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Haemogram Parameters in the Development of Retinopathy of Prematurity  [PDF]
Muberra Akdogan, Didem Arda Demirag, Ipek Guney Varal, Sad?k Gorkem Cevik, Yasemin Ustundag
Open Journal of Ophthalmology (OJOph) , 2018, DOI: 10.4236/ojoph.2018.82011
Abstract:
Purpose: Retinopathy of prematurity (ROP), an abnormal proliferation of retinal vessels in premature infants with low birth weight, develops due to many factors. This study investigated a possible correlation between haematological parameters and ROP development. Method: This study included 189 infants without ROP and 128 with ROP. All were born at 35 weeks’ gestation or earlier, had a CBC drawn within 72 hours of birth, and had haemogram data for the first month. Haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red cell distribution width (RDW), platelet counts (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) values were obtained from hospital data and retrospectively analysed. Results: The mean gestational age was 31 weeks and 29 weeks for the control and ROP groups, respectively; the mean birth weights were 1757 g and 1332 g, respectively. The ROP group’s birth Hb, MCV and RDW were significantly lower than the control group (p < 0.001), whereas PLT and MPV were significantly higher (p < 0.001). The ROP group’s Hb and PLT in the first month were significantly lower than the control group (p < 0.001), whereas RDW, MPV and PDW were significantly higher (p < 0.001). Conclusion: Premature infants with ROP had lower Hb and increased platelet, MPV and PDW in early postnatal life than infants without ROP. In the first month, when ROP develops, low PLT, PDW and Hb and high MPV could be indicators for ROP diagnosis, follow-up and treatment.
Outcome of Cataract Surgery in Patients Treated for Retinopathy of Prematurity  [PDF]
Huy Nguyen, Kimberly G. Yen
Open Journal of Ophthalmology (OJOph) , 2017, DOI: 10.4236/ojoph.2017.74038
Abstract:
Background/Aims: Pediatric patients with treated retinopathy of prematurity (ROP) may develop visually significant cataracts. We report the outcome of cataract surgery in patients who had ROP treatment. Method: Retrospective chart review of 19 eyes from 16 patients who had ROP treatment and subsequent cataract surgery between August, 2002 and March, 2015. Results: Eighteen of 19 eyes received laser treatment for ROP; 1 eye received intravitreal bevacizumab. 5 eyes received lens-sparing pars plana vitrectomy (LSPPV) in addition to laser. Average follow up was 10.1 ± 5.5 years. Average visual acuity improved from 20/324 prior to and 20/110 after cataract surgery (p = 0.06). 13/19 (68%) of the eyes received laser only and developed cataracts an average of 6.2 ± 5.6 years after laser treatment. 5/19 (26%) eyes developed cataracts an average of 6.4 ± 4.2 years after LSPPV and laser. In one eye, a cataract developed after a bevacizumab injection 2.9 years after the injection. Visual axis opacification (VAO) developed in 2/5 (40%) eyes after Ce/PCIOL/PPC-Antvx, 8/10 eyes (80%) after CE/IOL, and in 0/4 eyes after CE/PPC-AntVx. Ocular comorbidities included strabismus, nystagmus, amblyopia, optic atrophy, corneal band keratopathy, and phthisis bulbi. Conclusion: Cataract surgery in patients who have a history of ROP can be complicated by anatomical changes from prematurity and prior vitreoretinal surgeries. Vision improvement is limited by other ocular comorbidities.
Analysis of risk factors in the development of retinopathy of prematurity
Kne?evi? Sanja,Stojanovi? Nade?da,Oros Ana,Savi? Dragana
Srpski Arhiv za Celokupno Lekarstvo , 2011, DOI: 10.2298/sarh1108433k
Abstract: Introduction. Retinopathy of prematurity (ROP) is a multifactorial disease that occurs most frequently in very small and very sick preterm infants, and it has been identified as the major cause of childhood blindness. Objective. The aim of this study was to evaluate ROP incidence and risk factors associated with varying degrees of illness. Methods. The study was conducted at the Centre for Neonatology, Paediatric Clinic of the Clinical Centre Kragujevac, Serbia, in the period from June 2006 to December 2008. Ophthalmologic screening was performed in all children with body weight lower than 2000 g or gestational age lower than 36 weeks. We analyzed eighteen postnatal and six perinatal risk factors and the group correlations for each of the risk factors. Results. Out of 317 children that were screened, 56 (17.7%) developed a mild form of ROP, while 68 (21.5%) developed a severe form. Univariate analysis revealed a large number of statistically significant risk factors for the development of ROP, especially the severe form. Multivariate logistical analysis further separated two independent risk factors: small birth weight (p=0.001) and damage of central nervous system (p=0.01). Independent risk factors for transition from mild to severe forms of ROP were identified as: small birth weight (p=0.05) and perinatal risk factors (p=0.02). Conclusion. Small birth weight and central nervous system damage were risk factors for the development of ROP, perinatal risk factors were identified as significant for transition from mild to severe form of ROP.
Surgery for stage 5 retinopathy of prematurity: The learning curve and evolving technique  [cached]
Gopal Lingam,Sharma Tarun,Shanmugam Mahesh,Badrinath S
Indian Journal of Ophthalmology , 2000,
Abstract: Purpose: To describe our experience with management of eyes with stage 5 retinopathy of prematurity (ROP) Methods: Closed vitreoretinal surgery was done on 96 eyes of patients with stage 5 ROP. Lens was sacrificed in all but one eye. Surgery involved an attempt to clear all preretinal tissue and open the peripheral trough all round. In most instances bimanual surgery under viscoelastic was performed. Results: At last follow up, anatomical success (defined as attached posterior pole) was achieved in 22.5% cases. Significant postoperative problems included reproliferation and secondary glaucoma. Only two infants obtained mobile vision. Conclusion: Late identification of disease, lack of prior treatment such as laser or cryo, and higher incidence of narrow-narrow funnel configuration were responsible for the poor surgical results noted in this series. The poor surgical and functional results reemphasise the need for prompt screening and management of infants at risk.
Factors given by birth and oxygenotherapy in relation to development of retinopathy of prematurity  [PDF]
Oluji? Maja,Oros Ana,Bregun-Doronjski Alekandra,Velisavljev-Filipovi? Gordana
Medicinski Pregled , 2012, DOI: 10.2298/mpns1208326o
Abstract: Introduction. Retinopathy of prematurity is a disease of the eye which affects the blood vessels of the retina and represents the most important cause of blindness and low vision in children worldwide. There are many risk factors given by birth and parameters of general health status that may influence this disease. The aim of this study was to investigate the significance of the factors given by birth and use of oxygen in relation to the development of premature retinopathy. Material and Methods. A two-year-long prospective study was done at the Institute for Child and Youth Health Care of Vojvodina. In this study the following parameters were examined: weight, gestational age as a factor given by birth and parameters of oxygenotherapy - the number of days on oxygenotherapy and the number of days of mechanical ventilation. The findings on the eye fundus were also taken into consideration. Results. The test results suggest that the gestational age is the most important factor given by birth which determines the possibility of development of premature retinopathy. Conclusion. In fact, the most important risk factor for the development of premature retinopathy is premature birth.
Multiple pregnancies and its relationship with the development of retinopathy of prematurity (ROP)
Motta MMS, Fortes Filho JB, Coblentz J, Fiorot CA
Clinical Ophthalmology , 2011, DOI: http://dx.doi.org/10.2147/OPTH.S25431
Abstract: ltiple pregnancies and its relationship with the development of retinopathy of prematurity (ROP) Original Research (2246) Total Article Views Authors: Motta MMS, Fortes Filho JB, Coblentz J, Fiorot CA Published Date December 2011 Volume 2011:5 Pages 1783 - 1787 DOI: http://dx.doi.org/10.2147/OPTH.S25431 Mário Martins dos Santos Motta1, Jo o Borges Fortes Filho2, Jacqueline Coblentz1, Claudia Amaral Fiorot3 1Department of Ophthalmology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil; 2Department of Ophthalmology, Faculty of Medicine, Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil; 3Hospital Naval Marcílio Dias, Rio de Janeiro RJ, Brazil Background: The influence of multiple gestation on the occurrence of retinopathy of prematurity (ROP) is still not completely understood. Objectives: To verify the incidence of any stage of ROP and threshold ROP in singletons and in multiple gestation among preterm infants. Methods: This was an institutional, prospective, and descriptive cohort study, which included preterm newborns with birth weight (BW) of 1500 g or less and/or gestational age (GA) of 32 weeks or less, as admitted to the neonatal units at Laranjeiras and Amparo Hospitals in Rio de Janeiro, Brazil, between January 2001 and July 2005, and whom remained hospitalized for at least 28 days. There were no exclusion criteria. Patients were divided into two groups: Group 1 included multiples; and Group 2 consisted of singletons. Results: A total of 159 infants that remained in neonatal unit care for at least 28 days were included in this study. Group 1 comprised 56 (35%) multiples; and Group 2 comprised 103 (65%) singletons. Mean BW was 1072 g ± 272 and 1089 g ± 282 in Groups 1 and 2, respectively (analysis of variance [ANOVA] P > 0.05). Mean GA among multiple gestation (Group 1) was 29 weeks ± 2.1; and 29 weeks ± 2.4 among singletons (Group 2) (ANOVA P > 0.05). Days in oxygen therapy ranged from 0 to 188 days. Median among Group 1 was 15 days, while median in Group 2 was 10 days (Kruskal–Wallis P > 0.05). Any stage ROP was detected in 66 (41.5%) of the whole cohort comprising 159 babies. Among the 56 multiples, 30 (53.6%) achieved any stage ROP, and among 103 singletons, 36 (35%) achieved any stage ROP (Chi-square test P < 0.05). Threshold ROP occurred in 12 (7.5%) of the 159 patients included. Three (5.3%) patients from Group 1 and nine (8.7%) patients in Group 2 reached threshold ROP needing laser treatment (Fisher’s exact test P > 0.05). Conclusion: This study showed higher frequency of any stage of ROP in twins and triplets but not regarding threshold disease. Because of the relatively small number of patients in this sample, other studies are necessary to determine if gemelarity plays a role in the occurrence of ROP.
Multiple pregnancies and its relationship with the development of retinopathy of prematurity (ROP)  [cached]
Motta MMS,Fortes Filho JB,Coblentz J,Fiorot CA
Clinical Ophthalmology , 2011,
Abstract: Mário Martins dos Santos Motta1, Jo o Borges Fortes Filho2, Jacqueline Coblentz1, Claudia Amaral Fiorot31Department of Ophthalmology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil; 2Department of Ophthalmology, Faculty of Medicine, Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil; 3Hospital Naval Marcílio Dias, Rio de Janeiro RJ, BrazilBackground: The influence of multiple gestation on the occurrence of retinopathy of prematurity (ROP) is still not completely understood.Objectives: To verify the incidence of any stage of ROP and threshold ROP in singletons and in multiple gestation among preterm infants.Methods: This was an institutional, prospective, and descriptive cohort study, which included preterm newborns with birth weight (BW) of 1500 g or less and/or gestational age (GA) of 32 weeks or less, as admitted to the neonatal units at Laranjeiras and Amparo Hospitals in Rio de Janeiro, Brazil, between January 2001 and July 2005, and whom remained hospitalized for at least 28 days. There were no exclusion criteria. Patients were divided into two groups: Group 1 included multiples; and Group 2 consisted of singletons.Results: A total of 159 infants that remained in neonatal unit care for at least 28 days were included in this study. Group 1 comprised 56 (35%) multiples; and Group 2 comprised 103 (65%) singletons. Mean BW was 1072 g ± 272 and 1089 g ± 282 in Groups 1 and 2, respectively (analysis of variance [ANOVA] P > 0.05). Mean GA among multiple gestation (Group 1) was 29 weeks ± 2.1; and 29 weeks ± 2.4 among singletons (Group 2) (ANOVA P > 0.05). Days in oxygen therapy ranged from 0 to 188 days. Median among Group 1 was 15 days, while median in Group 2 was 10 days (Kruskal–Wallis P > 0.05). Any stage ROP was detected in 66 (41.5%) of the whole cohort comprising 159 babies. Among the 56 multiples, 30 (53.6%) achieved any stage ROP, and among 103 singletons, 36 (35%) achieved any stage ROP (Chi-square test P < 0.05). Threshold ROP occurred in 12 (7.5%) of the 159 patients included. Three (5.3%) patients from Group 1 and nine (8.7%) patients in Group 2 reached threshold ROP needing laser treatment (Fisher’s exact test P > 0.05).Conclusion: This study showed higher frequency of any stage of ROP in twins and triplets but not regarding threshold disease. Because of the relatively small number of patients in this sample, other studies are necessary to determine if gemelarity plays a role in the occurrence of ROP.Keywords: prematurity, retinopathy of prematurity,
Incidence and risk factors of retinopathy of prematurity
Rasyidah,Sujan Ali Fing
Paediatrica Indonesiana , 2013,
Abstract: Background Retinopathy of prematurity (ROP) is one of the main causes of visual impairment in premature infants.Objective To determine the incidence and risk factors for ROP in premature infants.Methods This retrospective study included premature infants born in Stella Mmaris Women’s and Children’s Hospital and admitted to the neonatal intensive care unit (NICU) and Neonatology Department from November 2009 to May 2012. We included all premature infants with body weight (BW) < 1500 g or gestational age (GA) < 32 weeks, and selected infants with BW 1500 - 2000 g or GA > 32 weeks with unstable clinical courses who had been screened for ROroP. Data was analyzed with Fisher’s exact test and independent t test.Results Of the 48 premature infants in the study, ROroP was detected in 6 (12.5%) of the subjects. Stages of ROP were classified according to the International Classification of of Prematurity. Stage 1 ROP was detected in 1 (2.1%) subject; stage 2 ROP was detected in 3 (6.25%) subjects; and stage 3 ROP was found in 2 (4.2%) subjects. The 2 infants with stage 3 ROroP required surgery. No was detected in infants with GA > 30 weeks or BW > 1250 g. Respiratory distress syndrome (RrDS), sepsis, blood transfusion, and apnea were found to be associated with development of ROP. Duration of oxygen therapy was found to be a significant risk factor for ROP in a comparison of the no ROP group to the ROP group: 14.0 (SD 9.508) days vs. 3.81 (SD 5.218) days, respectively (P<0.05). In addition, the duration of continuous positive airway pressure (CPAP) usage was also a significant risk factor for ROP, with 1.83 (SD 1.329) days in the ROP group vs. 0.76 (SD 1.122) days in the no ROP group (P<0.05).Conclusions The incidence of ROP in the premature infants in our study is 12.5%. Retinopathy of prematurity is associated with lower BbW, lower GA, lower Apgar score at the 5th minute, RrDS,6,7sepsis, apnea, blood transfusion, aminophylline usage, as well as longer duration of oxygen therapy and CPAP usages.
Fulminate type of retinopathy of prematurity.  [cached]
Shah Parag,Narendran V,Saravanan V,Raghuram A
Indian Journal of Ophthalmology , 2004,
Abstract: Routine ophthalmoscopic screening for retinopathy of prematurity (ROP) from the age of 2 weeks is necessary to detect and treat fulminate ROP.
Tests of screening criteria for retinopathy of prematurity  [PDF]
Oluji? Maja,Oros Ana,Bregun-Doronjski Aleksandra,Velisavljev-Filipovi? Gordana
Medicinski Pregled , 2012, DOI: 10.2298/mpns1210409o
Abstract: Introduction. Retinopathy of prematurity is a disease of the eye, i.e. the retinal blood vessels, which occurs exclusively in premature infants. The level of blindness in one country depends on the level of development of neonatal care and the opportunities to implement screening. The aim of this study was to examine the possibilities of changing screening criteria, provided that not a single child was left out from the survey. Material and Methods. A two-year prospective study, which was carried out in the period from January 1st 2007 to December 31st 2008, included 191 premature infants who were treated at the Institute for Child and Youth Healthcare of Vojvodina. Results. Different inclusion criteria regarding body mass and gestational age were applied for screening retinopathy of prematurity and we assessed the coverage of the sample if certain screening criteria were applied. According to the results of the research, when the applied screening criterion was 37/2000, there was not a single case of a blind, prematurely born baby. Discussion. Great migrations of population as well as big differences in characteristics of premature infants together with underlying multi-factor diseases besides retinopathy of prematurity send a warning signal to be very cautious. Conclusion. Although this study has given ground to shift the limits of screening, we will adhere to broad screening criteria.
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