STRUCTURAL OUTCOME OF TREATED RETINOPATHY OF PREMATURITY PATIENTS (original) (raw)
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The Early Treatment for Retinopathy Of Prematurity Study: structural findings at age 2 years
British Journal of Ophthalmology, 2006
To determine whether earlier treatment of high-risk, prethreshold retinopathy of prematurity (ROP) improves retinal structural outcome at 2 years of age. Methods: Infants with bilateral high-risk prethreshold ROP had one eye randomly assigned to treatment with peripheral retinal ablation. The fellow eye was managed conventionally, and either treated at threshold ROP or observed if threshold was never reached. In patients with asymmetrical disease, the highrisk, prethreshold eye was randomised to earlier treatment or to conventional management. At 2 years of age, children were examined comprehensively by certified ophthalmologists to determine structural outcomes for their eyes. For the purposes of this study, an unfavourable structural outcome was defined as (1) a posterior retinal fold involving the macula, (2) a retinal detachment involving the macula or (3) retrolental tissue or ''mass'' obscuring the view of the posterior pole. Results of the 2-year examination were compared with those from the 9 months examination. Results: Data were available on 339 of 374 (90.6%) surviving children. Unfavourable structural outcomes were reduced from 15.4% in conventionally managed eyes to 9.1% in earlier-treated eyes (p = 0.002) at 2 years of age. Ophthalmic side effects (excluding retinal structure) from the ROP or its treatment were similar in the earlier-treated eyes and the conventionally managed eyes. Conclusion: The benefit of earlier treatment of high-risk prethreshold ROP on retinal structure endures to 2 years of age, and is not counterbalanced by any known side effect caused by earlier intervention. Earlier treatment improves the chance for long-term favourable retinal structural outcome in eyes with high-risk prethreshold ROP. Long-term follow-up is planned to determine structural and functional outcomes at 6 years of age.
A clinical study of retinopathy of prematurity in neonates in a tertiary care hospital
International Journal of Contemporary Pediatrics, 2019
Background: Retinopathy of prematurity (ROP) is a disease process mostly reported in preterm neonates with a wide spectrum, ranging from mild, transient changes in the retina with regression to severe progressive vasoproliferation, scarring, detachment of retina and blindness. India shares 20% of the world childhood blindness. Besides congenital cataract, congenital glaucoma and ocular injuries, ROP is emerging as one of the important causes of childhood blindness in India. Methods: A cross sectional study was undertaken among all neonates born between 28-34 weeks of gestation admitted in NICU, who are under oxygen, screened for ROP. Babies with ocular disorder which interfere with fundus examination, babies who did not complete follow up till complete vascularisation of retina and babies with congenital retinal abnormalities were excluded from the study. Results: About 13.3% of male children and 18.0% of the female children had retinopathy of prematurity. Among the infants born before 30 weeks, 46.7% had retinopathy of prematurity. In the children with gestational age between 30-32 weeks, 15.4%, 8.5% in the 32-35 weeks and none among those born between more than 35 weeks. About 27.9% of the newborns with birth weight of less than 1.5kgs and 5.8% of those who had birth weight of 1.5-2.5kgs had retinopathy of prematurity. Conclusions: This study had shown a significant association of retinopathy of prematurity with the low gestational age, birth weight and oxygen therapy. Reducing subsequent post-natal risk factors depends on optimal perinatal and postnatal care, as well as adhering to strict ROP screening guidelines. Recognizing and treating ROP in a timely fashion is critical for achieving the best visual outcome.
Retinopathy of Prematurity: Incidence and Risk Factor: A Hospital Based Study
IOSR Journals , 2019
Background: Retinopathy of prematurity (ROP), which was previously called as Retrolental Fibroplasia (RFL), is a vaso-proliferative disorder of the retina. Preterm low birth weight infants are more prone for this disease those are exposed to large amount of Oxygen. Objectives: To study the incidence of ROP in preterm infants with a gestational age of ≤ 32 weeks or a birth weight of less than 1500 grams admitted to NICU for a period of 1 year. To identify the risk factor which could influence the development of ROP. Result: Out of 347 admission to NICU, 122 satisfied inclusion criteria. 20 babies developed any stage of ROP and 102 babies who did not develop ROP were termed as NON ROP. The mean birth weight among ROP was calculated 1178.70 ±309.513gm and NON ROP was1288.69±148.447gm .Overall incidence of ROP in this study was 16.39%. Statistical analysis showed Birth weight (p<0.001), Gestational age(p<0.016).Oxygen supplementation(p=0.000),Apnea(p<0.001),Sepsis(p=0.009),Anemia needing blood transfusion(p=0.0329), CPAP(P=0.000) were found risk factor for developing ROP. However Surfactant therapy, Mechanical Ventilation and Phototherapy were found insignificant. Conclusion: The timely retinal screening in high-risk preterm infants is important to prevent the development of ROP and its complications.
Retinopathy of Prematurity: Prevalence, risk factors and co- morbidities
Retinopathy of prematurity (ROP) is a disorder of retinal vasculature, characterized mainly by abnormal development of retinal vasculature and is an important and preventable cause of childhood blindness 1. It usually affects premature babies who are exposed to certain risk factors like : low gestational age, low birth weight and prolonged exposure to supplementary oxygen after delivery 2 to which it is found to be associated with. Recent advancements in neonatal care have led to an increase in the survival of low birth weight and premature infants 3 , resulting in a rise of ROP incidence 4,5. This research aims to find out various risk factors and associated comorbidities with ROP.
Outcome-based management of retinopathy of prematurity
Journal of American Association for Pediatric Ophthalmology and Strabismus, 1997
,-a and Charles J. Cooper, MS,-~ for the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity Cooperative Group Purpose:A system is presented for sequentially computing the risk of progression of retinopathy of prematurity (RO P) for infa nts born weighing not more tha n 1250 gm. A personal computer program is used to monitor infa nts' risk of threshold ROP from first appearance of ROP, and the progression in severity is tracked with multiple logistic risk models developed from data in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity. Methods:After entry of the infant's birth weight, gestational age, ethnicity, birth in the current hospital or elsewhere, single or multiple birth, and maturity zone of retinal vessels, risk of progression to threshold severity is calculated. New estimates of risk are computed at onset of ROP and prethreshold ROP (any zone I ROP, zone II stage 2+ or 3) according to the extent of retinal vascularization when ROP first appears, how rapidly ROP progresses, and how severe it is. When threshold ROP (8total or5 contiguous clock hours of stage 3+ in zone I or II)is reached, the system provides separate estimates of riskthatthe eye will have an unfavorable 3-month outcome if treated or not.Results: Estimates of risk of progression to threshold disease among the 4099 patients in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity natural history study varied from less than 1% to more than 70%. For eyes with threshold disease, the risk of an unfavorable outcome at 3 months without treatment varied from less than 10% to more than 90%.Conclusion:This method of tracking identifies infants at high riskfor severe ROP and poor structural outcome. It provides information about prognosis with a specificity heretofore impossible. (J AAPOS 1997;1:46-54) comprehensive approach to medical decision A making generally involves a wide variety of factors. Prominent among these is an evaluation of the likely outcome for the patient with or without therapy. The ophthalmologic management process for retinopathy of prematurity (ROP) requires making decisions during the course of examining premature infants, assessing an eye's prospects for requiring intervention with retinal ablative therapy, and evaluating the likelihood that such intervention will protect the posterior pole from an unfavorable outcome. The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study group has published an analysis of various risk factors that influence the chances for development of progressive ROP that may require treatment, as well as factors that can lead to poor visual or
The assessment of risk factors for retinopathy of prematurity
Medicinska istraživanja, 2015
Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants. Our study was conducted in order to determine which risk factors lead to the development of retinopathy of prematurity. This retrospective study included 108 newborns with birth weight (BW) < 1500 g and gestation age (GA) < 33 weeks, over the period of two years, who were treated at the
Retinopathy of Prematurity, A Hospital based Study
Introduction: Retinopathy of prematurity is a vasoproliferative disorder of the retina among premature infants. It is an important cause of preventable blindness in children. Recent advances in neonatal care in the last decade have improved the survival rates of premature infants, consequently the incidence of retinopathy of prematurity has increased in parallel. The objective of the present study was to identify the risk factors associated with development of ROP in preterm neonates. Material and Methods: This was a prospective observational study conducted on all preterm neonates admitted in the neonatology section of Government Medical College Srinagar who fulfilled the criteria for ROP screening. Results: A total of 150 preterm neonates were screened, out of which 32 had ROP of different stages. 7 babies were detected with stage 3 ROP and needed laser therapy. Risk factors associated with ROP were studied Conclusion: Our study revealed 21.3% incidence of ROP. Prematurity, low birth weight and oxygen therapy were found to be strong predictors of ROP. Sepsis,blood transfusion and apnea were found to be statistically significant factors associated with ROP.
Journal of Current Medical Research and Opinion, 2019
Background: Retinopathy of Prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with gestational age. ROP is a vascular retinal disease that can cause low vision or blindness. ROP is a common blinding disease in children which is becoming increasingly prevalent in the developing world. Aim: The aim of this study is to evaluate the incidence of Retinopathy of prematurity (ROP) and its association with risk factors such as low birth weight, gestational age, oxygen therapy, respiratory distress syndrome and sepsis among premature infants admitted to the Neonatal Intensive Care Unit (NICU) of Krishna Institute of Medical Sciences, Karad. Methods: Retrospective chart review of all infants admitted to the NICU between July 2017 and July 2019, who met the criteria for ROP screening: (a) ≤32 weeks of gestation, (b) ≤1.500 kg of birth weight, (c) infants with significant risk factors including sepsis, respiratory distress syndrome, or long-term oxygen use. Treatment was offered to infants with Stage III ROP disease or Stage II in Zone II with plus disease. Qualified infants were treated with argon laser photocoagulation within 48 h of diagnosis. Results : A total of 233 neonates who met the criteria were screened for ROP. Incidence of ROP was found to be 35.62% among the babies screened (n=83) majority of whom had stage 1 ROP (83.13%). Maximum incidence was seen in neonates of gestational age between 32-35 weeks (54.22%) and neonates of birth weight between 0.750 and 1.500 kg (85.54%). Other prevalent risk factors for development of ROP include Respiratory Distress Syndrome (59%) and Oxygen therapy (65%). Four neonates were found with plus disease and six neonates required laser treatment. Conclusion: The present study reflects the problem of ROP in a tertiary care centre. Prematurity, Low Birth Weight (LBW), high oxygen supplementation, respiratory distress syndrome were found to be independent risk factors in the development of ROP in neonates. Because of advancements in neonatal intensive care in developing countries and higher survival rate of premature infants, the incidence of ROP has increased. Unrecognized and untreated ROP will cause potential blindness in children. Hence, to prevent the adverse visual outcome and possible blindness; timely screening, recognition, and treatment of ROP is essential.