Retinopathy of prematurity: the influence of gestational age and retinal maturity on the statistical behavior of risk factors

The clinical and laboratory data on 140 premature infants, 74 cases with retinopathy of prematurity (ROP) and 66 control cases without ROP, were correlated with ROP grades of increasing severity. By using multiple linear regression (MLR), it is shown that for predicting ROP grades the importance of certain variables varies considerably depending on the gestational age. Below 32 weeks of gestation, acidosis, hyperoxemia, gestational age, pathologic paCO₂ levels, and multiple birth are strong regressors. Above 31 weeks, the most important regressors are multiple birth and acidosis, while gestational age and duration of FiO₂>0.4 are much less influential. Blood transfusions and artificial ventilation do not seem important in the MLR of either group. When ROP is regressed on the number of paO₂ values above 100 torr and gestational age or on the number of paCO₂ values above 50 torr and gestational age, the regression coefficients of these variables drop to near zero at a gestational age of about 32 weeks. This loss of weight of the two variables paO₂ and paCO₂ with increasing gestational age coincides with a comparable drop of the relative incidence of ROP and the relative incidence of immature retinal vessels. It is hypothesized that it is the proportion of infants with an immature retinal vasculature in populations of given gestational ages rather than the gestational age itself which is responsible for the widely varying importance of certain factors during the development of ROP.Dedicated to Professor E. Rossi, Director of the University Children's Hospital, Berne, to his 70th birthdayPresented at the 1984 meeting of the Club Jules Gonin in Lausanne, Switzerland     

Chosen etiopathogenetic factors in formation and development of retinopathy of prematurity (ROP)

Retinopathy of prematurity remains a serious problem in newborns. Sometimes despite of better ophthalmologic control and knowledge of pathomechanism of ROP, there is no possibility to avoid blindness. Today attention is concentrated on searching in pathophysiology, immunology and other branches of medical sciences to explain the nature of disease. The aim of this article is to analyze some factors which play an important role in development of ROP.     

Progressive visual loss in adults with retinopathy of prematurity (ROP)

Two visually monocular patients with retinopathy of prematurity, followed up for 14 and 5 years, developed progressive visual loss in their twenties and thirties, respectively. In one patient, who underwent no surgery, visual acuity deteriorated from 20/30 to 20/400 over a 14-year period. The second patient had surgery for retinal detachment. Visual acuity after surgery was 20/60. In the ensuing 2 years it dropped to counting fingers and the visual field constricted to 10 deg. We suggest that changes in the retinal pigment epithelium may compromise the photoreceptors in some ROP patients, thus leading to visual deterioration.Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc.; presented at the American Ophthalmological Society, Hot Springs, Virginia, 24 May, 1988, and at the XVIth Meeting of the Club Jules Gonin, Bruges, 4–8 September 1988     

Treatment of retinopathy of prematurity (ROP) outside International Classification of ROP (ICROP) guidelines

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate the incidence and clinical indications for which eyes were treated for retinopathy of prematurity (ROP) outside the...     

早产儿视网膜病发生的相关危险因素

目的　探讨早产儿视网膜病发生的相关危险因素。方法　以 1 35例早产儿患者为样本 ,对胎龄、性别、出生体重、吸氧时间、吸氧浓度、肺透明膜病、Apgar评分、颅内出血、支气管肺发育不良、反复呼吸暂停、动脉导管开放、眼底等检查。同时用单因素X2 检验和多因素logistic回归分析筛选和判定早产儿视网膜病发生的危险因素。结果　 2 8例患者合并有早产儿视网膜病 ,占 2 0 74 %。经logistic回归分析 ,发现吸氧浓度、吸氧时间、出生体重、胎龄与早产儿视网膜病发生显著相关。 结论　吸氧浓度、吸氧时间、出生体重、胎龄为早产儿视网膜病发生的重要危险因素 ,应重视并针对其危险因素加以预防。     

Long-term effects of retinopathy of prematurity (ROP) on rod and rod-driven function

The purpose of this study was to determine whether recovery of scotopic sensitivity occurs in human ROP, as it does in the rat models of ROP. Following a cross-sectional design, scotopic electroretinographic (ERG) responses to full-field stimuli were recorded from 85 subjects with a history of preterm birth. In 39 of these subjects, dark adapted visual threshold was also measured. Subjects were tested post-term as infants (median age 2.5 months) or at older ages (median age 10.5 years) and stratified by severity of ROP: severe, mild, or none. Rod photoreceptor sensitivity, S _ROD, was derived from the a-wave, and post-receptor sensitivity, log σ, was calculated from the b-wave stimulus–response function. Dark adapted visual threshold was measured using a forced-choice preferential procedure. For S _ROD, the deficit from normal for age varied significantly with ROP severity but not with age group. For log σ, in mild ROP, the deficit was smaller in older subjects than in infants, while in severe ROP, the deficit was quite large in both age groups. In subjects who never had ROP, S _ROD and log σ in both age groups were similar to those in term born controls. Deficits in dark adapted threshold and log σ were correlated in mild but not in severe ROP. The data are evidence that sensitivity of the post-receptor retina improves in those with a history of mild ROP. We speculate that beneficial reorganization of the post-receptor neural circuitry occurs in mild but not in severe ROP.     

早产儿视网膜病变高危因素分析

目的：了解早产儿视网膜病变(ROP)的发病情况及该病的危险因素。

方法：回顾性研究。以2018-01/2021-01高州市人民医院符合《中国早产儿视网膜病变的筛查指南(2014)》的161例新生儿为研究对象。采用Retcam Ⅲ对其进行眼底筛查。收集新生儿及母亲的临床资料。采用单因素分析及多因素Logistic回归分析ROP发生的高危因素。

结果：符合纳入标准的161例新生儿中,ROP组26例(16.1%)、非ROP组135例(83.9%)。在单因素分析结果显示胎龄、新生儿红细胞计数、出生体质量、母亲年龄、妊娠期高血压病、受孕方式在两组间存在差异(P<0.05)。多因素Logistic回归分析结果显示胎龄(OR=0.549,95%CI：0.391～0.770,P=0.001)是ROP的保护因素,妊娠期高血压病(OR=3.947,95%CI：1.049～14.852,P=0.042)及辅助生殖(OR=4.632,95%CI：1.112～19.305,P=0.035)是ROP的危险因素。

结论：患儿胎龄是发生ROP的保护性因素,辅助生殖是发生ROP的危险因素。应高度关注低胎龄、采用辅助生殖技术孕生以及母亲患有妊娠期高血压病的患儿,实现早发现、早治疗,以减少ROP所致的眼盲。     

Towards a universal approach for screening of retinopathy of prematurity (ROP)

To improve the cost-benefit ratio of our current screening program for retinopathy of prematurity (ROP), the records of 312 infants who had been screened for ROP were studied retrospectively. Using a safety-index containing three well known risk factors (birthweight, gestational age, oxygen use), infants were classified to be at high risk or low risk for the development of ROP. When all high risk infants would have been screened extensively from the 5 ^th postnatal week onwards and all low risk infants would have been screened once at the 7 ^th postnatal week, a 9.8% reduction of ophthalmological examinations would have been obtained at the expense of missing 2.9% of non vision threatening ROP.     

早产儿视网膜病变危险因素研究进展

早产儿视网膜病变(retinopathy of prematurity,ROP)是一种视网膜血管增生性疾病,近年来随着医疗水平的不断提高,其发病率也显著增高,该病已成为我国儿童致盲的主要原因之一.目前其发病机制尚不清楚,认为早产、低出生体质量和吸氧是该病的三大危险因素.本文就可能引发该病的多个因素进行综述,旨在扩充ROP的病因和发病机制,为该病的防治提供理论依据.     

未成熟儿视网膜病变危险因素分析

目的分析未成熟儿视网膜病变(retinopathy of     

Brazilian guidelines proposal for screening and treatment of retinopathy of prematurity (ROP)

Retinopathy of prematurity is one of the main causes of childhood blindness. Worldwide, there are more than 50,000 children blind due to retinopathy of prematurity. Visual impairment is a consequence of retinal detachment. It can be detected by serial ophthalmologic examination of infants at risk, and those identified with the severe form of the disease can be treated by laser or cryotherapy, which can decrease significantly the blindness due to ROP. The Brazilian Society of Pediatrics, Brazilian Council of Ophthalmology and Brazilian Society of Pediatric Ophthalmology suggest a guideline for the detection and treatment of retinopathy of prematurity in Brazil. This document was based on the results of the I Workshop of Retinopathy of Prematurity and presents the attributes for the implementation of an efficient diagnostic and treatment program.     

Analysis of risk factors for retinopathy of prematurity

AIM: To analyze the incidence and risk factors for retinopathy of prematurity (ROP). METHODS: A retrospective analysis was conducted on 568 premature infants from September 2005 to December 2010 with birth weight(BW) equal to or less than 2 500g or a gestational age(GA) at birth of 34 weeks or less. All of the members were examined by indirect binocular ophthalmoscopy. RESULTS: ROP occurred with an incidence rate of 10.7% among 568 premature infants, and stages 3 and above ROP occurred with an incidence rate of 2.5%. This study showed the infants were more prone to develop ROP with short geststional age, low BW, long time of oxygen inhalation, and severe infants diseases. Twins had a significantly higher rate of ROP(18.3%) than singleton babies(9.8%), ROP were severer in twins than singleton babies . CONCLUSION: Short GA, low BW, long time of oxygen inhalation, severe infants diseases, and non-singleton babies were the most significant risk factors associated with ROP.     

早产儿视网膜病变的危险因素研究进展

早产儿视网膜病变(retinopathy of prematurity,ROP)是早产儿视网膜血管发育异常所导致的眼病,可导致弱视、斜视、白内障、青光眼,甚至失明,严重影响存活早产儿的生存质量。据世界卫生组织统计,ROP导致早产儿失明的比例约为6%～18%,已成为导致世界儿童失明的首要原因。ROP的发病机制尚不完全清楚,国内外研究发现影响ROP发生的危险因素包括胎龄、出生体质量、吸氧、分娩方式、多胎、新生儿呼吸窘迫综合征、贫血、输血、败血症、感染、高碳酸血症、高胆红素血症、母体产前应用某种药物等。我们就ROP的危险因素和可能的作用机制进行综述,为ROP研究和防治提供理论支持。