AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Seco...AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children’s Hospital were included.Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively.Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction,which was compared with WINROP model and Digirop-Birth model.RESULTS:Infants from the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University(n=478)were randomly allocated into training(n=402)and internal validation group(n=76).Infants from Taizhou Women and Children’s Hospital were set as external validation group(n=76).Severe ROP were found in 52 of 402 infants,12 of 76 infants,and 7 of 76 infants in training group,internal validation group,and external validation group,respectively.Birth weight[odds ratio(OR),0.997;95%confidence interval(CI),0.996-0.999;P<0.001],multiple births(OR,1.885;95%CI,1.013-3.506;P=0.045),and non-invasive ventilation(OR,0.288;95%CI,0.146-0.570;P<0.001)were identified as predictive factors for the prediction of severe ROP,by univariate analysis and multivariate analysis.For predicting severe ROP based on the internal validation group,the areas under receiver operating characteristic curve(AUC)was 78.1(95%CI,64.2-92.0)for the nomogram,32.9(95%CI,15.3-50.5)for WINROP model,70.2(95%CI,55.8-84.6)for Digirop-Birth model.In external validation group,AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model(80.2 versus 51.1 and 63.4).The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model.The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability.CONCLUSION:Birth weight,multiple births,and noninvasive ventilation are independent predictors of severe ROP.The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.展开更多
AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematur...AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity(ROP)at our center were retrospectively reviewed between April 1,2016 and December 31,2017.Patient demographics,the side of ROP,multiple gestations,Apgar scores,zone,stage,plus disease,postmenstrual age at injection,surfactant therapy,blood transfusion therapy,hemorrhage before IVR,hemorrhage after IVR,gestational diabetes mellitus,pregnancy-induced hypertension,anemia,intraventricular hemorrhage,sepsis,respiratory distress syndrome,carbohemia,and congenital heart defects were recorded.Adjusted hazard ratios(HRs)and 95%confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.RESULTS:Of the 33 eyes,12(36.4%)had ROP recurrences 45.3(5.1,50.9)mo after initial IVR treatments.The independent risk factors for ROP recurrences were zone(ⅡvsⅠ,HR:0.056,P=0.003)and gestational diabetes mellitus(no vs yes,HR:0.095,P<0.001).The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR(0.13,0.70)at 55.0(51.0,58.9)mo after the initial IVR treatment.The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR(0.19,0.63)at 48.0(43.8,58.4)mo after the initial IVR treatment.CONCLUSION:Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zoneⅠand gestational diabetes mellitus are identified,and the mean uncorrected visual acuity is 0.46 logMAR at 51.0(44.0,58.9)mo.The findings of this study are important for followup management and for improving the visual function of ROP patients.展开更多
Retinopathy of prematurity(ROP)is a kind of disease that can be seen in premature infants.It may cause a series of short-and longterm complications such as poor vision in premature infants,causing irreversible damage ...Retinopathy of prematurity(ROP)is a kind of disease that can be seen in premature infants.It may cause a series of short-and longterm complications such as poor vision in premature infants,causing irreversible damage to them.Therefore,if we can prevent this disease,we can solve the above problems.This study summarized some factors that influence ROP,such as low gestational age,low birth weight,irrational oxygen use,anemia,blood transfusion,and thrombocytopenia;and also summarized a series of interventions that can prevent or delay the progression of ROP,such as reducing blood transfusion,the application of antenatal corticosteroids,and delaying clip umbilical cord,which can provide some reference for better clinical practice of preventing ROP.展开更多
BACKGROUND Intravitreal anti-vascular endothelial growth factor(IVA)injection is known to cause contraction of fibrovascular proliferation(FVP),when present in severe retinopathy of prematurity(ROP).AIM To assess the ...BACKGROUND Intravitreal anti-vascular endothelial growth factor(IVA)injection is known to cause contraction of fibrovascular proliferation(FVP),when present in severe retinopathy of prematurity(ROP).AIM To assess the structural outcomes of IVA injection in the treatment of severe posterior ROP with significant FVP.METHODS It was a retrospective study in which 36 eyes of 18 preterm babies who developed>4 clock hours of FVP in zone I or posterior zone II,were treated with either intravitreal 0.625 mg bevacizumab or intravitreal 0.2 mg of ranibizumab.Favorable structural outcome included resolution of plus disease and FVP without the development of tractional retinal detachment.Secondary outcome measure included either full retinal maturation at follow-up or development of recurrent disease requiring additional treatment.Adverse outcomes included progression to retinal detachment.RESULTS The mean gestational age of the 18 preterm babies was 30 wk(range 27-36),and mean birth weight was 1319 g(range 650-1980 g).Mean post-menstrual age(PMA)at the time of primary treatment was 35.5 wk(range 31-41 wk).All eyes showed regression of plus disease and FVP.5 eyes of 3 babies showed reactivation of disease and were treated with repeat IVA(n=2 eyes)or peripheral laser photocoagulation(n=3 eyes)respectively.16 out of 36(44%)reached retinal vascular maturation at final follow up at 5 years.CONCLUSION There was good resolution of severe posterior ROP with FVP with IVA,with retinal maturity of 44%at 5 year follow-up and a reactivation rate of 13.8%.When the IVA injection is given prior to 37 wk PMA,while disease is in phase 2,it is less likely to cause contracture of pre-existing FVP.展开更多
Retinopathy of prematurity(ROP)is the leading cause of preventable infant blindness in the world and predominantly affects babies who are born low birth weight and premature.India has the largest number of surviving p...Retinopathy of prematurity(ROP)is the leading cause of preventable infant blindness in the world and predominantly affects babies who are born low birth weight and premature.India has the largest number of surviving preterm births born annually.ROP blindness can be largely prevented if there is a robust screening program which detects treatment requiring disease in time.ROP treatment must be provided within 48 h of reaching this threshold of treatment making it a relative emergency.During the severe acute respiratory syndromecoronavirus disease 2019 pandemic in 2020 ROP screening was disrupted throughout the world due to lockdowns and restriction of movement of these infants,their families,specialists and healthcare workers.The Indian ROP Society issued guidelines for ROP screening and treatment in March 2020,which was aimed at preserving the chain-of-care despite the potential limitations and hazards during the(ongoing)pandemic.This preferred practice guideline is summarized in this manuscript.展开更多
Successful management of a case of aggressive posterior retinopathy of prematurity(APROP)poorly responsive to laser therapy with intravitreal bevacizumab(IVB)is discussed.IVB is useful as rescue therapy in such cases,...Successful management of a case of aggressive posterior retinopathy of prematurity(APROP)poorly responsive to laser therapy with intravitreal bevacizumab(IVB)is discussed.IVB is useful as rescue therapy in such cases,if given within the correct window period post laser therapy.展开更多
Retinopathy of prematurity (ROP), a retinal vascular disease of premature infants, continues to be a major cause of preventable childhood blindness all over the world. The incidence of ROP varies among countries, bein...Retinopathy of prematurity (ROP), a retinal vascular disease of premature infants, continues to be a major cause of preventable childhood blindness all over the world. The incidence of ROP varies among countries, being influenced by the quality of the level of neonatal intensive care. Here, we discuss the potential treatments that are now available or will soon or probably be available for ROP. Although ablation of the avascular retina with laser photocoagulation remains the current gold standard and well established therapy for ROP, some new therapeutic options including angiostatic therapies are being explored based on our knowledge of the pathophysiology of the ROP and complications and efficacy of laser treatment. However, prevention of the development of severe ROP and screening for ROP seem to be the best strategy in avoiding visual impairment caused by ROP in premature infants. New therapeutic interventions including vascular endothelial growth factor antibody administration, gene therapy and supplemental therapies should be supported with evidence-based data for the treatment of ROP.展开更多
AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observation...AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.展开更多
AIM:To evaluate the incidence of spontaneous regression of changes in the retina and vitreous in active stage of retinopathy of prematurity(ROP) and identify the possible relative factors during the regression.·M...AIM:To evaluate the incidence of spontaneous regression of changes in the retina and vitreous in active stage of retinopathy of prematurity(ROP) and identify the possible relative factors during the regression.·METHODS:This was a retrospective,hospital-based study.The study consisted of 39 premature infants with mild ROP showed spontaneous regression(Group A) and17 with severe ROP who had been treated before naturally involuting(Group B) from August 2008 through May 2011.Data on gender,single or multiple pregnancy,gestational age,birth weight,weight gain from birth to the sixth week of life,use of oxygen in mechanical ventilation,total duration of oxygen inhalation,surfactant given or not,need for and times of blood transfusion,1,5,10-min Apgar score,presence of bacterial or fungal or combined infection,hyaline membrane disease(HMD),patent ductus arteriosus(PDA),duration of stay in theneonatal intensive care unit(NICU) and duration of ROP were recorded.·RESULTS:The incidence of spontaneous regression of ROP with stage 1 was 86.7%,and with stage 2,stage 3was 57.1%,5.9%,respectively.With changes in zone Ⅲregression was detected 100%,in zone Ⅱ 46.2% and in zone Ⅰ 0%.The mean duration of ROP in spontaneous regression group was 5.65±3.14 weeks,lower than that of the treated ROP group(7.34 ±4.33 weeks),but this difference was not statistically significant(P =0.201).GA,1min Apgar score,5min Apgar score,duration of NICU stay,postnatal age of initial screening and oxygen therapy longer than 10 days were significant predictive factors for the spontaneous regression of ROP(P <0.05).Retinal hemorrhage was the only independent predictive factor the spontaneous regression of ROP(OR 0.030,95%CI 0.001-0.775,P =0.035).·CONCLUSION:This study showed most stage 1 and 2ROP and changes in zone Ⅲ can spontaneously regression in the end.Retinal hemorrhage is weakly inversely associated with the spontaneous regression.展开更多
Retinopathy of prematurity(ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of pr...Retinopathy of prematurity(ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940 s and 1950 s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP.展开更多
· AIM: To analyze the incidence and risk factors for retinopathy of prematurity (ROP). · METHODS: A retrospective analysis was conducted on 568 premature infants from September 2005 to December 2010 with bir...· AIM: To analyze the incidence and risk factors for retinopathy of prematurity (ROP). · METHODS: A retrospective analysis was conducted on 568 premature infants from September 2005 to December 2010 with birth weight(BW) equal to or less than 2 500g or a gestational age(GA) at birth of 34 weeks or less. All of the members were examined by indirect binocular ophthalmoscopy. · RESULTS: ROP occurred with an incidence rate of 10.7% among 568 premature infants, and stages 3 and above ROP occurred with an incidence rate of 2.5%. This study showed the infants were more prone to develop ROP with short geststional age, low BW, long time of oxygen inhalation, and severe infants diseases. Twins had a significantly higher rate of ROP(18.3%) than singleton babies(9.8%), ROP were severer in twins than singleton babies . · CONCLUSION: Short GA, low BW, long time of oxygen inhalation, severe infants diseases, and non-singleton babies were the most significant risk factors associated with ROP. ·展开更多
Retinopathy of prematurity(ROP) is a retinal vascular disorder frequently found in premature infants.Different therapeutic strategies have been developed to treat ROP.However,there are still many children with ROP suf...Retinopathy of prematurity(ROP) is a retinal vascular disorder frequently found in premature infants.Different therapeutic strategies have been developed to treat ROP.However,there are still many children with ROP suffering by severe limitations in vision or even blindness.Recently,ROP has been suggested to be caused by abnormal development of the retinal vasculature,but not simply resulted by retinal neovascularization which takes about 4 to 6 wk after birth in premature infants.Thus,instead of focusing on how to reduce retinal neovascularization,understanding the pathological changes and mechanisms that occur prior to retinal neovascularization is meaningful,which may lead to identify novel target(s) for the development of novel strategy to promote the healthy growth of retinal blood vessels rather than passively waiting for the appearance of retinal neovascularization and removing it by force.In this review,we discussed recent studies about,1) the pathogenesis prior to retinal neovascularization in oxygen-induced retinopathy(OIR;a ROP in animal model) and in premature infants with ROP;2) the preclinical and clinical research on preventive treatment of early OIR and ROP.We will not only highlight the importance of the mechanisms and signalling pathways in regulating early stage of ROP but also will provide guidance for actively exploring novel mechanisms and discovering novel treatments for early phase OIR and ROP prior to retinal neovascularization in the future.展开更多
AIM: To describe the involution patterns of vessel growth of retina through fluorescein angiography(FA) of children, who had been under treatment up to 1 y previously intravitreal ranibizumab(IVR) as monotherapy for r...AIM: To describe the involution patterns of vessel growth of retina through fluorescein angiography(FA) of children, who had been under treatment up to 1 y previously intravitreal ranibizumab(IVR) as monotherapy for retinopathy of prematurity(ROP). METHODS: This is a retrospective study. The medical information and FA of 17 children(34 eyes) whose area of avascular retina from the ora serrata was more than two disc diameters(DD) were analyzed. RESULTS: Among 34 eyes, all were the presence of finger-shaped vessels and arteriolar-venular shunts(100%,34/34 eyes). Popcorn abnormalities were found in most of the eyes(94.1%, 32/34 eyes). Furthermore, in many cases(23.5%, 8/34 eyes), there were leakage persisting in the region of the junction between avascular and vascular retina. In contrast, just 2 eyes(5.9%) showed damage of retinal capillary bed and 3 eyes(8.8%) showed large area of retinal pigment epithelium(RPE) atrophy. CONCLUSION: Although IVR can be very effective in ROP, we should remain cautious as infants may remain avascular peripheral retinas and abnormal vessel. FA allows accurate visualization of vessel abnormalities in eyes with ROP, which will be helpful to affect assessment of disease activity and therapeutic effect.展开更多
AIM: To estimate the potential systemic events during and after retinopathy of prematurity(ROP) screening.METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological ...AIM: To estimate the potential systemic events during and after retinopathy of prematurity(ROP) screening.METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24 h before, during, and 72 h after ROP screening. Control blood pressure(BP), saturation,pulse rate, and body temperature were routinely taken at various time internals before and after screening.Adverse effects pertain to cardiovascular system,respiratory system, gastric system, urinary system and nervous system were retrospect 0-72 h after ROP screening at a 24-hour interval.RESULTS: Totally 1254 prematurity babies receiving ROP screening during Jan. 1^(st) 2013 to Dec. 31^(th) 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg(P =0.04) after 3 doses of mydriatic drops.Immediately after the examination, there was a further 12. 64 mm Hg( P < 0. 01) increase in systolic BP and a 7.24 mm Hg(P <0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm(P <0.01) higher than the 133.3 ±9.0 bpm control level. The oxygen saturation shared an average drop of 5%(P <0.01) during screening. In prematurity with postconceptional age less than 31 wk, the incidence of apnea(23.5%), necrotizing enterocolitis(NEC)(8.7%), gastric residual(25.4%) and upper digestive tract hemorrhage(6.4%) also demonstrated a significant rise(P <0.01).CONCLUSION: In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.展开更多
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 end...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 twentynine 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 70 mo after the treatments.展开更多
· AIM: As a result of the increase in premature births and the advances in neonatal intensive care, retinopathy of prematurity (ROP) remains one of the most important causes of childhood blindness worldwide. The ...· AIM: As a result of the increase in premature births and the advances in neonatal intensive care, retinopathy of prematurity (ROP) remains one of the most important causes of childhood blindness worldwide. The main factors in the development of ROP are gestational age, birth weight and oxygen therapy. ROP continues to gain importance due to the increasing survival rates of more immature babies. · METHODS: Between January 2007 and October 2008, 203 premature infants treated at the Neonatal Intensive Care Unit (NNICU) were prospectively enrolled and the relationship between known risk factors and the occurance of ROP was studied. · RESULTS: ROP in various stages developed in 86 cases (42.4%). Statistically significant correlations were found between the development of ROP and birth weight (P < 0.0001) gestational age (P <0.0001), oxygen treatment and its duration (P <0.0001 and P =0.002), mechanical ventilation (MV) and its duration (P =0,0001 and P =0.0001), apnea(P = 0.001), intraventricular hemorrhage (IVH) (P =0.046), sepsis (P =0.0001), use of erythropoietin (EPO) (P =0.003), the number of blood transfusions and frequency (P =0.0001 and P =0.0001), surfactant application (P =0.0001), the presence of patent ductus arteriosus (PDA) (P =0.001) or bronchopu- lmonary dysplasia (BPD) (P =0.0001). No significant correlations were found between the occurance of ROP and maternal pre-eclampsia (P =0.293), multiple pregnancy (P = 0.218), or hyperbilirubinemia (P =0.494). Severity of ROP was related significantly with birth weight (P =0.0001), but no significant correlation between severity of ROP and gestational age was present. · CONCLUSION: Early description and reduction of the risk factors related with the occurance of ROP with the help of routine screening programs may warrant the prevention of visual loss, however early ophthalmic diagnosis and treatment are still mandatory to provide better visual rehabilitation. ·展开更多
AIM:To report the changes in detection rate and characteristics of retinopathy of prematurity(ROP)in infants,during a 12-year period in Northwest China.METHODS:The medical records of infants were retrospectively colle...AIM:To report the changes in detection rate and characteristics of retinopathy of prematurity(ROP)in infants,during a 12-year period in Northwest China.METHODS:The medical records of infants were retrospectively collected and reviewed using an established clinical database.The detection rate and severity of ROP were compared between two consecutive periods(P1:2008-2013,P2:2014-2019).Gender,gestational age(GA),birth weight(BW),multiple births,delivery pattern,and postmenstrual age of the first fundus screen were analyzed in all visiting infants.RESULTS:During the 12-year study period,7832 infants were initially included;among them,1266(16.16%)were diagnosed with ROP,441 of whom(5.63%)developed severe ROP.Throughout the study period,the total number of infants being screened showed a trend of slight fluctuation after a rapid increase;however,an annual increase was observed in the number of infants diagnosed with ROP and severe ROP.The proportion of each stage at the first screening of infants with ROP was stable.The detection rate of ROP increased from 2.33%in 2008 to 16.18%in 2010,decreased to 10.73%in 2014,and then increased to 27.47%in 2019.For severe ROP,the detection rate gradually increased from 0 in 2008 to 12.49%in 2019.Among the infants with ROP,96(7.58%)did not meet the screening criteria set by the Chinese Medical Association in 2014(GA<32wk,or BW<2000 g);among them,14(1.11%)needed treatment because of severe ROP.CONCLUSION:From 2008 to 2019,the detection rates of ROP and severe ROP in infants screened in Northwest China were 16.16%and 5.63%,respectively.The characteristics of the ROP infants were similar to those in other middle-income regions.The"tertiary prevention network of ROP"is a potentially effective screening approach.展开更多
AIM: To evaluate the effect of intravitreal ranibizumab injection for retinopathy of prematurity(ROP) in Zone Ⅱ Stage 3^+.METHODS: Data was collected for ROP patients with Zone Ⅱ Stage 3^+ who received intravitreal ...AIM: To evaluate the effect of intravitreal ranibizumab injection for retinopathy of prematurity(ROP) in Zone Ⅱ Stage 3^+.METHODS: Data was collected for ROP patients with Zone Ⅱ Stage 3^+ who received intravitreal ranibizumab injections between October 2014 and Janu ary 2017 at the Department of Ophthalmology in our hospital. No prior laser or other intravitreal treatment was done. Prior to the intervention and at each follow-up visit, fundus examination was performed. Gestational age at birth, sex, birth weight, ROP zone, ROP stage, post menstrual age(PMA) at treatment, and follow-up pe riod were recorded. The final clinical status of the retina was evaluated for each patient. The primary outcome mea sures included ROP recurrences requiring re-treatment, complete or incomplete peripheral vascularization.RESULTS: Eighty-six eyes of 46 premature infants with Zone Ⅱ Stage 3^+ ROP were enrolled in the study. The mean gestational age at birth was 28.18±1.67(range: 25 to 33)wk and the mean birth weight was 1070.57±226.85(range: 720.00 to 1650.00) g. The mean PMA at treatment was 38.32±2.99(range: 32.29 to 46.00)wk. Seventy-one eyes(82.56%) were treated success fully with intravitreal ranibizumab as monotherapy. Fifteen eyes(17.44%) developed recurrent disease. The mean interval between the treatment and retreatment was 5.96±3.22(range: 1.86 to 11.71)wk. All eyes vascularized into zone Ⅲ at the end of the study and among them 62 eyes(72.09%) achieved complete vascu larization.CONCLUSION: Intravitreal ranibizumab injection is an effective treatment in Zone Ⅱ Stage 3^+ ROP patients. More patients with longer follow-up duration are necessary to confirm the safety and efficacy of this treatment.展开更多
AIM: To investigate common polymorphisms in VEGF, ACE, TNF and GST genes with retinopathy of prematurity(ROP) risk among Chinese infants. METHODS: Nine polymorphisms in the above genes were genotyped on 724 advanced c...AIM: To investigate common polymorphisms in VEGF, ACE, TNF and GST genes with retinopathy of prematurity(ROP) risk among Chinese infants. METHODS: Nine polymorphisms in the above genes were genotyped on 724 advanced cases of ROP and 878 prematurely-born infants of low birth weight who were without any ophthalmologic disease. The frequencies of the polymorphisms were compared between cases and controls to identify the association present, if any. RESULTS: Of the nine polymorphisms, only two showed significant associations: ACE insertion deletion(ID) polymorphism(P=0.031) and TNF-308 G/A polymorphism(P<0.001). The former was associated with a reduced ROP risk [ID genotype, adjusted OR(aOR): 0.603, 95%CI: 0.427-0.893, P=0.034; DD genotype, aOR: 0.468, 95%CI: 0.229-0.626, P=0.002], while the latter showed an increased risk(GA genotype, aOR: 1.956, 95%CI: 1.396-2.465, P<0.001; AA genotype, aOR: 2.809, 95%CI: 1.802-4.484, P<0.001). The association was also noted at the allele level(ACE D allele a OR: 0.698, 95%CI: 0.294-0.883, P<0.001; TNF-308A allele a OR: 1.776, 95%CI: 1.446-2.561, P<0.001). CONCLUSION: The ACE ID polymorphism can protect against ROP development while the TNF-308G/A can increase the risk of the disease among Chinese infants.展开更多
AIM:To investigate the ratio of spontaneous regression of retinopathy of prematurity(ROP)and to explore the possible relevant predictive factors.METHODS:A retrospective review of 405 infants who were diagnosed with RO...AIM:To investigate the ratio of spontaneous regression of retinopathy of prematurity(ROP)and to explore the possible relevant predictive factors.METHODS:A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected.Stage,zone,and duration of ROP were recorded.Statistical analysis was performed on 51 possible predictive factors.RESULTS:Totally 356 infants showed spontaneous regression.The incidence was 100%,95.3%,and 22.7%in stage 1,2,and 3,respectively.The 13.4%of the ROP with plus disease eventually resolved spontaneously.All affected eyes of aggressive posterior retinopathy of prematurity(APROP)failed to spontaneously regress.The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP.Days of mechanical ventilation(OR=0.981,95%CI,0.965-0.997,P=0.021),retinal hemorrhage(OR=0.173,95%CI,0.064-0.470,P=0.001),delivery pattern(OR=2.750,95%CI,1.132-6.681,P=0.025),maternal anemia in pregnancy(OR=0.142,95%CI,0.036-0.563,P=0.005),the stages(at initial diagnosis OR=0.183,95%CI,0.041-0.816,P=0.026;at final diagnosis OR=0.031,95%CI,0.006-0.167,P<0.001),and with plus disease or not(OR=0.005,95%CI,0.001-0.031,P<0.001)were independent predictive factors of the spontaneous regression of ROP.CONCLUSION:Most mild ROP can spontaneously resolve.Active treatment is still recommended for stage 3 ROP,zone I ROP,AP-ROP,and ROP with plus disease.Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution.The pattern of delivery and the mother's anemia during pregnancy can also affect the prognosis of ROP.展开更多
基金Supported by Wenzhou Science and Technology Project(No.Y20190173).
文摘AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children’s Hospital were included.Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively.Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction,which was compared with WINROP model and Digirop-Birth model.RESULTS:Infants from the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University(n=478)were randomly allocated into training(n=402)and internal validation group(n=76).Infants from Taizhou Women and Children’s Hospital were set as external validation group(n=76).Severe ROP were found in 52 of 402 infants,12 of 76 infants,and 7 of 76 infants in training group,internal validation group,and external validation group,respectively.Birth weight[odds ratio(OR),0.997;95%confidence interval(CI),0.996-0.999;P<0.001],multiple births(OR,1.885;95%CI,1.013-3.506;P=0.045),and non-invasive ventilation(OR,0.288;95%CI,0.146-0.570;P<0.001)were identified as predictive factors for the prediction of severe ROP,by univariate analysis and multivariate analysis.For predicting severe ROP based on the internal validation group,the areas under receiver operating characteristic curve(AUC)was 78.1(95%CI,64.2-92.0)for the nomogram,32.9(95%CI,15.3-50.5)for WINROP model,70.2(95%CI,55.8-84.6)for Digirop-Birth model.In external validation group,AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model(80.2 versus 51.1 and 63.4).The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model.The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability.CONCLUSION:Birth weight,multiple births,and noninvasive ventilation are independent predictors of severe ROP.The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.
文摘AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity(ROP)at our center were retrospectively reviewed between April 1,2016 and December 31,2017.Patient demographics,the side of ROP,multiple gestations,Apgar scores,zone,stage,plus disease,postmenstrual age at injection,surfactant therapy,blood transfusion therapy,hemorrhage before IVR,hemorrhage after IVR,gestational diabetes mellitus,pregnancy-induced hypertension,anemia,intraventricular hemorrhage,sepsis,respiratory distress syndrome,carbohemia,and congenital heart defects were recorded.Adjusted hazard ratios(HRs)and 95%confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.RESULTS:Of the 33 eyes,12(36.4%)had ROP recurrences 45.3(5.1,50.9)mo after initial IVR treatments.The independent risk factors for ROP recurrences were zone(ⅡvsⅠ,HR:0.056,P=0.003)and gestational diabetes mellitus(no vs yes,HR:0.095,P<0.001).The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR(0.13,0.70)at 55.0(51.0,58.9)mo after the initial IVR treatment.The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR(0.19,0.63)at 48.0(43.8,58.4)mo after the initial IVR treatment.CONCLUSION:Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zoneⅠand gestational diabetes mellitus are identified,and the mean uncorrected visual acuity is 0.46 logMAR at 51.0(44.0,58.9)mo.The findings of this study are important for followup management and for improving the visual function of ROP patients.
文摘Retinopathy of prematurity(ROP)is a kind of disease that can be seen in premature infants.It may cause a series of short-and longterm complications such as poor vision in premature infants,causing irreversible damage to them.Therefore,if we can prevent this disease,we can solve the above problems.This study summarized some factors that influence ROP,such as low gestational age,low birth weight,irrational oxygen use,anemia,blood transfusion,and thrombocytopenia;and also summarized a series of interventions that can prevent or delay the progression of ROP,such as reducing blood transfusion,the application of antenatal corticosteroids,and delaying clip umbilical cord,which can provide some reference for better clinical practice of preventing ROP.
文摘BACKGROUND Intravitreal anti-vascular endothelial growth factor(IVA)injection is known to cause contraction of fibrovascular proliferation(FVP),when present in severe retinopathy of prematurity(ROP).AIM To assess the structural outcomes of IVA injection in the treatment of severe posterior ROP with significant FVP.METHODS It was a retrospective study in which 36 eyes of 18 preterm babies who developed>4 clock hours of FVP in zone I or posterior zone II,were treated with either intravitreal 0.625 mg bevacizumab or intravitreal 0.2 mg of ranibizumab.Favorable structural outcome included resolution of plus disease and FVP without the development of tractional retinal detachment.Secondary outcome measure included either full retinal maturation at follow-up or development of recurrent disease requiring additional treatment.Adverse outcomes included progression to retinal detachment.RESULTS The mean gestational age of the 18 preterm babies was 30 wk(range 27-36),and mean birth weight was 1319 g(range 650-1980 g).Mean post-menstrual age(PMA)at the time of primary treatment was 35.5 wk(range 31-41 wk).All eyes showed regression of plus disease and FVP.5 eyes of 3 babies showed reactivation of disease and were treated with repeat IVA(n=2 eyes)or peripheral laser photocoagulation(n=3 eyes)respectively.16 out of 36(44%)reached retinal vascular maturation at final follow up at 5 years.CONCLUSION There was good resolution of severe posterior ROP with FVP with IVA,with retinal maturity of 44%at 5 year follow-up and a reactivation rate of 13.8%.When the IVA injection is given prior to 37 wk PMA,while disease is in phase 2,it is less likely to cause contracture of pre-existing FVP.
文摘Retinopathy of prematurity(ROP)is the leading cause of preventable infant blindness in the world and predominantly affects babies who are born low birth weight and premature.India has the largest number of surviving preterm births born annually.ROP blindness can be largely prevented if there is a robust screening program which detects treatment requiring disease in time.ROP treatment must be provided within 48 h of reaching this threshold of treatment making it a relative emergency.During the severe acute respiratory syndromecoronavirus disease 2019 pandemic in 2020 ROP screening was disrupted throughout the world due to lockdowns and restriction of movement of these infants,their families,specialists and healthcare workers.The Indian ROP Society issued guidelines for ROP screening and treatment in March 2020,which was aimed at preserving the chain-of-care despite the potential limitations and hazards during the(ongoing)pandemic.This preferred practice guideline is summarized in this manuscript.
文摘Successful management of a case of aggressive posterior retinopathy of prematurity(APROP)poorly responsive to laser therapy with intravitreal bevacizumab(IVB)is discussed.IVB is useful as rescue therapy in such cases,if given within the correct window period post laser therapy.
文摘Retinopathy of prematurity (ROP), a retinal vascular disease of premature infants, continues to be a major cause of preventable childhood blindness all over the world. The incidence of ROP varies among countries, being influenced by the quality of the level of neonatal intensive care. Here, we discuss the potential treatments that are now available or will soon or probably be available for ROP. Although ablation of the avascular retina with laser photocoagulation remains the current gold standard and well established therapy for ROP, some new therapeutic options including angiostatic therapies are being explored based on our knowledge of the pathophysiology of the ROP and complications and efficacy of laser treatment. However, prevention of the development of severe ROP and screening for ROP seem to be the best strategy in avoiding visual impairment caused by ROP in premature infants. New therapeutic interventions including vascular endothelial growth factor antibody administration, gene therapy and supplemental therapies should be supported with evidence-based data for the treatment of ROP.
文摘AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.
基金Guangdong Provincial Science and Technology Projects,China (No.2011B031800105)
文摘AIM:To evaluate the incidence of spontaneous regression of changes in the retina and vitreous in active stage of retinopathy of prematurity(ROP) and identify the possible relative factors during the regression.·METHODS:This was a retrospective,hospital-based study.The study consisted of 39 premature infants with mild ROP showed spontaneous regression(Group A) and17 with severe ROP who had been treated before naturally involuting(Group B) from August 2008 through May 2011.Data on gender,single or multiple pregnancy,gestational age,birth weight,weight gain from birth to the sixth week of life,use of oxygen in mechanical ventilation,total duration of oxygen inhalation,surfactant given or not,need for and times of blood transfusion,1,5,10-min Apgar score,presence of bacterial or fungal or combined infection,hyaline membrane disease(HMD),patent ductus arteriosus(PDA),duration of stay in theneonatal intensive care unit(NICU) and duration of ROP were recorded.·RESULTS:The incidence of spontaneous regression of ROP with stage 1 was 86.7%,and with stage 2,stage 3was 57.1%,5.9%,respectively.With changes in zone Ⅲregression was detected 100%,in zone Ⅱ 46.2% and in zone Ⅰ 0%.The mean duration of ROP in spontaneous regression group was 5.65±3.14 weeks,lower than that of the treated ROP group(7.34 ±4.33 weeks),but this difference was not statistically significant(P =0.201).GA,1min Apgar score,5min Apgar score,duration of NICU stay,postnatal age of initial screening and oxygen therapy longer than 10 days were significant predictive factors for the spontaneous regression of ROP(P <0.05).Retinal hemorrhage was the only independent predictive factor the spontaneous regression of ROP(OR 0.030,95%CI 0.001-0.775,P =0.035).·CONCLUSION:This study showed most stage 1 and 2ROP and changes in zone Ⅲ can spontaneously regression in the end.Retinal hemorrhage is weakly inversely associated with the spontaneous regression.
文摘Retinopathy of prematurity(ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940 s and 1950 s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP.
文摘· AIM: To analyze the incidence and risk factors for retinopathy of prematurity (ROP). · METHODS: A retrospective analysis was conducted on 568 premature infants from September 2005 to December 2010 with birth weight(BW) equal to or less than 2 500g or a gestational age(GA) at birth of 34 weeks or less. All of the members were examined by indirect binocular ophthalmoscopy. · RESULTS: ROP occurred with an incidence rate of 10.7% among 568 premature infants, and stages 3 and above ROP occurred with an incidence rate of 2.5%. This study showed the infants were more prone to develop ROP with short geststional age, low BW, long time of oxygen inhalation, and severe infants diseases. Twins had a significantly higher rate of ROP(18.3%) than singleton babies(9.8%), ROP were severer in twins than singleton babies . · CONCLUSION: Short GA, low BW, long time of oxygen inhalation, severe infants diseases, and non-singleton babies were the most significant risk factors associated with ROP. ·
基金Supported by the National Natural Science Foundation of China(No.81570873)the Science and Technology Department of Shaanxi Province(No.2015JM8481)
文摘Retinopathy of prematurity(ROP) is a retinal vascular disorder frequently found in premature infants.Different therapeutic strategies have been developed to treat ROP.However,there are still many children with ROP suffering by severe limitations in vision or even blindness.Recently,ROP has been suggested to be caused by abnormal development of the retinal vasculature,but not simply resulted by retinal neovascularization which takes about 4 to 6 wk after birth in premature infants.Thus,instead of focusing on how to reduce retinal neovascularization,understanding the pathological changes and mechanisms that occur prior to retinal neovascularization is meaningful,which may lead to identify novel target(s) for the development of novel strategy to promote the healthy growth of retinal blood vessels rather than passively waiting for the appearance of retinal neovascularization and removing it by force.In this review,we discussed recent studies about,1) the pathogenesis prior to retinal neovascularization in oxygen-induced retinopathy(OIR;a ROP in animal model) and in premature infants with ROP;2) the preclinical and clinical research on preventive treatment of early OIR and ROP.We will not only highlight the importance of the mechanisms and signalling pathways in regulating early stage of ROP but also will provide guidance for actively exploring novel mechanisms and discovering novel treatments for early phase OIR and ROP prior to retinal neovascularization in the future.
文摘AIM: To describe the involution patterns of vessel growth of retina through fluorescein angiography(FA) of children, who had been under treatment up to 1 y previously intravitreal ranibizumab(IVR) as monotherapy for retinopathy of prematurity(ROP). METHODS: This is a retrospective study. The medical information and FA of 17 children(34 eyes) whose area of avascular retina from the ora serrata was more than two disc diameters(DD) were analyzed. RESULTS: Among 34 eyes, all were the presence of finger-shaped vessels and arteriolar-venular shunts(100%,34/34 eyes). Popcorn abnormalities were found in most of the eyes(94.1%, 32/34 eyes). Furthermore, in many cases(23.5%, 8/34 eyes), there were leakage persisting in the region of the junction between avascular and vascular retina. In contrast, just 2 eyes(5.9%) showed damage of retinal capillary bed and 3 eyes(8.8%) showed large area of retinal pigment epithelium(RPE) atrophy. CONCLUSION: Although IVR can be very effective in ROP, we should remain cautious as infants may remain avascular peripheral retinas and abnormal vessel. FA allows accurate visualization of vessel abnormalities in eyes with ROP, which will be helpful to affect assessment of disease activity and therapeutic effect.
基金Supported by the National Natural Science Foundation of China(No.71173055)
文摘AIM: To estimate the potential systemic events during and after retinopathy of prematurity(ROP) screening.METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24 h before, during, and 72 h after ROP screening. Control blood pressure(BP), saturation,pulse rate, and body temperature were routinely taken at various time internals before and after screening.Adverse effects pertain to cardiovascular system,respiratory system, gastric system, urinary system and nervous system were retrospect 0-72 h after ROP screening at a 24-hour interval.RESULTS: Totally 1254 prematurity babies receiving ROP screening during Jan. 1^(st) 2013 to Dec. 31^(th) 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg(P =0.04) after 3 doses of mydriatic drops.Immediately after the examination, there was a further 12. 64 mm Hg( P < 0. 01) increase in systolic BP and a 7.24 mm Hg(P <0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm(P <0.01) higher than the 133.3 ±9.0 bpm control level. The oxygen saturation shared an average drop of 5%(P <0.01) during screening. In prematurity with postconceptional age less than 31 wk, the incidence of apnea(23.5%), necrotizing enterocolitis(NEC)(8.7%), gastric residual(25.4%) and upper digestive tract hemorrhage(6.4%) also demonstrated a significant rise(P <0.01).CONCLUSION: In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.
文摘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 twentynine 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 70 mo after the treatments.
文摘· AIM: As a result of the increase in premature births and the advances in neonatal intensive care, retinopathy of prematurity (ROP) remains one of the most important causes of childhood blindness worldwide. The main factors in the development of ROP are gestational age, birth weight and oxygen therapy. ROP continues to gain importance due to the increasing survival rates of more immature babies. · METHODS: Between January 2007 and October 2008, 203 premature infants treated at the Neonatal Intensive Care Unit (NNICU) were prospectively enrolled and the relationship between known risk factors and the occurance of ROP was studied. · RESULTS: ROP in various stages developed in 86 cases (42.4%). Statistically significant correlations were found between the development of ROP and birth weight (P < 0.0001) gestational age (P <0.0001), oxygen treatment and its duration (P <0.0001 and P =0.002), mechanical ventilation (MV) and its duration (P =0,0001 and P =0.0001), apnea(P = 0.001), intraventricular hemorrhage (IVH) (P =0.046), sepsis (P =0.0001), use of erythropoietin (EPO) (P =0.003), the number of blood transfusions and frequency (P =0.0001 and P =0.0001), surfactant application (P =0.0001), the presence of patent ductus arteriosus (PDA) (P =0.001) or bronchopu- lmonary dysplasia (BPD) (P =0.0001). No significant correlations were found between the occurance of ROP and maternal pre-eclampsia (P =0.293), multiple pregnancy (P = 0.218), or hyperbilirubinemia (P =0.494). Severity of ROP was related significantly with birth weight (P =0.0001), but no significant correlation between severity of ROP and gestational age was present. · CONCLUSION: Early description and reduction of the risk factors related with the occurance of ROP with the help of routine screening programs may warrant the prevention of visual loss, however early ophthalmic diagnosis and treatment are still mandatory to provide better visual rehabilitation. ·
基金Supported by the National Natural Science Foundation of China(No.81770936)Key Research and Development Program of Shaanxi Province(No.2021SF-159,No.2017SF-222,No.2015SF-217)。
文摘AIM:To report the changes in detection rate and characteristics of retinopathy of prematurity(ROP)in infants,during a 12-year period in Northwest China.METHODS:The medical records of infants were retrospectively collected and reviewed using an established clinical database.The detection rate and severity of ROP were compared between two consecutive periods(P1:2008-2013,P2:2014-2019).Gender,gestational age(GA),birth weight(BW),multiple births,delivery pattern,and postmenstrual age of the first fundus screen were analyzed in all visiting infants.RESULTS:During the 12-year study period,7832 infants were initially included;among them,1266(16.16%)were diagnosed with ROP,441 of whom(5.63%)developed severe ROP.Throughout the study period,the total number of infants being screened showed a trend of slight fluctuation after a rapid increase;however,an annual increase was observed in the number of infants diagnosed with ROP and severe ROP.The proportion of each stage at the first screening of infants with ROP was stable.The detection rate of ROP increased from 2.33%in 2008 to 16.18%in 2010,decreased to 10.73%in 2014,and then increased to 27.47%in 2019.For severe ROP,the detection rate gradually increased from 0 in 2008 to 12.49%in 2019.Among the infants with ROP,96(7.58%)did not meet the screening criteria set by the Chinese Medical Association in 2014(GA<32wk,or BW<2000 g);among them,14(1.11%)needed treatment because of severe ROP.CONCLUSION:From 2008 to 2019,the detection rates of ROP and severe ROP in infants screened in Northwest China were 16.16%and 5.63%,respectively.The characteristics of the ROP infants were similar to those in other middle-income regions.The"tertiary prevention network of ROP"is a potentially effective screening approach.
基金Supported by Project of Medical Science Youth Development of PLA(No.16QNP001)
文摘AIM: To evaluate the effect of intravitreal ranibizumab injection for retinopathy of prematurity(ROP) in Zone Ⅱ Stage 3^+.METHODS: Data was collected for ROP patients with Zone Ⅱ Stage 3^+ who received intravitreal ranibizumab injections between October 2014 and Janu ary 2017 at the Department of Ophthalmology in our hospital. No prior laser or other intravitreal treatment was done. Prior to the intervention and at each follow-up visit, fundus examination was performed. Gestational age at birth, sex, birth weight, ROP zone, ROP stage, post menstrual age(PMA) at treatment, and follow-up pe riod were recorded. The final clinical status of the retina was evaluated for each patient. The primary outcome mea sures included ROP recurrences requiring re-treatment, complete or incomplete peripheral vascularization.RESULTS: Eighty-six eyes of 46 premature infants with Zone Ⅱ Stage 3^+ ROP were enrolled in the study. The mean gestational age at birth was 28.18±1.67(range: 25 to 33)wk and the mean birth weight was 1070.57±226.85(range: 720.00 to 1650.00) g. The mean PMA at treatment was 38.32±2.99(range: 32.29 to 46.00)wk. Seventy-one eyes(82.56%) were treated success fully with intravitreal ranibizumab as monotherapy. Fifteen eyes(17.44%) developed recurrent disease. The mean interval between the treatment and retreatment was 5.96±3.22(range: 1.86 to 11.71)wk. All eyes vascularized into zone Ⅲ at the end of the study and among them 62 eyes(72.09%) achieved complete vascu larization.CONCLUSION: Intravitreal ranibizumab injection is an effective treatment in Zone Ⅱ Stage 3^+ ROP patients. More patients with longer follow-up duration are necessary to confirm the safety and efficacy of this treatment.
文摘AIM: To investigate common polymorphisms in VEGF, ACE, TNF and GST genes with retinopathy of prematurity(ROP) risk among Chinese infants. METHODS: Nine polymorphisms in the above genes were genotyped on 724 advanced cases of ROP and 878 prematurely-born infants of low birth weight who were without any ophthalmologic disease. The frequencies of the polymorphisms were compared between cases and controls to identify the association present, if any. RESULTS: Of the nine polymorphisms, only two showed significant associations: ACE insertion deletion(ID) polymorphism(P=0.031) and TNF-308 G/A polymorphism(P<0.001). The former was associated with a reduced ROP risk [ID genotype, adjusted OR(aOR): 0.603, 95%CI: 0.427-0.893, P=0.034; DD genotype, aOR: 0.468, 95%CI: 0.229-0.626, P=0.002], while the latter showed an increased risk(GA genotype, aOR: 1.956, 95%CI: 1.396-2.465, P<0.001; AA genotype, aOR: 2.809, 95%CI: 1.802-4.484, P<0.001). The association was also noted at the allele level(ACE D allele a OR: 0.698, 95%CI: 0.294-0.883, P<0.001; TNF-308A allele a OR: 1.776, 95%CI: 1.446-2.561, P<0.001). CONCLUSION: The ACE ID polymorphism can protect against ROP development while the TNF-308G/A can increase the risk of the disease among Chinese infants.
文摘AIM:To investigate the ratio of spontaneous regression of retinopathy of prematurity(ROP)and to explore the possible relevant predictive factors.METHODS:A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected.Stage,zone,and duration of ROP were recorded.Statistical analysis was performed on 51 possible predictive factors.RESULTS:Totally 356 infants showed spontaneous regression.The incidence was 100%,95.3%,and 22.7%in stage 1,2,and 3,respectively.The 13.4%of the ROP with plus disease eventually resolved spontaneously.All affected eyes of aggressive posterior retinopathy of prematurity(APROP)failed to spontaneously regress.The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP.Days of mechanical ventilation(OR=0.981,95%CI,0.965-0.997,P=0.021),retinal hemorrhage(OR=0.173,95%CI,0.064-0.470,P=0.001),delivery pattern(OR=2.750,95%CI,1.132-6.681,P=0.025),maternal anemia in pregnancy(OR=0.142,95%CI,0.036-0.563,P=0.005),the stages(at initial diagnosis OR=0.183,95%CI,0.041-0.816,P=0.026;at final diagnosis OR=0.031,95%CI,0.006-0.167,P<0.001),and with plus disease or not(OR=0.005,95%CI,0.001-0.031,P<0.001)were independent predictive factors of the spontaneous regression of ROP.CONCLUSION:Most mild ROP can spontaneously resolve.Active treatment is still recommended for stage 3 ROP,zone I ROP,AP-ROP,and ROP with plus disease.Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution.The pattern of delivery and the mother's anemia during pregnancy can also affect the prognosis of ROP.
