Retinopathy of Prematurity: A Clinical Approach

Retinopathy of prematurity (ROP), previously known as retrolental fibroplasia, was first described by Terry in 1942 (1). It is a vasoproliferative disorder that is a leading cause of childhood blindness in the United States, causing 550 new cases of infant blindness each year (2). It occurs principally in premature infants treated with high concentrations of oxygen. There are two phases of ROP: (i) an acute phase in which normal vasculogenesis is interrupted, and (ii) a chronic phase in which vascular membranes proliferate into thevitreous. This proliferation can lead to retinal detachment, scarring of the macula, and significant visual loss (3).This article summarizes the incidence, pathophysiology, and classification of ROP. Current protocols for evaluating and treating ROP, as well as long-term sequelae, are also described.

ROP REACTIVATED!

Purpose:To report a case of ROP reactivation, later in life following natural regression in infancy.Methods:Prospective study focusing on ocular presentation and outcome of long term ROP follow-up at Tertiary Hospital, India. A 12-year-old female, seen by us first at 8 years of age, with a 6-monthly follow-up with known history of bilateral ROP came with complaints of black spots. The incident occurred after 4 years of follow-up in this patient at our center.On examination, patient had (OD) falciform fold at the macula and (OS) had regressed ROP. Left eye had developed new vascular buds (vessels) along avascular arcade. FFA was done and leaks with non-perfusion areas were noted. Patient didn’t receive any treatment in the past and was on 6 monthly follow-ups.Result:Based on the clinical symptoms and signs, reactivation of ROP was suspected and FFA examination revealed filing defects and leaks. After consent, laser therapy was given to stop the progression .Visual acuity and retina remained steady during the follow-up period. Bone densitometry done on patient showed low calcium levels.Conclusion: Patients with history of ROP treatment with or without active signs should be evaluated lifelong to detect and avert vision threatening complications.Keywords: ROP, Retinopathy of prematurity, retrolental fibroplasia

International Publication Trends of Retinopathy of Prematurity Literature Over 40 Years

Purpose: The purpose of this study was to conduct a bibliometric analysis to evaluate the publication trends of retinopathy of prematurity (ROP) literature over time, focusing on geographic and economic origins. Methods: A search for indexed English abstracts was performed in PubMed using search terms “retinopathy of prematurity” or “retrolental fibroplasia” from 1976 to 2015 and divided into 4 decades. Original research articles involving humans were included. Countries were grouped into high-, middle-, and low-income groups using World Bank criteria, and impact factors (IFs) were gathered from 2014 Thomson Reuters Journal Citation Reports. Results: A total of 5425 publications were identified, of which 2045 met the inclusion criteria. The ratios of publications per decade increased over time: 1976 to 1985 (5.4%), 1986 to 1995 (15.8%), 1996 to 2005 (25%), 2006 to 2015 (53.7%; Pearson r = .93, 95% confidence interval: 0.87-0.96). The rates of publications by income group were high—(82.2%), middle—(17.7%), and low—(0.1%). Respective mean (standard deviation) IFs by income group were 2.79 (4.87), 1.23 (1.17), and 0.42 (0.45). Top producing countries were the United States (37%), the United Kingdom (6.7%), India (4.6%), Japan (3.9%), and Turkey (3.5%). There was a significant difference between the time distribution of publications between high- and middle-income groups, where the latter has produced increasing publications in recent years ( P < .001), but in journals with lower IFs overall ( P < .001). Conclusions: Publications regarding ROP are increasing in number. Investigators from middle-income countries are increasingly contributing to the ROP literature but, overall, may not be recognized yet in journals with high IFs.