Retinopathy of prematurity: postmenstrual age at threshold in a transitional economy is similar to that in developed countries

Carden, Susan M.; Luu, Lan Ngoc; Nguyen, Tinh Xuan; Huynh, Tess; Good, William V.

doi:10.1111/j.1442-9071.2008.01682.x

Cited by 14 publications

(10 citation statements)

References 7 publications

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“…At group 2, two patients needed laser twice and also a scleral buckle procedure and one patient needed an antiVEGF intravitreous injection of bevacizumab (Avastin ® ) in order to stop ROP progression. Comparing our data regarding the PCA at treatment for threshold ROP with the recent article published from Vietnam, as previous referenced, we observed that the PCA at treatment for inborn and for referred patients in that study were similar at 36.2 ± 2.3 weeks and 36.3 ± 2.2 weeks, respectively, while in our study the PCA for inborn was 37 weeks and the PCA for referred patients was 39 weeks, two weeks later, despite the lower BW and GA found in our patients (15) . It is well known, from the results of the Cryo-ROP, that ROP, prethreshold and threshold disease, usually occurs at completed 36 and 37 weeks of PCA, respectively.…”

Section: Discussioncontrasting

confidence: 44%

“…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. These data show a lower BW and GA cohort of treated patients when compared to a similar data (1,369 ± 184 g and 30 ± 1.8 weeks) from a recent published article from Hanoi, Vietnam, a country in transitional economy, like Brazil (15) . Lower GA and BW have been implicated in the occurrence of ROP in most studies and both are considered the most important risk factors for severe ROP that require treatment in different populations and in different countries (16,17) .…”

Section: Discussionmentioning

confidence: 67%

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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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Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 67%

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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“…Carden et al 22 reported that 58 infants referred to the National Hospital of Paediatrics in Hanoi, Vietnam with ROP had birth weights ranging from 800–1900 g and gestational ages ranging from 28–35 weeks. Gu et al 23 reported birth weights of infants with ROP in China ranging from 1501–2000 g. Risk factors reported to cause ROP in more mature neonates are septicaemia and poorly controlled oxygen therapy.…”

Section: Discussionmentioning

confidence: 99%

Fluorescein angiographic observations of peripheral retinal vessel growth in infants after intravitreal injection of bevacizumab as sole therapy for zone I and posterior zone II retinopathy of prematurity

et al. 2014

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AimTo evaluate vascularisation of the peripheral retina using fluorescein angiography (FA) digital recordings of infants who had been treated with intravitreal bevacizumab (IVB) as sole therapy for zone I and posterior zone II retinopathy of prematurity (ROP).MethodsA retrospective evaluation was performed of medical records, RetCam fundus images and RetCam fluorescein angiogram videos of 10 neonates (20 eyes) who received intravitreal bevacizumab injections as the only treatment for zone I and posterior zone II ROP between August 2007 and November 2012.ResultsAll eyes had initial resolution of posterior disease after IVB injection as documented by RetCam colour fundus photographs. Using a distance of 2 disc diameters from the ora serrata to vascular termini as the upper limit of allowable avascular retina in children, the FA of these infants demonstrated that 11 of 20 eyes had not achieved normal retinal vascularisation.ConclusionsAlthough bevacizumab appears effective in bringing resolution of zone I and posterior zone II ROP and allowing growth of peripheral retinal vessels, in our series of 20 eyes, complete normal peripheral retinal vascularisation was not achieved in half of the patients.

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“…[2] Oxygen management inadequacies in middle-income country NICUs lead to larger infants being at risk than in high-income countries. [3][4][5] In SA, an estimated 16 000 infants are at risk of ROP and require screening each year. [2,6] In 1995, ROP accounted for 10.6% of cases of blindness in schools for the blind.…”

mentioning

confidence: 99%

Retinopathy of prematurity screening criteria and workload implications at Tygerberg Children’s Hospital, South Africa: A cross-sectional study

et al. 2016

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Background. Screening guidelines for retinopathy of prematurity (ROP) used in high-income countries are not appropriate for middleincome countries, and screening requirements may vary even between units within one city. Objective. To determine optimal ROP screening criteria, and its workload implications, for Tygerberg Children's Hospital (TCH), Cape Town, South Africa. Methods. This cross-sectional study included premature infants screened for ROP at TCH from 1 January 2009 to 31 December 2014. Logistic regression analysis for prediction and classification was performed. Predictors were birth weight (BW) and gestational age (GA). Endpoints were clinically significant ROP (CSROP) and type 1 ROP (T1ROP). Results. Of 1 104 eligible infants, 33.4% had ROP (CSROP 9.1%, T1ROP 2.5%). All T1ROP infants received laser therapy. The number of screening examinations was inversely correlated with GA and BW. The number needed to screen to identify one infant requiring treatment was 41 (entailing 83 examinations, 4 screening hours, one technician and three doctors). Screening infants with a GA of ≤28 weeks or a BW of <1 000 g would have detected all infants with T1ROP but missed two outliers with CSROP. These outliers would only have been detected with a GA of ≤32 weeks or a BW <1 500 g. Conclusions. Detection of infants with T1ROP is resource intensive. Larger infants require screening to include a few outliers, but they require fewer examinations than smaller infants. Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

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Retinopathy of prematurity: postmenstrual age at threshold in a transitional economy is similar to that in developed countries

Abstract: Despite the relative maturity of the gestation of these infants compared with infants in developed countries who develop severe retinopathy of prematurity, the timing of treatment for threshold disease appears to be related to postmenstrual age.

Cited by 14 publications

References 7 publications

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

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

Fluorescein angiographic observations of peripheral retinal vessel growth in infants after intravitreal injection of bevacizumab as sole therapy for zone I and posterior zone II retinopathy of prematurity

Retinopathy of prematurity screening criteria and workload implications at Tygerberg Children’s Hospital, South Africa: A cross-sectional study

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