Retinopathy of prematurity in Brazil: an emerging problem

Quinn, Graham E.

doi:10.2223/jped.1631

Cited by 15 publications

(13 citation statements)

References 12 publications

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“…[1][2][3] ROP severe enough to require treatment usually occurs around the 37-38th postconceptional week (PCA: defined as gestational age (GA) at birth plus weeks of life). There is, therefore, a time interval during which the occurrence of ROP may be predicted and the disease may be promptly treated.…”

Section: Introductionmentioning

confidence: 99%

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Eckert

Filho

Maia

et al. 2011

Eye

101

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Aims This study describes the development of a score based on cumulative risk factors for the prediction of severe retinopathy of prematurity (ROP) comparing the performance of the score against the birth weight (BW) and gestational age (GA) in order to predict the onset of ROP. Methods A prospective cohort of preterm infants with BWp1500 g and/or GAp32 weeks was studied. The score was developed based on BW, GA, proportional weight gain from birth to the 6th week of life, use of oxygen in mechanical ventilation, and need for blood transfusions from birth to the 6th week of life. The score was established after linear regression, considering the impact of each variable on the occurrences of any stage and severe ROP. Receiver operating characteristic (ROC) curves were used to determine the best sensitivity and specificity values for the score. All variables were entered into an Excel spreadsheet (Microsoft) for practical use by ophthalmologists during screening sessions. Results The sample included 474 patients. The area under the ROC curve for the score was 0.77 and 0.88 to predict any stage and severe ROP, respectively. These values were significantly higher for the score than for BW (0.71) and GA (0.69) when measured separately. Conclusions ROPScore is an excellent index of neonatal risk factors for ROP, which is easy to record and more accurate than BW and GA to predict any stage ROP or severe ROP in preterm infants. The scoring system is simple enough to be routinely used by ophthalmologists during screening examination for detection of ROP.

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Section: Introductionmentioning

confidence: 99%

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Eckert

Filho

Maia

et al. 2011

Eye

101

View full text Add to dashboard Cite

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“…The incidences of any stage of ROP and severe ROP that required treatment in inborn patients in our institution were previously related as 29.9% and 7.4%, respectively, which is a very low percentage, even for countries with established standards of excellence in perinatal care (14) . Mean BW and GA for the inborn at HCPA treated for ROP in our study were 918 ± 232 g and 28 ± 2.0 weeks, respectively.…”

Section: Discussionmentioning

confidence: 69%

Postconceptional age at the treatment of retinopathy of prematurity in inborn and referred preterm infants from the same institution

Filho¹,

Eckert²,

Valiatti³

et al. 2011

Arq. Bras. Oftalmol.

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Purpose: The outcomes of the treatment of retinopathy of prematurity (ROP) seem to be better in inborn patients than in those patients who were referred for ROP treatment. This study aims to investigate the timing of treatment and the outcomes in inborn patients and in patients referred for treatment to the Hospital de Clínicas de Porto Alegre, Brazil. Methods: An institutional prospective cohort study was conducted from 2002 to 2010 and included in group 1 all inborn preterm neonates treated for retinopathy of prematurity and in group 2 all babies referred for treatment to the same institution. All of the included patients presented birth weight (BW) ≤1,500 g and/or gestational age (GA) ≤32 weeks. Main outcomes were postconceptional age at the treatment and one year follow-up outcomes in both groups. The considered variables were: BW, GA, stage and location of retinopathy of prematurity at treatment. Results: Group 1 comprised 24 inborn patients. Mean BW and GA at birth were 918 ± 232 g and 28.2 ± 2.1 weeks, respectively, and median post-conceptional postconceptional age at treatment was 37 weeks. Group 2 comprised 14 infants transferred for treatment. Mean BW and GA at birth were 885 ± 188 g and 28.2 ± 2.4 weeks, respectively, and median postconceptional age at treatment was 39 weeks. Mean BW and GA were similar in both groups (P=0.654 and P=0.949, respectively), but the difference among the postconceptional age was significant (P=0.029). Conclusions: Inborn patients were treated for retinopathy of prematurity during the 37 th week of postconceptional age while transferred patients were treated, usually, after the 39 th week postconceptional age. The worst outcomes observed among referred patients could be partially explained by the delayed time for treatment.Keywords: Infant, very low birth weight; Retinopathy of prematurity/therapy; Gestational age; Hospitals, public; Risk factors; Survival rates RESUMO Objetivos: Os resultados do tratamento da retinopatia da prematuridade (ROP) parecem ser melhores em pacientes nascidos na mesma instituição onde o tratamento foi praticado do que naqueles pacientes transferidos para o tratamento em centros de referência. Este estudo tem como objetivos investigar o momento do tratamento e seus resultados em pacientes nascidos e em pacientes transferidos para o tratamento em uma mesma instituição. Métodos: Estudo de coorte institucional e prospectivo conduzido de 2002 a 2010 e incluiu no grupo 1 todos os prematuros tratados para a retinopatia da prematuridade nascidos na instituição e no grupo 2 todos os prematuros tratados para a retinopatia da prematuridade transferidos para o tratamento. Todos os pacientes incluídos tinham peso de nascimento (PN) ≤1.500 gramas e/ou idade gestacional (IG) ≤32 semanas. As principais consideradas foram a idade pós-concepção (IPC) por ocasião do tratamento e os resultados do tratamento ao final do 1º ano de vida dos pacientes nos 2 grupos. As variáveis consideradas foram

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“…ROP prevalence in the study is comparable to studies from industrialized countries. 33,34 The implementation of screening programs for early detection and treatment of ROP in other Brazilian hospitals, as well as better training in ophthalmologic services for properly following up these young patients, would greatly contribute to lowering the primary cause of avoidable childhood blindness in Brazil.…”

Section: -24mentioning

confidence: 99%

Ser pequeno para a idade gestacional é um fator de risco para a retinopatia da prematuridade? Estudo com 345 pré-termos de muito baixo peso

Filho¹,

Valiatti²,

Eckert³

et al. 2009

J. Pediatr. (Rio J.)

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Objective: To analyze prevalence and risk factors for retinopathy of prematurity (ROP) among preterm infants born small for gestational age (SGA) and appropriate for gestational age (AGA). Methods:A prospective cohort study included preterm infants with birth weight (BW) ≤ 1,500 grams and gestational age (GA) ≤ 32 weeks, divided into two groups: AGA or SGA. Prevalences and risk factors for ROP were determined in both groups. Logistic regression was used for the significant variables after univariate analysis.Results: A total of 345 patients were examined: 199 included in the AGA group and 146 in the SGA. Mean BW and GA in the whole cohort (345 patients) were 1,128.12 grams (±239.9) and 29.7 weeks (±1.9), respectively. The prevalence of any stage ROP and severe ROP (needing treatment) was 29.6 and 7.0%, respectively. ROP in any evolutive stage developed in 66 AGA (33.2%) and in 36 SGA (24.7%) (p = 0.111). Severe ROP occurred in 15 AGA (7.5%) and in nine SGA (6.2%) (p = 0.779). After adjusted logistic regression, weight gain from birth to sixth week of life and need for blood transfusions were found to be significant risk factors for ROP in both groups. Conclusions:This study has shown that being SGA was not a significant risk factor for any stage ROP or for severe ROP in this cohort and, also, that the risk factors for ROP were similar among SGA and AGA very-low-birth-weight preterm babies.J Pediatr (Rio J). 2009;85(1):48-54: Prematurity, retinopathy of prematurity, very low birth weight infant, risk factors, small for gestational age, appropriate for gestational age.

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Retinopathy of prematurity in Brazil: an emerging problem

Abstract: A tragédia resultante da cegueira causada pela retinopatia da prematuridade (RP) não advém da falta de conhecimento acerca da doença. Com base nos resultados de estudos multicêntricos abrangentes

Cited by 15 publications

References 12 publications

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Postconceptional age at the treatment of retinopathy of prematurity in inborn and referred preterm infants from the same institution

Ser pequeno para a idade gestacional é um fator de risco para a retinopatia da prematuridade? Estudo com 345 pré-termos de muito baixo peso

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