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) 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 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: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 effects of diode laser treatment on ocular biometric parameters in premature infants with retinopathy of prematurity(ROP).METHODS:Premature infants who received diode laser treatment for ROP(n=6...AIM:To investigate the effects of diode laser treatment on ocular biometric parameters in premature infants with retinopathy of prematurity(ROP).METHODS:Premature infants who received diode laser treatment for ROP(n=68)and premature infants with spontaneous regressed ROP without treatment(n=50)were performed longitudinal ocular biometric measurements including anterior chamber depth,lens thickness and axial length as follows:1 d prior to laser treatment,and 3,6,9,and 12 mo after the laser treatment.RESULTS:The mean birth weight,gestational age and initial examination time values were 936.53±302.07 g,26.66±2.42 wk,36.26±2.73 wk in the treatment group and 959.78±260.08 g,27.28±2.10 wk,36.56±2.54 wk in the control group.There was no statistically significant difference in these demographic characteristics of the groups.Anterior chamber depth,lens thickness and axial length demonstrated statistically significant linear increases during the study period in the two groups(P<0.001 for each).There were no statistically significant differences between the two groups in terms of anterior chamber depth after laser treatment.Measurements of the lens thickness at 9 th and 12 th months(9 th month 3.70±0.22 vs 3.60±0.21 mm,P=0.017;12 th month 3.81±0.21 vs 3.69±0.22 mm,P=0.002)and the axial length at 12 th month(19.35±0.79 vs 19.13±0.54 mm,P=0.031)after laser treatment were statistically higher in the treatment group.CONCLUSION:Diode laser retinal photocoagulation treatment in premature infants seems to increase the lens thickness and axial length.展开更多
AIM:To evaluate the predicting efficacy of severe retinopathy of prematurity(ROP)by the WINROP algorithm(http://winrop.com)in Southern China.METHODS:All preterm infants with the gestational age(GA)less than 32 wk were...AIM:To evaluate the predicting efficacy of severe retinopathy of prematurity(ROP)by the WINROP algorithm(http://winrop.com)in Southern China.METHODS:All preterm infants with the gestational age(GA)less than 32 wk were included.Their ROP screening results and serial postnatal body weight were analysed retrospectively.Weekly body weight was entered into and measured by the WINROP system.The outcomes were analysed,and the sensitivity,specificity,positive predictive value and negative predictive value(NPV)were calculated.RESULTS:Totally 432 infants with a median GA of 30.0(24.0-31.9)wk,and a median birth weight(BW)of 1360(540-2700)g were included.Among these 432 infants,50 were diagnosed as type 1 ROP but only 28 were identified by the WINROP algorithm.The sensitivity was 56%(28/50)and the NPV was 92%(252/274).However,for infants with BW<1000g or GA<28 wk,the sensitivity was 93.8%(15/16)and 93.3%(14/15),respectively.Meanwhile,with several postnatal complications added as additional risk factors,the sensitivity was increased to 96%(48/50).CONCLUSION:The sensitivity of the WINROP algorithm from the Southern Chinese cohort is not as high as that reported in developed countries.This algorithm is effective for detecting severe ROP from extremely small or preterm infants.Modification of the algorithm with additional risk factors could improve the predictive value for infants with a GA>28 wk in China.展开更多
Long noncoding RNA(lncRNA)regulates the proliferation and migration of human retinal endothelial cells,as well as retinal neovascularization in diabetic retinopathy.Based on similarities between the pathogenesis of re...Long noncoding RNA(lncRNA)regulates the proliferation and migration of human retinal endothelial cells,as well as retinal neovascularization in diabetic retinopathy.Based on similarities between the pathogenesis of retinopathy of prematurity(ROP)and diabetic retinopathy,lncRNA may also play a role in ROP.Seven-day-old mice were administered 75±2% oxygen for 5 days and normoxic air for another 5 days to establish a ROP model.Expression of lncRNA and mRNA in the retinal tissue of mice was detected by high-throughput sequencing technology,and biological functions of the resulted differentially expressed RNAs were evaluated by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses.The results showed that compared with the control group,57 lncRNAs were differentially expressed,including 43 upregulated and 14 downregulated,in the retinal tissue of ROP mice.Compared with control mice,42 mRNAs were differentially expressed in the retinal tissue of ROP mice,including 24 upregulated and 18 downregulated mRNAs.Differentially expressed genes were involved in ocular development and related metabolic pathways.The differentially expressed lncRNAs may regulate ROP in mice via microRNAs and multiple signaling pathways.Our results revealed that these differentially expressed lncRNAs may be therapeutic targets for ROP treatment.This study was approved by the Medical Ethics Committee of Shengjing Hospital of China Medical University on February 25,2016(approval No.2016PS074K).展开更多
AIM:To estimate overall prevalence of retinopathy of prematurity(ROP) in Iran using a systematic review and Meta-analysis. METHODS: A systematic review and Meta-analysis was performed of all published studies pertaini...AIM:To estimate overall prevalence of retinopathy of prematurity(ROP) in Iran using a systematic review and Meta-analysis. METHODS: A systematic review and Meta-analysis was performed of all published studies pertaining to prevalence of ROP using international and national electronic databases(ISI Web of Sciences,PubM ed,Scopus,Google Scholar,SID,MagI ran,and IranM edex) from their inception until May 2016 with standard keywords. Begg and Egger tests were used to examine the publication bias and Cochran test and I^2 statistics were used to evaluate the statistical heterogeneity. Pooled estimate of the prevalence of ROP were calculated using random effects Metaanalysis.RESULTS: The publication bias assumption was rejected by Egger tests with P-value equal to 0.024. The results of Cochran test and I^2 statistics revealed substantial heterogeneity(Q=1099.02,df=25,I^2=97.7%,P=0.001). The overall prevalence of ROP using the random effect model in Iran was 26.1%(95% CI: 20.3%-31.8%).CONCLUSION: The prevalence of ROP is relatively high in Iran. Low birth weight and gestational age are significant risk factors for the disease. Improved care,including oxygen delivery and monitoring,for preterm babies in all facility settings would reduce the number of babies affected with ROP.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
AIM:To examine changes in retinal vasculature after treatment with different oxygen concentrations from common retinopathy of prematurity(ROP) models and to determine a novel and practical ROP model.METHODS:A sample o...AIM:To examine changes in retinal vasculature after treatment with different oxygen concentrations from common retinopathy of prematurity(ROP) models and to determine a novel and practical ROP model.METHODS:A sample of 14 newborn Sprague-Dawley rats was used.The study group(n=7) was exposed to95%oxygen for 4h per day followed by normoxic laboratory conditions for 20 h.This cycle was repeated for 14 d.The control group(n=7) was subjected to normobaric normoxic conditions.On postnatal day 14(P14),the two groups were placed in room air for 7d.On P21,the two groups were examined using indirect ophthalmoscopy.All eyes were enucleated for immunofluorescence(IF) staining of the vasculature of retinas and analysis of vascular endothelial growth factor(VEGF),hypoxia inducible factor-1 alpha(HIF-1α),placental growth factor(PLGF) in vitreous humor,and then the rats were sacrificed by decapitation.All procedures were repeated using another litter of 14 pups.RESULTS:In the study group and under normobaric hyperoxic conditions,retinal neovascularization and peripheral avascular retina were determined in 85%of the rats through indirect ophthalmoscopic examination.Also IF staining of retina of the study group showed retarded peripheral vascular growth.The difference between the two groups for VEGF,HIF-1α and PLGF concentrations of vitreous humor was statistically significant(P=0.003,0.007,0.027 respectively).CONCLUSION:Fluctuating oxygen concentrations are primarily responsible for retinal neovascularization.Our new ROP model is practical and applicable for all retinal neovascularization studies,considering the laboratory procedures.展开更多
AIM:To understand retinopathy of prematurity(ROP)screening and treatment preferences among Chinese ophthalmologists.METHODS:A Chinese language survey was administered anonymously using Web Q(Catalyst,Seattle,WA,USA)am...AIM:To understand retinopathy of prematurity(ROP)screening and treatment preferences among Chinese ophthalmologists.METHODS:A Chinese language survey was administered anonymously using Web Q(Catalyst,Seattle,WA,USA)among Chinese ROP screeners from December 2016 to January 2017.RESULTS:Among 70 ophthalmologists contacted,65 responded(93%;78%female,mean age 40 y,57%pediatric ophthalmologists and 25%retina specialists).Most used screening criteria of birth weight≤2 kg(62%)with variation in cut-off gestational age(≤37 wk,34%;≤34 wk,22%;≤32 wk,31%).Ret Cam(Natus Medical Incorporated,Pleasanton,CA,USA)wide-field fundus photography assisted most screeners(72%)and was exclusively used by many(29%).Among 55 ophthalmologists treating ROP,anti-vascular endothelial growth factor(VEGF)was preferred over laser for both zoneⅠ(76%vs 24%)and zoneⅡROP(58%vs 42%).Retina specialists(P=0.004)and ophthalmologists with>3 mo of training(P=0.03)were more likely to use antiVEGF over laser for zoneⅠROP.Lack of laser training(8/20,40%),access(6/20,30%)and anesthesia(4/20,20%)were common barriers to laser treatment.CONCLUSION:Chinese ROP screeners favor antiVEGF injection and Ret Cam imaging for ROP management.A better understanding of ROP screening and treatment informs future research and education efforts in China.展开更多
Dear Editor,Iam Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagn...Dear Editor,Iam Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagnosis of unsuspected retinoblastoma(RB)in an in vitro fertilisation(IVF)infant with retinopathy of prematurity.The simultaneous presentation of RB and prematurity of retinopathy(ROP)in an IVF infant is very rare.The relationship between RB and IVF is still indeterminate and mechanisms that lead to ocular or systemic展开更多
Background:India leads all nations in the number of preterms born annually.With over 3.5 million infants,a reducing infant mortality rate and an expanding base of rural neonatal intensive care units,the number of infa...Background:India leads all nations in the number of preterms born annually.With over 3.5 million infants,a reducing infant mortality rate and an expanding base of rural neonatal intensive care units,the number of infants requiring retinopathy of prematurity(ROP)screening has dramatically increased.The number of ROP specialists in the country is currently inadequate.Leading ROP specialists of the country initiated the Indian ROP(IROP)society to address these challenges.Methods:In 2016,the IROP society was conceived and registered as a professional body with a mission to prevent needless blindness from ROP by promoting standards of excellence.A national online membership drive was carried out.The data collected in this survey was analyzed to collate information on past training,practice patterns,ease of screening and treatment,use of wide-field imaging and willingness to be certified.Results:Of the 113 members at the time of submission,67.3%were male.88.5%were formally trained for ROP and 85.8%were vitreo-retinal specialists.Of the practicing members,96%were“comfortable”with screening and 86%with ROP treatment and this correlated with training(P=0.001 and P=0.002 respectively).Only 25.7%performed vitreous surgery for ROP.Wide field imaging was used by 33%of members in their practice and 52%of those who did not,wanted to use it in the future.Members who used imaging performed more number of laser treatments than those who did not(P=0.008).Laser was the preferred modality of treatment for 98%of members.A majority of the members(92.5%)were willing to be audited.Conclusions:The IROP society is a novel platform for ROP specialists to collaborate.The society has setup short,mid and long-term goals to make ROP care more accessible and affordable with appropriate use of technology.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.
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 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.
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 effects of diode laser treatment on ocular biometric parameters in premature infants with retinopathy of prematurity(ROP).METHODS:Premature infants who received diode laser treatment for ROP(n=68)and premature infants with spontaneous regressed ROP without treatment(n=50)were performed longitudinal ocular biometric measurements including anterior chamber depth,lens thickness and axial length as follows:1 d prior to laser treatment,and 3,6,9,and 12 mo after the laser treatment.RESULTS:The mean birth weight,gestational age and initial examination time values were 936.53±302.07 g,26.66±2.42 wk,36.26±2.73 wk in the treatment group and 959.78±260.08 g,27.28±2.10 wk,36.56±2.54 wk in the control group.There was no statistically significant difference in these demographic characteristics of the groups.Anterior chamber depth,lens thickness and axial length demonstrated statistically significant linear increases during the study period in the two groups(P<0.001 for each).There were no statistically significant differences between the two groups in terms of anterior chamber depth after laser treatment.Measurements of the lens thickness at 9 th and 12 th months(9 th month 3.70±0.22 vs 3.60±0.21 mm,P=0.017;12 th month 3.81±0.21 vs 3.69±0.22 mm,P=0.002)and the axial length at 12 th month(19.35±0.79 vs 19.13±0.54 mm,P=0.031)after laser treatment were statistically higher in the treatment group.CONCLUSION:Diode laser retinal photocoagulation treatment in premature infants seems to increase the lens thickness and axial length.
基金Supported by the National Nature Science Foundation of China(No.81500722)。
文摘AIM:To evaluate the predicting efficacy of severe retinopathy of prematurity(ROP)by the WINROP algorithm(http://winrop.com)in Southern China.METHODS:All preterm infants with the gestational age(GA)less than 32 wk were included.Their ROP screening results and serial postnatal body weight were analysed retrospectively.Weekly body weight was entered into and measured by the WINROP system.The outcomes were analysed,and the sensitivity,specificity,positive predictive value and negative predictive value(NPV)were calculated.RESULTS:Totally 432 infants with a median GA of 30.0(24.0-31.9)wk,and a median birth weight(BW)of 1360(540-2700)g were included.Among these 432 infants,50 were diagnosed as type 1 ROP but only 28 were identified by the WINROP algorithm.The sensitivity was 56%(28/50)and the NPV was 92%(252/274).However,for infants with BW<1000g or GA<28 wk,the sensitivity was 93.8%(15/16)and 93.3%(14/15),respectively.Meanwhile,with several postnatal complications added as additional risk factors,the sensitivity was increased to 96%(48/50).CONCLUSION:The sensitivity of the WINROP algorithm from the Southern Chinese cohort is not as high as that reported in developed countries.This algorithm is effective for detecting severe ROP from extremely small or preterm infants.Modification of the algorithm with additional risk factors could improve the predictive value for infants with a GA>28 wk in China.
基金supported by the National Natural Science Foundation of China,No.81600747(to YD)Startup Foundation for Doctors of Liaoning Province,China,No.201501020(to YD)
文摘Long noncoding RNA(lncRNA)regulates the proliferation and migration of human retinal endothelial cells,as well as retinal neovascularization in diabetic retinopathy.Based on similarities between the pathogenesis of retinopathy of prematurity(ROP)and diabetic retinopathy,lncRNA may also play a role in ROP.Seven-day-old mice were administered 75±2% oxygen for 5 days and normoxic air for another 5 days to establish a ROP model.Expression of lncRNA and mRNA in the retinal tissue of mice was detected by high-throughput sequencing technology,and biological functions of the resulted differentially expressed RNAs were evaluated by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses.The results showed that compared with the control group,57 lncRNAs were differentially expressed,including 43 upregulated and 14 downregulated,in the retinal tissue of ROP mice.Compared with control mice,42 mRNAs were differentially expressed in the retinal tissue of ROP mice,including 24 upregulated and 18 downregulated mRNAs.Differentially expressed genes were involved in ocular development and related metabolic pathways.The differentially expressed lncRNAs may regulate ROP in mice via microRNAs and multiple signaling pathways.Our results revealed that these differentially expressed lncRNAs may be therapeutic targets for ROP treatment.This study was approved by the Medical Ethics Committee of Shengjing Hospital of China Medical University on February 25,2016(approval No.2016PS074K).
文摘AIM:To estimate overall prevalence of retinopathy of prematurity(ROP) in Iran using a systematic review and Meta-analysis. METHODS: A systematic review and Meta-analysis was performed of all published studies pertaining to prevalence of ROP using international and national electronic databases(ISI Web of Sciences,PubM ed,Scopus,Google Scholar,SID,MagI ran,and IranM edex) from their inception until May 2016 with standard keywords. Begg and Egger tests were used to examine the publication bias and Cochran test and I^2 statistics were used to evaluate the statistical heterogeneity. Pooled estimate of the prevalence of ROP were calculated using random effects Metaanalysis.RESULTS: The publication bias assumption was rejected by Egger tests with P-value equal to 0.024. The results of Cochran test and I^2 statistics revealed substantial heterogeneity(Q=1099.02,df=25,I^2=97.7%,P=0.001). The overall prevalence of ROP using the random effect model in Iran was 26.1%(95% CI: 20.3%-31.8%).CONCLUSION: The prevalence of ROP is relatively high in Iran. Low birth weight and gestational age are significant risk factors for the disease. Improved care,including oxygen delivery and monitoring,for preterm babies in all facility settings would reduce the number of babies affected with ROP.
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.
文摘AIM:To examine changes in retinal vasculature after treatment with different oxygen concentrations from common retinopathy of prematurity(ROP) models and to determine a novel and practical ROP model.METHODS:A sample of 14 newborn Sprague-Dawley rats was used.The study group(n=7) was exposed to95%oxygen for 4h per day followed by normoxic laboratory conditions for 20 h.This cycle was repeated for 14 d.The control group(n=7) was subjected to normobaric normoxic conditions.On postnatal day 14(P14),the two groups were placed in room air for 7d.On P21,the two groups were examined using indirect ophthalmoscopy.All eyes were enucleated for immunofluorescence(IF) staining of the vasculature of retinas and analysis of vascular endothelial growth factor(VEGF),hypoxia inducible factor-1 alpha(HIF-1α),placental growth factor(PLGF) in vitreous humor,and then the rats were sacrificed by decapitation.All procedures were repeated using another litter of 14 pups.RESULTS:In the study group and under normobaric hyperoxic conditions,retinal neovascularization and peripheral avascular retina were determined in 85%of the rats through indirect ophthalmoscopic examination.Also IF staining of retina of the study group showed retarded peripheral vascular growth.The difference between the two groups for VEGF,HIF-1α and PLGF concentrations of vitreous humor was statistically significant(P=0.003,0.007,0.027 respectively).CONCLUSION:Fluctuating oxygen concentrations are primarily responsible for retinal neovascularization.Our new ROP model is practical and applicable for all retinal neovascularization studies,considering the laboratory procedures.
基金Supported by Research to Prevent Blindness and the NIH CORE Grant(No.EY001730)。
文摘AIM:To understand retinopathy of prematurity(ROP)screening and treatment preferences among Chinese ophthalmologists.METHODS:A Chinese language survey was administered anonymously using Web Q(Catalyst,Seattle,WA,USA)among Chinese ROP screeners from December 2016 to January 2017.RESULTS:Among 70 ophthalmologists contacted,65 responded(93%;78%female,mean age 40 y,57%pediatric ophthalmologists and 25%retina specialists).Most used screening criteria of birth weight≤2 kg(62%)with variation in cut-off gestational age(≤37 wk,34%;≤34 wk,22%;≤32 wk,31%).Ret Cam(Natus Medical Incorporated,Pleasanton,CA,USA)wide-field fundus photography assisted most screeners(72%)and was exclusively used by many(29%).Among 55 ophthalmologists treating ROP,anti-vascular endothelial growth factor(VEGF)was preferred over laser for both zoneⅠ(76%vs 24%)and zoneⅡROP(58%vs 42%).Retina specialists(P=0.004)and ophthalmologists with>3 mo of training(P=0.03)were more likely to use antiVEGF over laser for zoneⅠROP.Lack of laser training(8/20,40%),access(6/20,30%)and anesthesia(4/20,20%)were common barriers to laser treatment.CONCLUSION:Chinese ROP screeners favor antiVEGF injection and Ret Cam imaging for ROP management.A better understanding of ROP screening and treatment informs future research and education efforts in China.
文摘Dear Editor,Iam Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagnosis of unsuspected retinoblastoma(RB)in an in vitro fertilisation(IVF)infant with retinopathy of prematurity.The simultaneous presentation of RB and prematurity of retinopathy(ROP)in an IVF infant is very rare.The relationship between RB and IVF is still indeterminate and mechanisms that lead to ocular or systemic
文摘Background:India leads all nations in the number of preterms born annually.With over 3.5 million infants,a reducing infant mortality rate and an expanding base of rural neonatal intensive care units,the number of infants requiring retinopathy of prematurity(ROP)screening has dramatically increased.The number of ROP specialists in the country is currently inadequate.Leading ROP specialists of the country initiated the Indian ROP(IROP)society to address these challenges.Methods:In 2016,the IROP society was conceived and registered as a professional body with a mission to prevent needless blindness from ROP by promoting standards of excellence.A national online membership drive was carried out.The data collected in this survey was analyzed to collate information on past training,practice patterns,ease of screening and treatment,use of wide-field imaging and willingness to be certified.Results:Of the 113 members at the time of submission,67.3%were male.88.5%were formally trained for ROP and 85.8%were vitreo-retinal specialists.Of the practicing members,96%were“comfortable”with screening and 86%with ROP treatment and this correlated with training(P=0.001 and P=0.002 respectively).Only 25.7%performed vitreous surgery for ROP.Wide field imaging was used by 33%of members in their practice and 52%of those who did not,wanted to use it in the future.Members who used imaging performed more number of laser treatments than those who did not(P=0.008).Laser was the preferred modality of treatment for 98%of members.A majority of the members(92.5%)were willing to be audited.Conclusions:The IROP society is a novel platform for ROP specialists to collaborate.The society has setup short,mid and long-term goals to make ROP care more accessible and affordable with appropriate use of technology.
