Nonhyperoxic retrolental fibroplasia

Retrolental fibroplasia (RLF) has most often been observed in preterm infants exposed to high ambient oxygen concentrations. This case report describes an infant near term who was never exposed to supplemental oxygen but in whom stage 4 RLF developed. The etiologic role of exchange transfusion is discussed.     

Present status of retrolental fibroplasia in France

A national survey showed that retrolental fibroplasia still exists in France, as it does in other countries of the world. Retrolental fibroplasia is a condition that principally affects low birth weight premature babies in whom oxygen therapy has not been adequately controlled. The premature babies who have apnaeic attacks are most risk. Strict control of all oxygen therapy, preferably using continuous monitoring techniques together with other changes in the methods of treatment should reduce the incidence of this condition.     

Development of blind infants and children with retrolental fibroplasia: implications for physicians

Despite an apparent increase in the incidence of retrolental fibroplasia (RLF) and renewed interest in its pathophysiology and prevention, clinicians are often ill prepared to help the family promote the optimal development of its blind or severely visually impaired child. The physician's management approach is molded by both knowledge about the effects of blindness and prematurity on subsequent development and attitudes about blindness. Both issues are reviewed, with particular focus on the developmental course of the infant or child who is blind due to RLF. Although the literature regarding developmental outcome of premature infants with RLF has failed to reach definitive conclusions, studies reveal a tendency toward an IQ distribution similar to or slightly lower than that of various control samples. Blind children with RLF may also be at increased risk for emotional problems, largely as a function of early maladaptive family interaction patterns. Implications of these and other developmental patterns are translated into general and specific interventions that neonatologists, ophthalmologists, and primary care physicians can facilitate. Such physician guidance can help assure the blind or severely visually impaired child's optimal cognitive and emotional development.     

Risk factors for retrolental fibroplasia: experience with 3,025 premature infants. National Collaborative Study on Patent Ductus Arteriosus in Premature Infants

The rate of retrolental fibroplasia in relation to prenatal and neonatal characteristics was explored on the basis of a cohort of 3,025 neonates with birth weight less than 1,750 g. The overall rate of retrolental fibroplasia of any degree at hospital discharge was 11%, varying from 43% for those with birth weight between 500 and 749 g to 3% for those in the 1,500- to 1,750-g category. Among the potential determinants, the main interest was in nonhyperoxic characteristics, conditional on measures of prematurity and oxygen supplementation. Maternal diabetes and antihistamine use during the last 2 weeks of pregnancy were associated with significantly higher rates of retrolental fibroplasia, whereas toxemia was associated with lower rates. Frequent apneic spells, bronchopulmonary dysplasia, and sepsis in the neonate were also associated with significantly higher rates. On the other hand, the data indicate no independent role of low Apgar score, intraventricular hemorrhage, exchange transfusion, patent ductus arteriosus, or certain other characteristics previously postulated as risk factors.