Abstract
Following current recommendations for preventing retinopathy of prematurity (ROP) involves screening a large number of patients. We performed a prospective study to establish a useful screening system for ROP prediction and we have determined that measuring serum levels of IGF1 at week three and the presence of sepsis have a high predictive value for the subsequent development of ROP. A total of 145 premature newborn, with birthweight <1500 g and/or <32 weeks gestational age, were enrolled. 26.9% of them showed some form of retinopathy. A significant association was found between the development of retinopathy and each of the following variables: early gestational age, low birthweight, requiring mechanical ventilation, oxygen treatment, intracranial haemorrhage, sepsis during the first three weeks, bronchopulmonary dysplasia, the need for erythrocyte transfusion, erythropoietin treatment, and low levels of serum IGF1 in the third week. A multiple logistic regression analysis was used to obtain curves for the probability of developing ROP, based on the main factors linked with ROP, namely serum levels of IGF1 and presence of sepsis. Such preclinical screening has the ability to identify patients with high-risk of developing retinopathy and should lead to better prediction for ROP, while at the same time optimising the use of clinical resources, both human and material.
Highlights
Retinopathy of prematurity (ROP) is a retinal vascular disease affecting premature babies which, without early identification and treatment, can lead to retinal detachment and loss of vision
In each patient included in the study, serum level of insulin-like growth factor (IGF1) was measured in the third week after birth -it was described that insulin-like growth factor 1 (IGF1) levels at third week have more sensitivity and specificity on detection ROP disease [9]. 1.2 ml of blood was obtained by peripheral venipuncture, serum obtained by centrifugation and analysis carried out using an enzyme-labelled chemiluminescent immunometric assay (IMMULITE 2000 IGF-I, Siemens (R) Healthcare Diagnostics Ltd., Surrey, UK)
We have developed a method for the prediction of retinopathy of prematurity, based on serum levels of IGF1 in the third week and the presence or absence of sepsis in the first three weeks after birth
Summary
Retinopathy of prematurity (ROP) is a retinal vascular disease affecting premature babies which, without early identification and treatment, can lead to retinal detachment and loss of vision. ROP is one of the main causes of blindness in premature babies [1],[2]. Multiple pathogenic factors have been identified for ROP. Important among these are an association with blood oxygen saturation and with infection [3],[4],[5],[6]. A deficit of IGF1 in the first few weeks of post-natal life pre-dispose to nonproliferative stages of the disease, while a subsequent increase in IGF1 levels can lead to proliferative stages of ROP [7],[8],[9]
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