Aggressive Posterior Retinopathy Of Prematurity Research Articles

Postnatal weight gain as a predictor of retinopathy of prematurity in preterm babies

Aims: The aim of this study is to observe the postnatal weight gain as a predictor of retinopathy of prematurity (ROP) in preterm babies. Materials and Methods: A prospective cohort study was conducted from October 2018 to March 2020 in the Department of Neonatology and Ophthalmology, BSMMU Shahbag, Dhaka. Preterm neonates whose gestational age (GA) <35 weeks and birth weight (BW) <2000 g were included in the study. Results: The frequency of ROP was 35%. Most of them had Stage 1 ROP 17 (52%), and second most cause was aggressive posterior ROP 8 (24%). Severe form of ROP is more in “postnatal weight gain not achieved group.” On bivariate analysis, postnatal weight gain, BW, gestation, sepsis, apnea, necrotizing enterocolitis, use of oxygen, continuous positive airway pressure, mechanical ventilation, and blood transfusion were significantly associated with ROP. Not achieving postnatal weight gain and low gestation were significantly associated with ROP on logistic regression analysis. Conclusion: Not achieving postnatal weight gain and low GA are a predictor of retinopathy of retinopathy.

Discordant ROP (Retinopathy of prematurity) development in twins less than 32 weeks of gestational age.

Background and aim:Retinopathy of prematurity (ROP), is a vasoprolipherative disorder of the immature retina and a major cause of preventable blindness in childhood. Although the development of ROP is multifactorial, the principal reasons are lower gestational age and lower birth weight. However, in twins their gestational ages were the same, ROP development can be discordant. This study aims to evaluate the etiologic factors of discordant ROP development in twins.Methods:We reviewed the last 5 years' records and found the twins whose discordant ROP development. This discordance was; 1. Different stages of ROP, 2. One sibling treated the other is not, 3. One sibling has aggressive posterior ROP the other is not, 4. One sibling has more influenced area as zones the other is not. We documented some data of these twins, as birth order, birth weight, resuscitation at birth, morbidities, the number of hemotransfusion, age of regaining birth weight, relative weight gain at 28 weeks.Results:We evaluated a total of 26 cases of 13 twins. The mean gestational age and birth weight of the entire study group were 27.7 ± 2, and 1053 ± 364 grams, respectively. We found that more transfused preterm baby in twins is more likely to show severe ROP. Sepsis and the duration of mechanical ventilation may be risk factors for more severe ROP in twins.Conclusion:We can reduce discordant retinopathy in less than 32-weeks premature twins by using methods such as cord milking and by improving non-invasive ventilation modalities. (www.actabiomedica.it)

Cataract in retinopathy of prematurity - A review.

Preterm babies with retinopathy of prematurity (ROP) can become blind if they do not receive appropriate timely intervention. The presence of cataract in these individuals in addition to visual deprivation amblyopia, also delays proper screening, adequate treatment, and makes follow-up assessment difficult. Anatomical differences in these infants and amblyopia management, especially in unilateral cataract, are other important concerns, and hence, management of these cases with cataract and ROP is challenging. In this review, studies where ROP cases were associated with cataract, were evaluated with a focus on preterm individuals less than 6 months age. Preterm babies are at increased risk of developing cataract because of systemic factors. In addition, those with ROP may have cataract associated with retinal detachment or treatment received. The type of cataract, risk factors, and pathophysiology associated with each cause varies. This review highlights these different aspects of cataract in ROP including causes, pathophysiology, types of cataracts, and management. The management of these cases is critical in terms of the timing of cataract surgery and the challenges associated with surgery and posterior segment management for ROP. Anatomical differences, preoperative retina status, pupillary dilatation, neovascularization of iris in aggressive posterior ROP, fundus examination, amblyopia, and follow-up are various important aspects in the management of the same. The preoperative workup, intraoperative challenges, postoperative care, and rehabilitation in these individuals are discussed.

Analysis of a two-year independent screening effort for retinopathy of prematurity in rural Egypt

BackgroundThe third epidemic of retinopathy of prematurity (ROP) has majorly involved middle income countries in which tailored screening and local guidelines require development. The data regarding ROP prevalence and cutoff numbers for screening in Egypt are lacking.MethodsRetrospective analysis of an independent screening effort spanning 2 years (February 2019 to February 2021) and involving 32 neonatal care units within Sharkia governorate, Egypt. Infants of gestational age (GA) ≤ 34 weeks and/or birth weight (BW) ≤ 2000 g were included, as well as those with unstable clinical course. Two eyecare centers located in Sharkia and Cairo governorates served as referral centers for any required interventions.ResultsOf the 276 screened infants, 133 (48.2%) had some form of ROP that was bilateral in 127 (95.5%) of them. Aggressive posterior ROP (AP-ROP) was detected in both eyes of 24 infants (8.7%). The median (IQR) GA of infants with ROP was 32 (30–34) weeks, and the median (IQR) BW was 1600 (1350–2000) g. Sixty-three infants (47.4%) required treatment. Of the total 84 eyes that primarily were treated, 73 (86.9%) received intravitreal ranibizumab, 8 (9.5%) underwent laser ablation therapy, and 3 eyes (3.6%) underwent surgery. Recurrence rate was 16.7% (14 eyes). Final outcome was favorable in 83 eyes (98.8%). Applying the American Academy criteria would have led to the missing of 36.8% of infants with ROP and 28.6% of those requiring treatment in our sample.ConclusionThe incidence of both ROP and AP-ROP in the Egyptian rural setting appears to be in the high end of global reported rates. Prevention measures should urgently be planned and implemented.

Angiographic findings in cases with a history of severe retinopathy of prematurity treated with anti-VEGFs: Follow-up to age 6 years.

To report the effects of anti-vascular endothelial growth factor (VEGF) treatment in vascular development for cases of acute retinopathy of prematurity (ROP) using fluorescent angiography (FA) and to present the results of our observational approach to retinal sequelae. A total of 31 eyes in 19 patients with a history of treatment with anti-VEGF agents for classic type 1 ROP and aggressive posterior ROP who underwent FA between March 2014 to February 2020 were reviewed. Angiograms of retinal developmental features of patients aged 4months to 6years were examined. The patients mean gestational age were 26.06 ± 1.90weeks and the mean birth weight were 837.68 ± 236.79g. All cases showed various abnormalities at the vascular and avascular retina, and the posterior pole. All but one case showed a peripheral avascular area on FA evaluation during the follow-up period. We did not apply prophylactic laser treatment to these avascular retina. On the final examination, except one case, we did not observe any late reactivation in any patients. FA is an important tool for assessing vascular maturation in infants. Every leakage should not be assumed to be evidence of late activation, as some leaks may be related to vascular immaturity. Retinal vascularization may not be completed in all patients, however this does not mean that all these patients need prophylactic laser application. Our observational approach may be more daring than the reports frequently encountered in the literature, but it should be noted that unnecessary laser treatment will also eliminate all the advantages of anti-VEGF treatment.

Preterm refraction and ocular biometry in children with and without retinopathy of prematurity in the first year of life

To determine ocular biometric and refractive profiles of premature children at risk of retinopathy of prematurity (ROP), comparing those who did and did not require laser treatment.In this prospective study, premature infants underwent biometry and refraction with their first ROP examination. Study parameters were assessed again at 3 months, 6 months, and 1 year. The main outcome measures were spherical equivalent, axial length, and keratometry.A total of 122 infants (243 eyes) were included. At baseline, infants without ROP, those with ROP who never needed treatment, and those who later needed treatment had overall comparable axial length (P = 0.53) and myopia (P = 0.05); the highest severity group had higher corneal steepness and more myopia at baseline. At 1 year, children with laser-treated ROP had the shortest axial lengths, with the least decrease in keratometry, and the greatest increase in myopia (-2.0 D; P = 0.001). Anisometropia, if present initially, persisted through the 1-year examination. Mean refractive error was more myopic in zone 1 disease (P = 0.3) and in aggressive posterior ROP (P = 0.15).Severe ROP is associated with disruption of emmetropization, and steeper corneas and more myopia at the first ROP examination, before any intervention. In our study cohort, these differences became more marked over the course of 1 year after laser therapy. The myopia in these cases was not axial. Laser therapy did not induce new anisometropia.

Automatic diagnosis for aggressive posterior retinopathy of prematurity via deep attentive convolutional neural network

Retinopathy of Prematurity (ROP) is one of the most common childhood blindness in premature infants, and Aggressive Posterior Retinopathy of Prematurity (AP-ROP) is a special type of ROP, which will rapidly evolve into the fifth stage of ROP, even blindness if not detecting and treating in time. However, the incidence of AP-ROP is low and the symptoms are rare, which can easily cause misdiagnosis. Early diagnosis of AP-ROP using computer-assisted methods can help clinician make decision accurately. This paper proposes an automated AP-ROP diagnosis system, which divides a complex task into two tasks. Specifically, the two independent networks are utilized to automatically diagnose AP-ROP in an end-to-end way. Network 1 is responsible for identifying whether there is ROP in fundus images, and Network 2 is devised to divide ROP fundus images into AP-ROP and Regular ROP. A channel attention module is added to the two networks to improve the feature representation. In addition, a bilinear pooling module is leveraged to obtain complementary information between layers. The transfer learning mechanism is used to transfer the parameters of Network 1 to Network 2 to improve the classification performance of Network 2. The network is trained with 6867 fundus images that are collected from 2012 to 2018, in which 1709 fundus images are used as a validation set to assist training the network model, and the system performance is evaluated with another 3654 images. The accuracy, recall and specificity of Network 1 to identify the presence of ROP are 98.88%, 98.42% and 99.28%, respectively. The accuracy, sensitivity and specificity for diagnosing AP-ROP using Network 2 are 93.09%, 87.70% and 95.40%, respectively. After combining Network 1 and Network 2, the joint diagnosis accuracy of the test set is 95.81%, which is significantly better than using single three-class networks (95.16% for ResNet50 and 94.53% for ResNet101). We use a further 100 fundus images in 2019 for clinical evaluation of the automated AP-ROP diagnosis system. In the clinical environment, the diagnosis accuracy of the system is 100%, which is better than 90.00%, 85.00%, and 70.00% from the three ophthalmologists, respectively. Our system in this study achieves good performance, and the combined method is better than the three-classification method. Through the final performance evaluation of the devised framework, our classification results are close to those of prevalence ophthalmologists, which indicate that our method can effectively assist ophthalmologists to implement the diagnosis of AP-ROP.

Treatment outcomes of combination of anti-vascular endothelial growth factor injection and laser photocoagulation in Type 1 ROP and APROP.

To study treatment outcomes of combination treatment of intravitreal anti-vascular endothelial growth factor (VEGF) injection and laser photocoagulation in Type 1 Retinopathy of Prematurity (ROP) and Aggressive Posterior ROP (APROP). This is a retrospective observational study of 87 eyes of 48 premature babies who presented with Type I ROP or APROP and were treated with combination of laser and anti-VEGF therapy. Retrospective evaluation of case records was done to collect data on gestational age, birth weight, age at intervention, anterior segment and fundus findings, intervention with laser and anti-VEGF and response to treatment. Outcome measure was defined as attached retina at posterior pole at last follow-up. Mean gestational age was 29.1weeks, and mean birth weight was 1226.9 gms. Sixty-six (75.8%) eyes had Type I ROP and 21 (24.1%) eyes had APROP at presentation. Five eyes (3 patients) were lost to follow-up after treatment. Of 82 eyes, 80.5% (66 eyes) showed regression of ROP following combination treatment and 19.5% (16 eyes) needed surgery. Of these, 15 underwent surgery and 12 had successful outcome. Mean follow-up duration of patients was 52weeks. Finally, 95.1% (78 eyes) had attached retina at posterior pole and 4.9% (4 eyes) had detached retina. We conclude that combination therapy is an effective and safe treatment strategy for Type I ROP and APROP.

Aggressive Posterior Retinopathy of Prematurity (APROP): LASER as the Primary Modality of Treatment.

PurposeTo study the success rate of LASER as a primary modality of treatment in aggressive posterior retinopathy of prematurity (APROP) cases.MethodsThis is a prospective case series of 56 eyes of 28 preterm babies (males = 21) with APROP who underwent laser therapy. Babies were divided into groups on the basis of gestational age (GA), birth weight (BW), and postmenstrual age (PMA) at which treatment was performed. GA (in weeks): 28 (n = 7), 28–30 (n = 11), 30 (n = 10). BW (in grams): 1000 (n = 8), 1000–1200 (n = 10), 1200 (n = 10). PMA (in weeks): 32 (n = 6), 32–34 (n = 18), 34 (n = 4). Success was calculated as complete regression of disease without need for any other modality of treatment such as anti-vascular endothelial growth factor (anti-VEGF) or pars plana vitrectomy.Results The overall success rate was 94.64% (53/56). Two babies who needed additional modality of treatment were 28 weeks of GA (one eye) and 28–30 weeks (two eyes). One baby (one eye) was 1000 gm and the other (two eyes) was 1200 gm, while PMA at which additional treatment was needed was 30 weeks in one baby (one eye) and 33 weeks in the other (two eyes).Conclusion In this era of anti-VEGF treatment, even in cases of APROP, LASER should still be considered as a primary modality of treatment, as it is a one-time treatment without the concern of systemic side effects and recurrent/persistent avascular zones.

Система диагностики, наблюдения и лечения недоношенных детей

Purpose. Тo analyze of the effectiveness of the monitoring and treatment of premature babies. Material and methods. From 2012 to 2020 we observed 2113 preterm infants. Retinopathy of prematurity (ROP) was revealed in 731 cases (34.59%), 29 of them with aggressive posterior ROP (AP-ROP) (3.97%). 199 patients (27.22%) had indications for laser coagulation of the retina (LCR); repeated interventions were performed in 23 cases (11.56%). In 173 case (86.94%), an induced regression of the disease occurred. An unfavorable outcome of ROP was diagnosed in 26 cases (13.06%). 258 children with a cicatricial phase of ROP were dynamic observed. Results and conclusions. The effectiveness of LCR at the threshold stage has reached at 94.78%. Regression in type-I occurred in 89.09%. In cases of AP-ROP, the efficiency of LCR was 51.72%. The total number of children with terminal stages was 106 people (14.5%). In the cicatricial period of 258 people, 134 revealed ametropia, secondary glaucoma in 7 patients, complicated cataract in 6 and strabismus in 35. Timely diagnostics and monitoring reveals early signs of ROP and laser treatment. These activities minimize risk of disability from blindness and low vision. An insignificant number of LCR performed, a small number of patients with terminal stages of ROP indicates the high efficiency of modern conditions for nursing premature babies. Functional results depend on the degree of residual changes, refractive pathology and strabismus. Correction of ametropia, functional treatment, strabismus surgery in the preschool period, allow to develop and maintain visual function in the most of patients in the cicatricial phase of ROP. Key words: retinopathy of prematurity, laser coagulation of the retina, aggressive posterior retinopathy of prematurity.

Первый опыт применения ингибитора фактора роста эндотелия сосудов ранибизумаб в комплексной терапии ретинопатии недоношенных в УРФО в ГАУЗ СО МКМЦ «Бонум»

Material and methods. The study included 16 patients (31 eyes). Types and terms of treatment. Stage I in the treatment of ROP, laser coagulation of the avascular areas of the retina was performed in three patients with aggressive posterior ROP (4 eyes, 12.9%). In all patients, the progression of the disease was noted. Intravitreal injection of ranibizumab was performed in the period from 8 to 16 weeks (10.5±2.0 weeks), PCV from 32.3 to 39.6 weeks (37.0±1.8 weeks). Result. After laser treatment and IVI of ranibizumab, 11 patients (31 eyes, 81.6%) showed regression of the disease. In 5 patients (6 eyes, 19.4%) - progression. If the ROP progressed, a 25G or 27G lenssparing vitrectomy was performed. Complete regression of ROP was achieved in one patient (1 eye, 16.7%). Partial regression was observed in two patients (2 eyes, 33.3%). In two patients (3 eyes, 50%), the disease progressed to stage 5 with the development of total retinal detachment. Conclusion. As a result of the complex treatment of severe forms of the active stage of retinopathy of prematurity in the regional children's ophthalmological center MKMC "Bonum" in Yekaterinburg, the following data were obtained: complete regression with retinal adhesion is observed in 12 patients (26 eyes, 83.4%), of which in one patient (1 eye, 3.2%) regression was achieved after vitrectomy. Partial regression with the formation of a peripheral retinal detachment after vitrectomy was achieved in two patients (two eyes - 6.5%). Progression of retinopathy of prematurity to stage V with the development of total retinal detachment in two patients (3 eyes, 9.6%). Complex treatment of severe stages of active ROP using laser treatment, IVI and vitrectomy allows to preserve vision in 90.4% of patients. Key words: retinopathy of prematurity; intravitreal injection; laser coagulation of the retina; vitrectomy.

Clinical profile on incidence and course of Retinopathy of Prematurity in a tertiary care hospital of Northern India

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of retina of preterm infants. It remains the leading cause of childhood blindness worldwide. Aggressive posterior retinopathy of prematurity (APROP) is rapidly progressive severe form of ROP.&#x0D; Aims and Objectives: The present study was done to assess incidence and evaluate course of ROP in preterm babies born before 34 weeks and birth weight &lt;1750 grams.&#x0D; Material and Methods: The current study was a two year prospective observational study. Screening of all neonates born with gestational age ≤34 weeks and birth weight &lt;1750 grams was done for ROP at 4 weeks of their postnatal age by indirect ophthalmoscopy and followed up till vascularization was complete. All neonates identified with APROP and ROP with plus disease was treated with double-frequency Nd YAG laser.&#x0D; Results: Of 318 neonates screened, 34.9% neonates (111) were observed to have ROP. 2.5% (8/318) neonates diagnosed with APROP and 4.4% neonates (14/318) having ROP with plus disease including pre-threshold and threshold ROP were treated with double frequency Nd Yag laser. All 14 treatment requiring ROP babies and 6 APROP babies showed total regression while one neonate with APROP succumbed to septicaemia during follow up and one APROP baby had to be referred to higher centre after he developed partial retinal detachment (RD) (Stage 4a).&#x0D; Conclusion: 34.9% had ROP, only 6.28% needed intervention. Laser monotherapy even when administered early has lesser favorable structural and functional outcome in APROP as compared to classical ROP.

Intraocular pressure effect of anti-vascular endothelial growth factor injection for aggressive posterior retinopathy of prematurity.

To compare the effect of 0.0125mL and 0.025mL doses of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection on intraocular pressure (IOP) in eyes with aggressive posterior retinopathy of prematurity (ROP). In this retrospective cohort study, charts of 52 eyes of 26 consecutive infants were reviewed. The patients received 0.0125mL (Group 1) or 0.025mL (Group 2) anti-VEGF agents' intravitreally. The IOP was measured before injection, on the first day, during the first week, and in the first month. After each injection, optic nerve head perfusion was evaluated by a binocular indirect ophthalmoscope. IOP values, complications, use of antiglaucomatous drops, and the effects of anti-VEGF drugs were recorded. The mean baseline IOP before injection was 16.0 ± 3.7mmHg for Group 1 and 15.5 ± 4.5mmHg for Group 2 (p = 0.365). The mean value of IOP on the first day was statistically increased in Group 2 (29.2 ± 6.1mmHg) compared with Group 1 (24.1 ± 6.8mmHg) (p = 0.013). Moreover, antiglaucomatous drops were needed in 12 eyes for Group 2 compared with seven eyes for Group 1. Anterior chamber paracentesis was not performed after any of the injections. This study found that IOP increases after intravitreal injections of anti-VEGF agents for the treatment of ROP. The injection of 0.025mL anti-VEGF agents increases IOP more than the 0.0125mL injection in the treatment of infants with aggressive posterior ROP.

Clinical features of premature twin babies with intersibling asymmetry of retinopathy of prematurity severity

ObjectiveTo report the clinical features of premature twin babies showing intersibling asymmetry in their severity of retinopathy of prematurity (ROP) and analyze risk factors associated with development of severe ROP between twin siblings with discordant ROP severity. MethodsA retrospective study of records of 105 premature twin pairs was conducted. The criteria for discordant ROP with an intersibling difference in ROP severity were as follows: (i) two or more stages of difference in ROP between siblings, (ii) one sibling having treatment-requiring ROP and the other having no ROP or ROP that regressed spontaneously, or (iii) one sibling having aggressive posterior ROP and the other having staged or no ROP. Twin siblings were classified into two groups according to the severity of ROP (no or less ROP and more severe ROP). We examined ocular features in twins having intersibling asymmetry of ROP and analyzed perinatal risk factors for ROP. ResultsOf 105 twin pairs, 32 pairs (30.5%) showed intersibling asymmetry of ROP severity, and 15 pairs (14.3%) showed ROP asymmetry in terms of need for ROP treatment. The development of more severe ROP was associated with longer duration of oxygen supplementation and greater frequency of total blood and packed red blood cell transfusion (p = 0.020, p = 0.045, and p = 0.036, respectively). Longer duration of oxygen supplementation remained a statistically independent risk factor of severe ROP using multivariate logistic regression analysis. ConclusionsOphthalmologists caring for premature infants should be aware of the variable courses and progressions of ROP between twin babies. Longer duration of oxygen supplementation and greater frequency of blood transfusions were associated with higher ROP severity in twins.

Clinical Characteristics of Preterm Neonates with Aggressive Posterior Retinopathy of Prematurity.

PurposeWe aimed to identify the risk factors that may predispose preterm neonates to develop aggressive posterior retinopathy of prematurity (APROP).MethodsThis retrospective case control study included 16 infants with APROP in zone 1 or posterior zone 2. Thirty-four gestational age and birth weight-matched controls with stage 2 or less ROP were included. We reviewed medical records on infant birth and postnatal characteristics.ResultsPatients who developed APROP had a significantly longer duration of caffeine therapy, were significantly more likely to be small for gestational age (SGA), and were more likely to have a positive blood culture than patients who developed less severe ROP. Patients with APROP who required retreatment had received inotropes for a longer duration of time, had received more plasma transfusions, were more likely to have IVH, and had a greater decrease in the serum hemoglobin during hospitalization.ConclusionBeing SGA, receiving caffeine for a longer duration, and having culture-proven sepsis were associated with APROP. IVH, a low serum hemoglobin, the need for more plasma transfusions, and a longer duration of inotropes were associated with APROP which required retreatment.

An Observational Study of Different Treatment Practices for Aggressive Posterior Retinopathy of Prematurity.

To evaluate risk factors and outcomes of preferred practice for infants with aggressive posterior retinopathy of prematurity (APROP) at a tertiary eye center in India. This was an observational study of infants with APROP where patients were divided into three groups after 2 weeks of initial treatment depending on the treatment received: anti-VEGF only, laser only, and combination of anti-VEGF injection followed by laser within 2 weeks of anti-VEGF injection (combined group). All infants were evaluated for risk factors and followed up at 1, 2, 4, 8, and 12 weeks to determine treatment outcomes in terms of regression, vascular re-growth, progression, and recurrence of the disease. Sixty eyes of 31 infants were included in the study, with 26 eyes in the anti-VEGF only group, 19 eyes in the laser-only group, and 15 eyes in the combined group. Infants in the combined group presented late with lower birth weight (BW), smaller gestational age (GA), and a history of longer duration of ventilatory support. After 3 months of follow-up, regression occurred in 73.08% in the anti-VEGF only group, 89.5% in the laser-only group, and 86.66% in the combined group (P = .07). Zone of vascularization was greater in the anti-VEGF only group and the combined group compared to the laser-only group. Disease recurrence was seen in 27% in the anti-VEGF group, none in the laser-only group, and 13.33% in the combined group (P < .001). However, progression to stage 4 ROP requiring surgery was noted in 2 eyes in the laser-only group. Infants with APROP who have a lower GA or BW or require longer ventilatory support are possibly a subset best suited for planned combination therapy. A combination of anti-VEGF therapy followed by laser treatment within 2 weeks allows for early regression, a stable course, lower recurrence, and a larger area of retinal vascularization. [J Pediatr Ophthalmol Strabismus. 2021;58(6):370-376.].

Comparison of Outcomes Between Combined Sparing Laser Photocoagulation and Intravitreal Bevacizumab Treatment Versus Conventional Laser Photocoagulation in Aggressive Posterior Retinopathy of Prematurity.

To report the clinical outcomes of combined sparing laser photocoagulation and intravitreal bevacizumab treatment compared to conventional laser photocoagulation for the treatment of aggressive posterior retinopathy of prematurity (APROP). A medical chart review was performed on all consecutive eyes with APROP that were treated with conventional laser photocoagulation or laser photocoagulation and intravitreal bevacizumab (IVB) injection between July 2019 and August 2020. The data were recorded for time to reversal of plus disease, time to total regression of retinopathy of prematurity (ROP) after intervention, total laser spots and area, proportion of eyes with satisfactory anatomical outcomes, and adverse events. Outcomes of the two groups were compared. Sixteen eyes of 8 infants with APROP were included in the analysis. Eight eyes of 4 infants received combined sparing laser photocoagulation and IVB treatment, and 8 eyes of 4 infants received conventional laser photocoagulation. All 8 eyes in the combined treatment group and 6 of 8 eyes in the conventional treatment group showed regression of ROP with a satisfactory anatomical outcome. The average time to total regression of ROP was 34 days in the combined treatment group and 56 days in the conventional treatment group (P = .005). The number of laser spots was significantly lower in the combined treatment group (P = .03). Combined sparing laser photocoagulation and IVB treatment for eyes with APROP achieved ROP regression twice as fast, had fewer laser spots, and had a satisfactory anatomical outcome in comparison to conventional laser photocoagulation. [J Pediatr Ophthalmol Strabismus. 2021;58(5):292-297.].

Анализ частоты встречаемости ретинопатии недоношенных по данным Республиканской детской клинической больницы за 2018-2020 гг.

Purpose. To analyze stages of retinopathy of prematurity (ROP) and it’s unfavorable active forms, and the correlation between severity of ROP and gestanational age and birth weight of children in Republican Children's Clinical hospital (RCCH). Material and methods. We have examined 4036 children including 759 children with ROP, 596 children had I and II stages, 105 children with III stage, 58 children with Aggressive Posterior ROP (APROP) and 42 children with Plus disease. Results. The structure of ROP for 3 years is: I and II stages – 78,5%, III stage – 13,83%, APROP – 7,64%. There is direct relation between retinal lasercoagulation (RLC) and gestanational age and birth weight: the less are the indexes, the more is probability of unfavorable prognosis and operation necessity. Conclusions. Screening of premature children in catamnesis cabinet in RCCH, regular ophthalmic monitoring with up-to-date diagnostic methods and opportune prophylactic RLC in active phase of ROP allow to decrease disability of ROP. Key words: retinopathy of prematurity, premature children, lasercoagulation of retina.

FACTORS ASSOCIATED WITH REACTIVATION AFTER INTRAVITREAL BEVACIZUMAB OR RANIBIZUMAB THERAPY IN INFANTS WITH RETINOPATHY OF PREMATURITY.

To investigate the efficacy and risk factors of intravitreal antivascular endothelial growth factor injection (anti-VEGF therapy) for retinopathy of prematurity (ROP). We retrospectively reviewed 80 consecutive eyes of 43 patients with Type 1 ROP or worse who received anti-VEGF therapy during January 2012-February 2018. Patients were divided into those who were injected with 0.25 mg of bevacizumab (IVB group, 37 eyes) and 0.25 mg of ranibizumab (IVR group, 43 eyes). Serum VEGF concentrations of 18 patients were measured before and after IVR. Antivascular endothelial growth factor injection therapy reduced ROP activity in all eyes; however, 14 eyes (17.5%) exhibited reactivation. The reactivation rates of the IVB and IVR groups were 13.5% and 20.9%, respectively (P = 0.556). Multivariate logistic regression analysis showed that postmenstrual age ≤35 weeks at anti-VEGF therapy (P = 0.014) and aggressive posterior ROP (P = 0.044) was significantly associated with reactivation. Serum VEGF was significantly suppressed at Days 1 (P < 0.001) and 7 (P = 0.012) after IVR and returned to the preinjection level by Day 14 (P = 0.210). Both IVR and IVB seemed effective in reducing ROP activity. Reactivation after anti-VEGF therapy may be associated with younger postmenstrual age at anti-VEGF therapy and aggressive posterior ROP.

Systemic conbercept pharmacokinetics and VEGF pharmacodynamics following intravitreal injections of conbercept in patients with retinopathy of prematurity

BackgroundData on serum vascular endothelial growth factor (VEGF) and drug levels in patients with retinopathy of prematurity (ROP) following intravitreal injections of conbercept (IVC) are lacking.MethodsMulticentre, prospective, non-randomised study of...