren
Keyword(s):  
Visual Impairment ◽  
Developmental Delay ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Retinopathy Of Prematurity ◽  
Ductus Arteriosus ◽  
Neurodevelopmental Outcomes ◽  
Active Approach ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

ObjectiveTo determine survival and outcomes in infants born at 22–24 weeks of gestation in a centre with a uniformly active approach to management of extremely preterm infants.Study designSingle-centre retrospective cohort study including infants born 2006–2015. Short-term morbidities assessed included retinopathy of prematurity, necrotising enterocolitis, patent ductus arteriosus, intraventricular haemorrhage, periventricular malacia and bronchopulmonary dysplasia. Neurodevelopmental outcomes assessed included cerebral palsy, visual impairment, hearing impairment and developmental delay.ResultsTotal survival was 64% (143/222), ranging from 52% at 22 weeks to 70% at 24 weeks. Of 133 (93%) children available for follow-up at 2.5 years corrected age, 34% had neurodevelopmental impairment with 11% classified as moderately to severely impaired. Treatment-requiring retinopathy of prematurity, severe bronchopulmonary dysplasia, visual impairment and developmental delay correlated with lower gestational age.ConclusionsA uniformly active approach to all extremely preterm infants results in survival rates that are not distinctly different across the gestational ages of 22–24 weeks and more than 50% survival even in infants at 22 weeks. The majority were unimpaired at 2.5 years, suggesting that such an approach does not result in higher rates of long-term adverse neurological outcome.

Validation of the postnatal growth and retinopathy of prematurity screening criteria: A retrospective Italian analysis

2021 ◽  
pp. 112067212110113
Author(s):  
Samuele Caruggi ◽  
Matteo Scaramuzzi ◽  
Maria Grazia Calevo ◽  
Enrico Priolo ◽  
Lorenza Sposetti ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Sensitivity And Specificity ◽  
Retinopathy Of Prematurity ◽  
Postnatal Growth ◽  
Detection Sensitivity ◽  
Screening Criteria ◽  
Screening Protocol ◽  
Type 1 Rop ◽  
Rop Screening

Purpose: Retinopathy of prematurity (ROP) is the leading cause of childhood blindness. The aim of our study is to validate the new screening criteria elaborated by the Postnatal Growth and Retinopathy of Prematurity (G-ROP) study group in a monocentric cohort of Italian preterm infants. Methods: We retrospectively applied the G-ROP screening criteria to a cohort of preterm infants born between May 2015 and July 2020 with known birth weight, gestational age, serial weight measurement, and known ROP outcome. Primary outcomes were sensitivity and specificity of ROP detection, especially of treatment requiring ROP. Secondary outcomes were reduction of ophthalmologic examinations and of infants requiring screening. Results: We retrospectively evaluated 595 children and 475 were included in our study. Of them, 119 developed any type ROP, 39 developed type 1 ROP, and 28 underwent treatment. G-ROP criteria predicted 39 of 39 cases of type 1 ROP (100% sensitivity and specificity). Sensitivity and specificity for detection of treated ROP were 100%. Considering any type ROP detection, sensitivity was 87.4% and specificity was 100%. Our analysis showed that screening could be avoided in 50% of patients, resulting in a 29% reduction of the number of examinations. Conclusions: Our study validates the new G-ROP screening protocol in a monocentric cohort of premature infants. We demonstrate that all Type 1 ROP and requiring treatment ROP could be found even with a reduction of eye examinations.

scholarly journals Effectiveness of Reverse Kangaroo Mother Care Position in Decreasing Adverse Physiological Events and Pain during Screening of Premature Infants for Retinopathy of Prematurity

2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Ma. Socorro Fatima P. Calitis ◽  
Maria Esterlita T. Villanueva-Uy ◽  
Socorro De Leon-Mendoza ◽  
Maria Angelica Villano ◽  
Jazel Eleazer-Verde
Keyword(s):  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Position Control ◽  
Low Cost ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Control Group ◽  
Infant Pain ◽  
Pipp Score ◽  
Rop Screening

Background. Retinopathy of prematurity (ROP) screening is uncomfortable and even painful in preterm infants. Objective. To determine the effectiveness of the Reverse-Kangaroo Mother Care (R-KMC) position compared with the conventional position in decreasing adverse physiological events and pain during ROP screening. Methods. This was a parallel randomized controlled trial with two arms- R-KMC position and conventional position (control). The primary outcomes included increased oxygen saturation, decreased heart and respiratory rates, and decreased pain intensity measured by Prematurity Infant Pain Profile (PIPP). Results. There were 100 preterm infants recruited. There were no differences in baseline characteristics, mean ROP screening duration, mean physiological parameters after the mydriatic application and during ROP screening between the two. Only the mean respiratory rates were significantly lower among the R-KMC group during the application of mydriatric agent. (50.26 ± 6.18 vs. 51.6 ± 8.35; p=0.0191). Relative risk (RR) in the control group is 37 to 84 versus 40 to 68 in the R-KMC group. The R-KMC group had a significantly lower mean PIPP score (6.5±2.06 vs. 8.8±2.80; p<0.0001) after mydriatic application and during ROP screening (7.6±2.05 vs. 9.8±2.90; p<0.0001) compared with control. No apnea was observed after mydriatic application, but one apneic episode was in control during ROP screening. 26% of the ROP screeners recommended the R-KMC position during ROP screening, while a majority (70%) was neutral. Conclusion. R-KMC position, a low-cost intervention, significantly reduces pain during ROP screening. It is recommended as a position of choice during ROP screening.

scholarly journals Role of studying the pathogenesis of retinopathy of prematurity in optimizing disease screening

2021 ◽  
Vol 16 (2) ◽  
pp. 5-13
Author(s):  
Lyudmila A. Katargina ◽  
Natal’ya B. Chesnokova ◽  
Natal’ya V. Balatskaya ◽  
Natal’ya Anatolievna Osipova ◽  
Anna Yurievna Panova
Keyword(s):  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Biological Effects ◽  
Clinical Analysis ◽  
Disease Screening ◽  
Pathological Process ◽  
Screening System ◽  
Treatment And Prevention ◽  
Rop Screening

Background: The efficiency of treatment and prevention of retinopathy of prematurity (ROP) has improved. In addition, the development of a disease screening system to reduce the incidence of disability resulting from this pathology is important. Aim: This study aimed to determine new laboratory criteria for screening and predicting the ROP course through in-depth investigation of the molecules participating in the pathogenesis of ROP. Material and methods: A comprehensive clinical and experimental study was performed to assess the local and systemic levels of 49 cytokines with various biological effects, four monoamines, and angiotensin-II (AT-II) at different stages of the pathological process. In the clinical analysis, 165 preterm infants at risk of ROP development were examined. For the experimental part, the disease course of 145 Wistar infant rats in the developed model of experimental ROP was analyzed. Results: Among cytokines, the seven most promising potential laboratory markers of ROP development and adverse course were as follows: MCP1 95 pg/mL, IGF-II 140 pg/mL, TGFbeta1 18000 pg/mL, and IGF-I 24 pg/mL in the blood serum of preterm infants before the first signs of ROP and VEGF-A 108 pg/mL, TGF-beta2 100 pg/mL, and PDGF-BB 1800 pg/mL at ROP manifestation. Among monoamines, serotonin (17.0 pg/mL) and L-DOPA indicated their prognostic value in the clinical and experimental settings. Moreover, a possible prognostic role of AT-II was found. Conclusion: In this study, methods to improve the ROP screening system are outlined, but further work is necessary to assess the possibility of implementing the results in clinical practice

Retinopathy of Prematurity: An Example of a Successful Screening Program

2010 ◽  
Vol 29 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Wendy VanStone
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Multidisciplinary Approach ◽  
Screening Program ◽  
Low Birth Weight Infants ◽  
Parental Compliance ◽  
American Academy Of Pediatrics ◽  
Rop Screening

Retinopathy of prematurity (ROP) is a persistent and often devastating morbidity associated with premature and low birth weight infants. It continues to be a frequent diagnosis in the neonatal intensive care unit, despite technologic advances and increased knowledge. The American Academy of Pediatrics (AAP) has issued practice guideline recommendations for ROP screening and treatment that aid in creating a consistent and reliable ROP protocol. Challenges exist in screening for and treating ROP, including delayed or omitted exams, lack of qualified examiners, lack of parental compliance with follow-up care, and fear of litigation. This article provides a detailed example of a successful ROP program based on the AAP recommendations and utilizing a multidisciplinary approach to ensure optimal ROP care for the preterm infant. It also discusses the role of the ROP coordinator assigned to the NICU.

Outcomes of a Protocol-Based Management for Zone 1 Retinopathy of Prematurity: The Indian Twin Cities ROP Screening Program Report Number 2

2011 ◽  
Vol 152 (4) ◽  
pp. 712 ◽  
Author(s):  
Anand Vinekar ◽  
Kavitha Avadhani ◽  
Sherine Braganza ◽  
Bhujang Shetty ◽  
Mangat Dogra ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Screening Program ◽  
Twin Cities ◽  
Rop Screening

scholarly journals Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110396
Author(s):  
Malshi Karunatilake ◽  
Sibasis Daspal ◽  
Veronica Mugarab Samedi ◽  
Shehla Rubab
Keyword(s):  
Birth Weight ◽  
Early Detection ◽  
Disease Severity ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Retinal Imaging ◽  
Wide Field ◽  
Children's Hospital ◽  
Rop Screening

Retinopathy of Prematurity (ROP) is a vascular proliferative disorder of preterm infants, with increased disease severity and incidence occurring with lower gestational age and birth weight. An alternate approach to ROP screening with wide-field digital retinal imaging helps with the early detection of ROP, especially during the pandemic.

scholarly journals Cost-effectiveness analysis of tele-retinopathy of prematurity screening in Iran

2021 ◽  
Vol 14 (4) ◽  
pp. 560-566
Author(s):  
Seyed-Farzad Mohammadi ◽  
◽  
Sahel Darabeigi ◽  
Nastaran Salimi ◽  
Afsar Farahani ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Retinopathy Of Prematurity ◽  
Screening Program ◽  
Screening Strategy ◽  
Cost Utility ◽  
Screening Methods ◽  
Screening System ◽  
Tree Model ◽  
Life Years ◽  
Rop Screening

AIM: To conduct a cost-utility analysis of the tele- retinopathy of prematurity (ROP) screening program against no screening. METHODS: A decision tree model was developed to identify and treat the infants with threshold ROP through the tele-screening system compared with no screening program from the societal perspective. We used the quality adjusted life years (QALY) index to measure the scenarios' effectiveness, which was discounted for the future years by 0.058. One hundred twenty-six randomly selected newborns with ROP required treatment were investigated to extract the treatment information. We considered the direct medical and non-medical costs in cost calculations analysed by the bottom-up approach. The figures of the model's inputs were calculated using the Monte Carlo simulation that generated 1000 random iteration of the data, and a one-way sensitivity analysis was performed on the model to cope with the potential uncertainties. RESULTS: The total and per capita needed the budget to establish a tele-ROP screening system were estimated at over 1.5 million and 35.13 USD, respectively. The total cost of identifying and treating an ROP case in tele-screening and no screening strategies were obtained as 108.72 and 63.52 USD, respectively, and their lifetime discounted QALY gained were calculated as 15.39 and 15.11, respectively. Therefore, incremental cost-effectiveness ratio (ICER) of tele-screening strategy against the competitive strategy was achieved as 161.43 USD. CONCLUSION: Tele-ROP screening program is one of the most cost-effective interventions in the Iranian health system and has a high priority to receive a budget for implementation.

A cost-minimisation analysis comparing alternative telemedicine screening approaches for retinopathy of prematurity

2021 ◽  
pp. 1357633X2097602
Author(s):  
Emmanuel Kim ◽  
Kim-Huong Nguyen ◽  
Tim Donovan ◽  
Sisira Edirippulige ◽  
Nigel R Armfield
Keyword(s):  
Health System ◽  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Current Practice ◽  
Decision Analytic Model ◽  
Activity Data ◽  
Cost Minimisation Analysis ◽  
Cost Minimisation ◽  
The Cost ◽  
Rop Screening

Introduction Screening for retinopathy of prematurity (ROP) is an important procedure in the prevention of blindness in high-risk preterm infants. In the regionalised healthcare system of Queensland (Australia), outside of the major centres, some preterm infants are cared for in special care nurseries (SCNs). When necessary, infants in these nurseries who are at risk of ROP are transferred to a tertiary hospital for screening by paediatric ophthalmologists. The transport of preterm infants for eye examinations adds risk and incurs significant costs to the health system. Using a cost-minimisation approach, we aimed to compare the costs of the current ROP screening practice with two alternative telemedicine approaches. Methods We constructed a decision analytic model to estimate costs from a health service perspective with a five-year analysis horizon; activity data from a tertiary ROP screening service were used to inform the models. The three models assessed were: (a) a digital retinal photography (DRP)-equipped travelling nurse, (b) equipping SCNs with DRP, and providing training to local nurses, and (c) current practice of infant transfer. In all cases, the tertiary centre provides specialist ophthalmologic review. Results Of the three models, we estimated the most expensive option to be equipping SCNs with DRP and providing training to local nurses (AUD$4114/infant). We found that the current practice of transferring infants was the second most expensive (AUD$1021/infant). The most economical model was the specialist nurse travelling to each SCN with a portable DRP (AUD$363/infant). A sensitivity analysis, which assessed uncertainty and variability around the cost estimates, found that the ranking for the expected costs of the alternative models of care did not change. Discussion This is the first economic and cost-minimisation analysis in Australia to compare the costs of the current screening programme with two alternative telemedicine approaches for screening ROP. Telemedicine programmes that facilitate non-physician screening may improve the cost efficiency of the health system while maintaining the health outcomes for children, and reducing the risk associated with infant transport.

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