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

Abstract

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

Vitreous changes after intravitreal bevacizumab monotherapy for retinopathy of prematurity: a case series

“…The mean post-conceptional age for intravitreal bevacizumab injection (IVB injection) described in our series was later compared to data found in the literature which is around 37 weeks post conceptional age [ 17 ]. Fortes et al concluded that inborn patients were treated for retinopathy of prematurity during the week 37 of post-conceptional age while transferred patients were treated, usually, after week 39 [ 18 ]. In our series, 6 eyes (out of 9) were treated in due date (PMA 40 weeks) or later.…”

Perfil clínico de recém-nascidos em investigação para a retinopatia da prematuridade em uma maternidade na região Amazônica

“…A utilização inadequada de oxigênio e episódios de hiperóxia e hipóxia que ocorrem no prematuro são fatores de risco para o desenvolvimento da ROP. Isso ocorre, pois após o nascimento, durante o crescimento do bebê, a retina entra em um estado de hipóxia, dessa forma aumentando a produção de fator de crescimento vascular endotelial (VEGF), causando a vascularização anormal da retina (Fortes Filho et al, 2011).…”

Intravitreal ranibizumab as a primary or a combined treatment for severe retinopathy of prematurity

“…However, PCA at treatment may influence outcomes. 32 Group 1 underwent treatment at a mean PCA of 36.6 weeks and group 2 at 38.2 weeks. It appears that better results observed in group 1 might be influenced by this variable.…”