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

Larraya, Ana Solans Pérez de; Molina, José María Ortega; Fernández, José Uberos; Ramírez, Amanda Rocío González; Serrano, José

doi:10.1155/2019/2721578

Cited by 11 publications

(4 citation statements)

References 29 publications

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“…For example, reducing the duration of mechanical ventilation affects the model both directly and indirectly by increasing the rate of vascularisation. Moreover, greater postnatal weight gain will produce a faster vascularisation of the retina [38]. Other risk factors, such as the need for blood transfusions or the presence of sepsis, are significant in the univariate analysis but disappear in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment

Protsyk,

García Serrano

2024

JPM

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Aim: The temporal avascular area of the retina and the duration of mechanical ventilation (DMV) may predict the need to treat retinopathy of prematurity (ROP). This study considers whether the rate of retinal vascularisation and related risk factors should be included in a predictive model of the need for ROP treatment. Methods: This single-centre, observational retrospective case–control study was conducted on 276 preterm infants included in an ROP screening programme. All had undergone at least three examinations of the fundus. The main outcome measures considered were DMV (in days of treatment), the temporal avascular area (in disc diameters, DD) and the rate of temporal retinal vascularisation (DD/week). Results: The multivariate logistic model that best explains ROP treatment (R2 = 63.1%) has three significant risk factors: each additional day of mechanical ventilation (OR, 1.05 [95% CI, 1.02–1.09]; p = 0.001); each additional DD of temporal avascular area (OR, 2.2 [95% CI, 1.7–2.9]; p < 0.001) and a vascularisation rate <0.5 DD/week (OR, 19.0 [95% CI, 6.5–55.5]; p < 0.001). Two tables are presented for calculating the expected need for ROP treatment according to these three risk factors. Conclusions: A greater DMV, a broad avascular area of the temporal retina at the first binocular screening and slow retinal vascularisation strongly predict the need for ROP treatment. The predictive model we describe must be validated externally in other centres.

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Section: Discussionmentioning

confidence: 99%

Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment

Protsyk,

García Serrano

2024

JPM

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“…The specific etiology of ROP is unknown, however it is believed to be associated with aberrant blood vessel proliferation in preterm newborns' retinas (32).…”

Section: Discussionmentioning

confidence: 99%

Ranibizumab for the treatment of retinopathy of prematurity: systematic review and meta-analysis

Alva,

Martínez,

Ortiz-Saavedra

et al. 2023

Front. Pediatr.

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Anti-VEGF drugs like ranibizumab can be used to treat retinopathy of prematurity (ROP) by halting the formation of abnormal blood vessels, or lasers can be used to burn the edges of the retina where these vessels are present. The objective is to compare the efficacy for ROP between ranibizumab and laser therapy.Material and methodsElectronic searches will be carried out in medical databases with key words and controlled vocabulary terms. Randomized controlled trials (RCT) will be assessed. The primary outcome will be the full ROP regression. Two reviewers will extract the data using predefined forms and, to assess the quality of the study, we will use RoB 2.0, the tool for randomized controlled trials developed by the Cochrane Collaboration. We used a combination of the inverse-variance approach and random-effects models for the meta-analysis.ResultsThe eyes of 182 preterm infants who had ranibizumab treatment were assessed in a total of 364 eyes, and 135 infants received laser therapy. The follow-up period was between 6 and 24 months. Ranibizumab was not associated with greater regression of ROP compared to laser therapy in preterm infants (RR: 1.09, CI 95%: 0.95–1.24; p: 0.22). Also, ranibizumab was not associated with recurrence of ROP compared to laser therapy in preterm infants (RR: 3.77, CI 95%: 0.55–25.81; p: 0.22).ConclusionsThe efficacy of ranibizumab compared to laser is very uncertain in terms of ROP regression and decreased ROP recurrence in preterm infants.Systematic Review Registrationidentifier PROSPERO (CRD42022324150).

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“…In a retrospective cohort by Larraya et al, 185 preterm infants were studied for speed of retinal vascularization, however, the authors did not address about the need to treatment or treatment effect. They reported that in multivariate analysis, intubation, high grade bronchopulmonary dysplasia, and poor weight gain at 4–6 weeks after birth, were significantly associated with speed of retinal vascularization < 0.5 disc diameter/week [ 13 ]. Hence, understanding an infant overall clinical picture is valuable in estimating the time to full vascularization.…”

Section: Discussionmentioning

confidence: 99%

Progression of retinal vascularization after intravitreal anti-vascular-endothelial growth factor therapy in retinopathy of prematurity

et al. 2022

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Background Anti-vascular endothelial growth factor (Anti-VEGF) therapy is now considered as one of standard therapies in approaching infants with retinopathy of prematurity (ROP). The purpose of this study was to assess the time to full retinal vascularization in infants with ROP who were treated with intravitreal bevacizumab (IVB). Methods This retrospective cohort study evaluated premature infants with ROP who were treated with IVB between 2012 and 2019. Demographic and clinical data were collected from the medical records and analyzed. Main outcomes were defined as time to complete vascularization and time of zone shift. Results Eight hundred sixty-five eyes from 441 patients were included. Average gestational age and birth weight were 28 ± 4 weeks and 1121 ± 624 g, respectively. Primary treatment failure and reactivation occurred in 35 eyes (4.0%) and 33 eyes (3.8%), respectively. Recurrent ROP occurred significantly more frequently in infants with pre-treatment zone 1 ROP compared to those with zone 2 ROP (7.6% versus 3%, p < 0.01). Patients with pre-treatment zone 2 reached zone 3 faster than those with pre-treatment zone 1 (142 ± 152 days versus 181 ± 174 days, p < 0.01); however, the time until full retinal vascularization did not significantly differ between the groups (p = 0.10). Conclusion This study revealed that pre-treatment ROP zone was associated with ROP reactivation rate but not with time to full vascularization in those treated with IVB. Trial registration Retrospectively registered; IR.TUMS.FARABI.REC.1399.040

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

Cited by 11 publications

References 29 publications

Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment

Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment

Ranibizumab for the treatment of retinopathy of prematurity: systematic review and meta-analysis

Progression of retinal vascularization after intravitreal anti-vascular-endothelial growth factor therapy in retinopathy of prematurity

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