Retinal vascular speed &lt;0.5 disc diameter per week as an early sign of retinopathy of prematurity requiring treatment

Larraya, Ana Solans Pérez de; Molina, José María Ortega; Fernández, José Uberos; Gómez, J. Escudero; Miranda, A.; Samaniego, Maria J Chaves; Serrano, José

doi:10.1177/1120672118761328

Cited by 11 publications

(25 citation statements)

References 25 publications

(30 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…Previous studies carried out at our center on a preliminary patient cohort have shown the usefulness of measuring the vascular/avascular area ( 5 , 48 ). Thus, vascularization speed from the temporal avascular area to the posterior pole below 0.5 DD/week has been identified as an independent risk factor for severe ROP requiring treatment ( 5 ). A study carried out at another center on a different patient cohort analyzed the impact of the risk factors for ROP and the effect of control measures of oxygen saturation levels implemented through the Oxygen With Love (OWL) program.…”

Section: Discussionmentioning

confidence: 99%

“…Michaelson reported that the growth rate of the superficial retinal vessels was 100 μm/day in the human fetus ( 65 ). Factors such as low GA and other vascular development inhibitors may lead to a greater avascular area in the temporal retina ( 5 , 48 ). Premature newborns who present with absence of vascularization in zone I at the first examination have a higher risk of ROP requiring treatment than those who present with absence of vascularization in zone II or III ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, the revascularization time required to reverse ROP in zone I is significantly longer than that required in zone II, which in turn is longer than that required in zone III ( 16 , 17 ). A retinal vascularization rate of <0.5 disc diameters (DD) per week ( 18 ) has been identified as an indication for ROP treatment ( 5 ). Therefore, why not study the temporal avascular area of the retina as a risk factor?…”

Section: Introductionmentioning

confidence: 99%

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Risk Calculator for Retinopathy of Prematurity Requiring Treatment

et al. 2020

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Importance: Vascular delay that occurs early in the development of retinopathy of prematurity (ROP) is a risk factor that can be compensated by ensuring a good rate of retinal vascularization to avoid ROP that requires treatment. Background: The objective of the present study was to determine the association between ROP that requires treatment and risk factors such as the extent of the temporal avascular area of the retina and the number of days of mechanical ventilation (MV). Design: Observational retrospective case-control study. Participants: Two hundred and twenty-eight premature newborns included in the screening protocol for retinopathy of prematurity. Methods: Subjects underwent retinal examination in the 4 and 6th postnatal weeks. Main Outcome Measures : The temporal avascular area was measured in disc diameters (DD), while the MV time was measured in days of treatment. Results: Patients with a longer MV time had a higher risk of treatment (R 2 : 24.7, p < 0.0001; increase in risk of 8.1% for each additional day), as did those who showed greater avascular area (R 2 : 24.7, p < 0.0001; increase in risk of 111% for each additional DD). An online calculator system and a table are presented for calculating the risk of ROP requiring treatment as a function of these two risk factors. Conclusions and Relevance: The temporal avascular area of the retina and MV time must be taken into account in the first examination of the newborn to predict the need for ROP treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk Calculator for Retinopathy of Prematurity Requiring Treatment

et al. 2020

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“…This risk increases when the temporal retinal vascularization is lower than 0.5 disc diameter/week (DD/w) [3].…”

Section: Introductionmentioning

confidence: 99%

Speed of Retinal Vascularization in Retinopathy of Prematurity: Risk and Protective Factors

Larraya

Molina

Fernández

et al. 2019

BioMed Research International

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Objective. The objective was to study the risk and protective factors involved in retinal vascular development of preterm infants with retinopathy of prematurity. Methods. Between 2000 and 2017, 185 preterm infants were included in the protocol for retinopathy of prematurity. Risk factors associated with speed of retinal vascularization <0.5 disc diameter/week were studied in each of them. Results. The statistically significant variables related to retinal vascular development <0.5 DD/w were intubation days, degree 3 of bronchopulmonary dysplasia, weight gain at 4-6 weeks, avascular temporal area, gestational age, number of transfusions, sepsis, number of risk factors, apnea at birth, presence of ductus arteriosus, and days of continuous positive airway pressure therapy. After the multivariate logistic regression analysis, only three variables were found to be significant: intubation days (p=0.005), degree 3 of bronchopulmonary dysplasia (p=0.022), and weight gain at 4–6 weeks (p=0.031). Conclusion. In retinopathy of prematurity, degree 3 of bronchopulmonary dysplasia and intubation days cause delayed retinal vascular development, whereas greater postnatal weight gain favors an appropriate rate of retinal vascularization.

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Development and Validation of a Deep Learning Model to Predict the Occurrence and Severity of Retinopathy of Prematurity

et al. 2022

JAMA Netw Open

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IMPORTANCERetinopathy of prematurity (ROP) is the leading cause of childhood blindness worldwide. Prediction of ROP before onset holds great promise for reducing the risk of blindness. OBJECTIVE To develop and validate a deep learning (DL) system to predict the occurrence and severity of ROP before 45 weeks' postmenstrual age. DESIGN, SETTING, AND PARTICIPANTS This retrospective prognostic study included 7033 retinal photographs of 725 infants in the training set and 763 retinal photographs of 90 infants in the external validation set, along with 46 characteristics for each infant. All images of both eyes from the same infant taken at the first screening were labeled according to the final diagnosis made between the first screening and 45 weeks' postmenstrual age. The DL system was developed using retinal photographs from the first ROP screening and clinical characteristics before or at the first screening in infants born between June 3, 2017, and August 28, 2019. EXPOSURES Two models were specifically designed for predictions of the occurrence (occurrence network [OC-Net]) and severity (severity network [SE-Net]) of ROP. Five-fold cross-validation was applied for internal validation. MAIN OUTCOMES AND MEASURES Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity to evaluate the performance in ROP prediction. RESULTSThis study included 815 infants (450 [55.2%] boys) with mean birth weight of 1.91 kg (95% CI, 1.87-1.95 kg) and mean gestational age of 33.1 weeks (95% CI, 32.9-33.3 weeks).

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Retinal vascular speed <0.5 disc diameter per week as an early sign of retinopathy of prematurity requiring treatment

Cited by 11 publications

References 25 publications

Risk Calculator for Retinopathy of Prematurity Requiring Treatment

Risk Calculator for Retinopathy of Prematurity Requiring Treatment

Speed of Retinal Vascularization in Retinopathy of Prematurity: Risk and Protective Factors

Development and Validation of a Deep Learning Model to Predict the Occurrence and Severity of Retinopathy of Prematurity

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