Abstract
PurposeTo demonstrate the clinical characteristics and treatment outcomes of severe retinopathy of prematurity (ROP) in preterm infants with birth weight (BW) above 1500 g in Turkey.MethodsA retrospective review of 5920 ROP records was performed in Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital. The records were obtained from ROP treatment center of the same institute between 2011 and 2016. The data comprised the demographic and clinical characteristics including, gestational age, BW, systemic risk factors, zone and stage of ROP, ROP type, treatment modality, treatment outcomes and inborn/outborn status of the babies.ResultsA total of 36 infants (71 eyes) with severe ROP and BW> 1500 g were retrieved. There were 30 infants (83.3%) with type 1 ROP and 6 infants (16.7%) with aggressive posterior ROP (APROP). 3 infants (8.3%) were born at our hospital whereas 33 (91.7%) were referred from outer private neonatal intensive care unit (NICU) centers. Zone I APROP was detected during the initial screening. 21 infants (58.3%) underwent laser treatment while 15 (41.7%) received intravitreal bevacizumab (IVB) injections. No unfavorable structural outcome was observed following either treatment modality.ConclusionSevere ROP may occur in heavier preterm infants. Laser treatment and IVB injections were useful in selected cases. Presence of APROP at first examination suggests an earlier screening in heavier babies. Standardization of private NICU centers as well as establishing a national ROP protocol is necessary in Turkey.
Highlights
Retinopathy of prematurity (ROP) is a leading cause of treatable childhood blindness which is characterized by abnormal retinal vascular development [1]
Zone I APROP was detected during the initial screening. 21 infants (58.3%) underwent laser treatment while 15 (41.7%)
Severe retinopathy of prematurity (ROP) may occur in heavier preterm infants
Summary
Retinopathy of prematurity (ROP) is a leading cause of treatable childhood blindness which is characterized by abnormal retinal vascular development [1]. It may progress to retinal detachment if more severe disease is left untreated. An early and appropriate treatment plays a great role in infants who are at risk for progression to retinal detachment [2]. Lower gestational age (GA) and birth weight (BW) have been shown as the main risk factors for the development of ROP [3]. Studies from developing and middle-income countries have indicated that more mature preterm babies can develop severe ROP [4]. It has been stated that Western ROP screening guidelines [5,6] might not be appropriate to detect all infants at risk in these regions resulting in a significant number of infants are being missed who can require treatment [7,8,9]
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