Risk Factors of Retinopathy of Prematurity Associated with Delayed Retinal Vascular Development

Abstract

Objectives: To assess risk factors of retinopathy of prematurity leading to delayed retinal vascularization in the first stage of ROP. Methods:A retrospective study (2000 -2016) was performed in 275 infants who were born at a gestational age of ≤ 32 weeks. Delayed vascular development was calculated as the difference in avascular area measured in terms of disc diameters between patients with risk factor and those with no risk factor. Results:Intrauterine fetal demise of one twin, apnea, exchange tranfusion and intubation days (≥ 10 days) lead to delayed retinal vascularization of 1.74, 1.58, 1.17, and 1.11 disc diameters and of 3.35, 3.04, 2.25 and 2.13 weeks respectively. Delayed retinal vascular development was less than 1 disc diameter in other factors such as HS-PDA, sepsis, degree of hyaline membrane ≥ III, cerebral hemorrhage, birth weight (every 100 g less), gestational age (every week less), postnatal weight gain (every 1 g less/day) and cerebral hemorrhage. However, since these factors are quantitative (birth weight, gestational age and postnatal weight gain), the greater the adverse effect, the greater the delay will be. Conclusions:Intrauterine fetal demise of one twin, apnea, exchange tranfusion and intubation days (≥ 10 days) lead to delayed retinal vascular development more than 1 disc diameter at 4 -6 weeks of postnatal life.

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

“…These factors increase the avascular area of the retina and play an important role in the development of ROP. 15,18,19 According to Harnett and Penn, 20 in ROP, there is a delay in physiologic retinal vascular development rather than vasoobliteration, with subsequent vasoproliferation in some infants with ROP. Hellström et al 21 confirmed that the optimisation of oxygen saturation, nutrition and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as the reduction of the effects of infection and inflammation promote postnatal growth and improve retinal vascular development.…”