Frequency Of Retinopathy Of Prematurity Research Articles

Frequency and risk factors of retinopathy of prematurity among preterm neonates in a tertiary care hospital of Bangladesh

Background: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, occurs in premature babies. Several factors like perinatal infection, inflammation, hypoxia, hypercapnia, higher oxygen support etc. have been attributed to the cause. Identifying the potentially modifiable risk factors will contribute to making preventive strategy. Objective: To identify the frequency and risk factors of ROP in premature babies. Methodology: This prospective observational study was conducted in the Department of Neonatology of BSMMU after approval from the institutional review board over a period of twelve months. Infants born <35 completed weeks, weighing <2000 g admitted in NICU are included in this study. After enrollment, screening for ROP was done at 20 days for the baby -gestational age of ≤ 30 weeks or birth weight ≤ 1200 g and at 30 days for the baby- gestational age ≤ 35 weeks or birth weight ≤ 2000g. ROP screening test was done by a pediatric ophthalmologist with indirect Ophthalmoscope. The outcome measures were the frequency and risk factors of ROP. Results: Between 2021 and 2022, 154 infants born ≤ 35 weeks gestation, weighing ≤ 2000 g were screened for ROP. Among the studied cases 30 (19.5%) patients had ROP. Among the 30 patients, 16 (53.33%) had AP-ROP, 3 (10%) had plus disease and 3 (10%) had stage IV (6.67%) ROP. Among the newborns diagnosed with ROP, 23 (76.67%) required treatments. Among them, Inj. Avastin was given to 18 (78.26%) patients, 5 (21.7%) needed Laser therapy but none of them required surgery. Univariate analysis showed risk of ROP was significantly higher in lower gestational age and lower birth weight group. Frequency of sepsis, duration of oxygen support, need for CPAP, hospital stay, and Intraventricular hemorrhage (IVH) were significantly higher among ROP group. Antenatal corticosteroid significantly lowered the risk of ROP. Multivariate analysis also showed that antenatal corticosteroid had protective effect against ROP and prematurity, lower birth weight, sepsis, longer duration of oxygen therapy, and longer duration of hospital stay increased the risk of ROP. Conclusions: This prospective observational study showed frequency of ROP was 19.5%. Prematurity, lower birth weight, lack of antenatal-corticosteroid, sepsis, longer duration of oxygen support, and longer hospital stay are some potential risk factors of developing ROP

Organizational models of ophthalmic observation of premature children in pediatric follow-up

Purpose: to assess the organizational effectiveness of ophthalmic observation of premature infants in pediatric follow-up in St. Petersburg. Material and methods. We analyzed the reports submitted by city interdistrict ophthalmological facilities for retinopathy of prematurity (ROP) and the observation department for premature infants for the period from July 1, 2018 to July 1, 2021 available at the children's multidisciplinary hospital. Results. In St. Petersburg, 6 interdistrict ophthalmological facilities perform regular monitoring of ROP children and a daytime in-patient clinic offers interdisciplinary treatment and early rehabilitation of infants with perinatal pathology accompanying severe prematurity. The data on the frequency of ROP and other visual disorders in children born prematurely are presented. Conclusions. Interdistrict observation facilities are a modern form of regular ophthalmic follow-up of premature infants of risk groups or ROP infants who live in conditions of a large city. A promising observation model of children with combined perinatal pathology and severe prematurity is the setting of a department (daytime in-patient facility) in the children's multidisciplinary hospital. This allows assessing the general health of this critical group of population" and ensure a timely start of combined interdisciplinary treatment and medical rehabilitation.

The incidence of retinopathy of prematurity in different gestational ages

Introduction: Since retinopathy of prematurity (ROP) is a preventable cause of blindness in children, evaluation of declared criteria for their screening is crucial. The aim of this study is to evaluate the incidence of the disease in Nikukari Eye Hospital according to gestational age and neonatal birth weight. Methods: In this cross-sectional study, after determining the frequency of neonatal retinopathy based on patients referred to the ROP clinic, neonates were divided into groups of 500 to 1000 g, 1001 to 1500 g, 1501 to 2000 g, and above 2000 g, and 28 weeks, 28-30 weeks, 30-32 weeks, 32-34 weeks, and over 34 weeks, and the frequency of ROP in each group was compared. Results: In the present study, 661 cases were evaluated, of which 93 infants (14.1%) had ROP. The mean±standard deviation of birth weight of patients with ROP was 1199.51±406.80 g and was significantly lower than those without ROP who had a mean birth weight of 2022.69±649.73 g (P=0.001). The mean±standard deviation (SD) of gestational age of patients with ROP was 29.22±2.67 weeks and was significantly lower than non-ROP patients, who had a mean gestational age of 33.41±2.73 weeks (P=0.001). Conclusion: The results of our study showed that 13 newborns weighing between 1500 and 2000 g were affected by the disease, which indicates the importance of ongoing screening in this group of children.

The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

To investigate the association of hepatic and renal parameters with the development of retinopathy of prematurity (ROP) in premature infants with a gestational age ≤ 32weeks. Medical records of 240 preterm infants were reviewed retrospectively, 85 of them were grouped as type 1, type 2 ROP, and control group. The 4th week hepatic and renal function test results of the groups, on the day of their first ROP examinations, were compared for the risk of development of ROP and the development of type 1 ROP. In this study, 12, 35, and 38 infants were enrolled in the type 1, type 2 ROP, and control group, respectively. The average gestational age and birth weight were higher; however, the duration of oxygen treatment was lower in the control group (p < 0.001). The blood glucose level was significantly higher in the type 1 ROP group than in the other groups (p = 0.023). The mean of total serum bilirubin of the type 1 ROP group was significantly lower than those of the type 2 ROP and control group (p = 0.032). Proteinuria was present in 85.7% of preterms with treatment-requiring ROP and proteinuria increased the risk of ROP by 3.9 times (OR with 95% CI 3.9 (1.19-12.75), p = 0.042). We found significantly higher blood glucose and lower total bilirubin level in the type 1 ROP group. Moreover, our findings suggest that proteinuria may not be only a comorbidity factor but also related to a higher frequency of ROP and type 1 ROP in preterm infants.

Frequency of retinopathy of prematurity at a tertiary referral center.

With advances in medical facilities and increased survival of premature infants, the prevalence of retinopathy of prematurity (ROP) has increased. This study aimed to determine the frequency of ROP and its associated risk factors. This descriptive-analytical, retrospective study included all premature infants with a birth weight (BW) ≤ 2,500 g and/or gestational age (GA) ≤ 35 weeks who were referred to Imam Khomeini Hospital in Ahvaz, Iran, for ROP screening over a 7-year period from April 2013 to April 2020. Demographic criteria, associated risk factors, and findings of eye examinations were collected and analyzed. Of the 812 at-risk infants screened, 807 met the inclusion criteria. ROP was observed in 316 (39.0%) of the 807 premature infants, with types I and II in 142 (45.0%) and 174 (55.0%) infants, respectively. The mean (SD) GA (29.6 [2.5] weeks versus 30.7 [2.5] weeks) and BW (1,203.6 [382.8] g versus 1,333.5 [386.5] g) were significantly lower in infants with ROP than in those without ROP (both P < 0.001). GA (r = 0.80; P < 0.001) and BW (r = 0.85; P < 0.001) had a strong positive correlation with ROP, and the correlation increased as GA and BW decreased (all P < 0.001). Associated risk factors in infants with ROP, in order of frequency, were oxygen therapy (22.8%), respiratory distress (16.1%), phototherapy (14.6%), blood transfusion (5.7%), apnea (4.1%), mechanical ventilation (1.6%), and intraventricular hemorrhage (0.9%). Multivariate regression analyses showed low GA and BW (both P < 0.05) as independent predictors of ROP. The frequency of ROP in premature infants was slightly higher than the average range reported for domestic and foreign statistics. Low BW and GA were independent predictors of ROP.

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.

Retinopathy of prematurity in infants without fetal growth restriction is decreased with the progression of acute histologic chorioamnionitis: New observation as a protective factor against retinopathy of prematurity

IntroductionIGF-1 deficiency in prenatal period is known to be a definite pathophysiology of retinopathy of prematurity(ROP), which is more frequent in infants with fetal growth restriction(FGR). Of note, recent reports demonstrated intra-amniotic inflammation(IAI) closely linked to acute histologic chorioamnionitis(acute-HCA) is associated with a decrease in intact-form of IGFBP-1, ultimately rising the probability of an increase in IGF-1. Therefore, we hypothesized ROP in preterm-infants without FGR would be decreased with the progression of acute-HCA. MethodsThe frequency of ROP was examined in 85 singleton preterm-infants(24.5weeks ≤ gestational-age[GA] at delivery<30weeks) due to either preterm-labor and intact-membranes(PTL) or preterm premature rupture of membranes(preterm-PROM) without FGR(birth-weight<5th percentile for GA). Patients were divided according to the progression of inflammation in extra-placental membranes(EPM) and the progression of inflammation in chorionic-vessel(CV) and umbilical-cord(UC). Results1) ROP was present in 40%(34/85) of study-population; 2) Of note, there was a significant stepwise-decrease in ROP with the progression of inflammation in EPM(inflammation-free EPM vs. inflammation restricted to CD vs. amnionitis; 55.6%[15/27]vs.39.5%[17/43]vs.13.3%[2/15]) and the progression of inflammation in CV and UC(inflammation-free CV and UC vs. inflammation restricted to CV and umbilical vessels vs. inflammation in Wharton's jelly[WJ]; 49.2%[29/59]vs.25.0%[3/12]vs.14.3%[2/14])(each-for P < 0.05, Chi-square test and each-for P < 0.01, linear-by-linear association); 3) Multiple logistic-regression analysis demonstrated amnionitis(Odds-Ratio 0.120, 95%Confidence-Interval 0.022–0.654, P = 0.014) and inflammation in WJ(Odds-Ratio 0.124, 95%Confidence-Interval 0.022–0.694, P = 0.018) were independent protective-factors against ROP. DiscussionROP in preterm-infants due to PTL or preterm-PROM without FGR is decreased with the progression of acute-HCA. This finding may be an evidence to suggest the progression of acute-HCA is closely associated with reducing the pathophysiology of ROP.

Early Postnatal Prediction of Retinopathy of Prematurity in Preterm Newborns in Neonatal Intensive Care Units

Retinopathy of Prematurity is an issue of the preterm infant portrayed by neurovascular interruption in the juvenile retina that may cause visual hindrance and visual deficiency. This examination planned to build up a screening device for early postnatal forecast of Retinopathy of Prematurity (ROP) in preterm infants dependent on danger factors inside the principal 48h of postnatal life. This examination was led on 200 preterm children admitted to NICU , Benha college Hospital and Nasser General Hospital in Shobra. All children were exposed to full history taking and complete clinical assessment. Fundus assessment by roundabout ophthalmoscope and computerized imaging of chosen cases were finished. There was critical factual increment of ROP among lower GA and BW (P<0.001). There was critical measurable increment of ROP in prematures with maternal history of chorioamnionitis and antenatal steroids adminstration (P<0.001). There was huge factual increment of ROP among youngsters with sepsis (P<0.001). The frequency of ROP in our investigation was 4.5%. Both birth weight at cutoff point <1.5 Kg and gestational age at cutoff point <33.5 wks had high affectability and particularity in expectation of ROP.

Retinopathy of prematurity, frequency and risk factors in very low birth weight infants.

Retinopathy of prematurity (ROP) is the principal cause of blindness during childhood. The objective of this study was to analyze the frequency of ROP and risk factors associated with ROP in a cohort of very low birth weight infants. A cases (ROP) and controls (no ROP) study of infants less than 1500 g was conducted. Perinatal and neonatal variables were analyzed. For the statistical analysis, χ2 test, Student's t-test and Mann-Whitney's U-test were used. For the study, 282 neonates were included: 152 (53.9%) with ROP and 130 (46.1%) without ROP. The most frequent stages observed were stage 1 and 2, with 139 (91.4%) patients, and stages 3 to 5, with only 13 patients (8.5%). In those neonates with ROP compared with neonates without ROP, the birth weight was less (902.7 vs. 1037.9 g) and the difference was significant (p < 0.0001). Also, the difference with gestational age (28.2 vs. 29.6; p < 0.0001), total ventilation days (32.8 vs. 16.1; p < 0.00001) and total oxygen days (87.7 vs. 62.6; p < 0.0001) was significant in neonates with ROP and neonates without the disease. Bronchopulmonary dysplasia, intraventricular hemorrhage and late onset sepsis were significant with patients with ROP. The frequency of ROP reported here is higher than the reported in Mexican population, with less cases of severe ROP. The neonatal surveillance in babies with less birth weight and gestational age is important to decrease the incidence of ROP.

Retinopathy of prematurity occurrence and evaluation of screening policy in a large tertiary Greek cohort.

To assess the frequency of retinopathy of prematurity (ROP) and evaluate the appropriateness of screening guidelines in a tertiary hospital in Thessaloniki, Greece. Retrospective review of consecutive infants admitted to the IInd Department of the Neonatal Care Unit of Aristotle University in the period April 2004-2015. ROP screening took place according to the Royal College of Paediatrics and Child Health and Royal College of Ophthalmologists (UK) guidelines [i.e. gestational age < 32weeks and/or birth weight < 1501g)], plus a few additional cases due to comorbidity. 1178 out of the 8782 admitted infants underwent ROP screening. ROP was detected in 232 (19.7%) infants of whom 87 developed severe form of the disease (i.e. ≥ stage 3). Treatment was required in 30 (2.5%) infants, all of whom fulfilled the screening criteria. Two of the 206 infants who were additionally screened due to comorbidity developed severe ROP which regressed spontaneously. Disease regression was achieved in 27/29 (93%) treated infants who survived. The frequency of ROP observed in this cohort was as low as that reported in other developed countries. The currently used screening criteria permitted identification of all infants who were at risk and, therefore, need not be changed.

Frequency and Risk Factors for Retinopathy of Prematurity in Very Low Birth Weight Infants in NICU, BSMMU

Introduction: Retinopathy of prematurity (ROP) is emerging as an important avoidable cause of childhood blindness both in developed and developing countries that primarily affects premature and very low birth weight infants. There has been paucity of studies on this topic in Bangladesh and there is no national prevalence data on ROP to understand the real burden of the disease. Hence this study has been undertaken to see its frequency and risk factors for ROP in very low weight infants admitted in NICU, BSMMU.&#x0D; Objectives: To find out the frequency and risk factors for ROP in very low birth weight infants admitted in NICU, BSMMU.&#x0D; Methodology: It was a prospective observational study and was carried out in the Department of Neonatology and Department of Ophthalmology, BSMMU from January 2014 to June 2015. Considering all inclusion and exclusion criteria total 162 very low birth weight neonates were enrolled in the study. ROP screening was performed as per unit protocol. All eye examinations were undertaken by experienced ophthalmologist who was especially trained in ROP.&#x0D; Result: Out of 162 study population, one hundred forty fore (88.9%) were very low birth weight, 18(11.1%) were extremely low birth weight and mean birth weight was 1294.35 (SD: 180.96) g. Frequency of ROP was 38(23.5%), where 30(20.83%) among very low birth weight (VLBW) and 8(44.44%) were among ELBW neonates. Out of 38 ROP cases, 5(13%) had stage 1 retinopathy, 3(8%) had stage 2 retinopathy, 16(42.1%) had stage 3 and remaining 14(36.8%) neonates had APROP. On univariate analysis seventeen factors were found to be significant but on stepwise logistic regression analysis only lower gestational age [OR=5.014; CI(95%),2.160-11.640, P=.001] and use of mechanical ventilator [OR=1.925; CI(95%),1.133-3.269, P=.015] was found to be the most significant for causation of ROP.&#x0D; Conclusion: The overall frequency of ROP was 38(23.5%), where as 30(20.83%) were among VLBW and 8(44.44%) were among ELBW neonates. Prevention of prematurity and judicious use of ventilator may reduce the incidence and severity of ROP&#x0D; TAJ 2019; 32(1): 54-61

The Effect of Serum Igf-1,Igfbp-3 And Erythrocyte Transfusıons on Development of Mıld Retınopathy of Prematurıty

Introduction: Most important factors in retinopathy of prematurity (ROP) are prematurity and oxygen toxicity although blood transfusions, insulin like growth factor-1 ( IGF-1), insulin like growth factor binding protein 3 (IGFBP-3) and vascular endothelial growth factor (VEGF) also have important roles. The objectives of this study were, to measure IGF-1 and IGFBP-3 levels in preterm newborns before and after blood transfusion and assess if the effect of transfusion in development of ROP is via these mediators, and to investigate whether IGF-1 and IGFBP-3 levels measured at 32 and 33 gestational age (GA) were different in preterm newborns with and without ROP. Material and Methods: Preterm newborns with gestational age ≤34 weeks were included and blood samples were obtained before and after red blood cell (RBC) transfusion. Results: Thirty newborns were included, 17 of whom had ROP ( stage 1: n=11, stage 2: n=5, stage 3: n=1). IGF-1 and IGFBP-3 levels did not change after RBC tranfusion. Excluding the patient with stage 3 ROP all ROP patients were referred as mild ROP. No difference was observed between IGF-1 and IGFBP-3 levels of the patients with and without mild ROP. Patients with mild ROP had significantly more number of transfusions. Conclusions: Erythrocyte transfusion increased the frequency of ROP, whereas IGFBP-3 and IGF-1 were not associated of ROP.

The Epidemiology of Retinopathy of Prematurity in the United States.

Retinopathy of prematurity (ROP) is a leading cause of blindness in premature and low birth weight infants. Here, the authors examine the incidence of ROP in the United States and evaluate risk factors associated with ROP development. The National Healthcare Cost and Utilization Project Kids' Inpatient Database was queried for all newborns with and without ROP. Adjusted odds ratios were constructed for predictors of ROP using multivariate logistic regression modeling. The incidence of ROP increased from 14.70% in 2000 to 19.88% in 2012. Multivariate regression analysis indicated that female gender, birth weight, and gestational age predicted ROP. The frequency of ROP was 2.40% in newborns weighing more than 2,500 grams (g) and 30.22% in newborns with a birth weight between 750 g and 999 g. The authors' report examines a nationwide cohort of ROP infants and reveals an increase in the incidence of ROP from 2000 to 2012. This trend is inversely related to a simultaneous decline in newborn mortality. [ Ophthalmic Surg Lasers Imaging Retina . 2017;48:553-562.].

Frequency of Retinopathy of Prematurity in a Tertiary Care Hospital

Introduction: Retinopathy of prematurity (ROP) is one of a preventable cause of blindness in neonates. Screening of preterm infants for ROP in Pakistan is currently under-recognized. The aim of this study was to determine the frequency of retinopathy of prematurity (ROP) in premature and very low birth weight neonates (birth weight ≤ 1500 g and gestational age ≤ 32 weeks) in a tertiary care hospital, Karachi, Pakistan. Methods: This was a cross-sectional study carried out in the neonatal intensive care unit (NICU) of Civil Hospital Sukkur from 1st June 2014 to 17th June 2015. Preterm neonates with birth weight ≤ 1.5 Kg and gestational age of ≤ 32 weeks were referred for ROP eye examination as an outpatient were included in the study after taking consent from parents. Premature neonates with major congenital malformations, chromosomal anomalies or congenital cataract or tumours of the eyes or those who died before eye examinations or did not attend the out-patient department for eye examination were excluded. Eye examination for ROP was performed on all infants, at 4 to 6 weeks chronological age, by a trained ophthalmologist, having at least 10 years of relevant experience. Results: A total of 86 babies enrolled in the study. Of them, 46 (53.5%) were male and 58 (67.4%) babies were 4 weeks old. ROP was identified in 9 (10.5%) neonates at the first eye examination. ROP was significantly associated with birth weight (p-value 0.031), gestational age (p-value 0.033) and chronological age (p-value<0.001). Conclusion: It was concluded from this study that frequency of ROP was 10.5%. ROP is significantly associated with birth weight, gestational age, and age of the infant.

Retinopathy of prematurity and associated factors in Lagos, Nigeria

Background: Screening and early treatment of retinopathy of prematurity (ROP) is important to reduce visual impairment in at risk infants.Aim: To determine the frequency and risk factors associated with ROP in preterm infants in Lagos University Teaching Hospital.Methods: This was a prospective cohort study of preterm infants with gestational age (GA) less than 32 weeks and birthweight 1500 g or less conducted from November 2011 to May 2014. The infants’ eyes were examined using an indirect ophthalmoscope at 4-6 weeks of life or at 34 weeks post-conceptual age. Examinations were repeated weekly until regression or progression to a high risk pre-threshold disease. Staging was according to the revised International Classification for ROP and treatment criteria were as defined by the Early Treatment for ROP study. The GA, birth weight (BW), use of oxygen, presence of respiratory distress syndrome and other risk factors were recorded and tested for significance.Results: Twelve (15%) of the 80 infants examined had any ROP and six (7.5%) had treatable ROP. The mean (SD) GA and BW for infants with ROP were both lower than for those without ROP; 28.2 (1.7) weeks vs 29.1 (1.6) weeks and 1124 (212) g vs 1251 (274) g for GA and BW, respectively. Risk factors such as supplemental oxygen, sepsis, respiratory distress and anaemia were not significantly associated with ROP.Conclusion: The frequency of ROP and treatable ROP was high; it is therefore recommended that routine care of preterm infants should include screening for ROP and that affordable treatment facilities should be provided in public hospitals.

Frequency of retinopathy of prematurity in premature neonates with a birth weight below 1500 grams and a gestational age less than 32 weeks: a study from a tertiary care hospital in a lower-middle income country….

IntroductionRetinopathy of prematurity (ROP) is a treatable cause of blindness in neonates. In Pakistan, ROP is often not recognized early because screening and treatment programs are not yet in place in most neonatal units, even in tertiary care hospitals. It is hoped that this report will help inform medical professionals of the magnitude of the problem and help to design appropriate management strategies.ObjectivesThe aim was to determine the frequency of ROP in premature and very low birth weight (BW) neonates (BW<1500 g and gestational age (GA) <32 weeks).Study DesignCross-sectional study.Study SettingNeonatal intensive care unit (NICU) of a tertiary care hospital in Karachi, Pakistan.Study DurationFrom June 2009 to May 2010.Subjects and MethodsNeonates with a Birth weight (BW) <1500 g and Gestational Age (GA) <32 weeks who were admitted to the NICU and received an eye examination, or were referred for a ROP eye examination as an outpatient, were included in the study. GA was estimated from intrauterine ultrasound findings. Neonates with major congenital malformations, syndromes or congenital cataracts or tumors of the eyes, and those that died before the eye examination or did not attend the out patients department for an eye examination, were excluded. The neonatal eye examination was performed by a trained ophthalmologist at 4 or 6 weeks of age.ResultsOut of 86 neonates, ROP was identified in nine neonates (10.5%) at the first eye examination. ROP was significantly associated with BW (P = 0.037), GA (P = 0.033), and chronological age (P<0.001).Conclusionswe identified ROP in 10.5% of neonates at first eye examination. Significant associations between ROP and a GA<32 weeks and a BW<1500 g were also observed.we also stress that serial follow-up of neonates at risk for ROP is important when making a final diagnosis.

Braille use among Norwegian children from 1967 to 2007: trends in the underlying causes

The aim of the study was to estimate the occurrence, diagnoses and time trends among Norwegian children that have received education in braille from 1967 to 2007. We used a retrospective population-based study design. The health care system is free for all inhabitants in Norway. We included all children that had received braille education the last four decades. From each student's record, we abstracted year born, country of birth, gender, year diagnosed, diagnosis, classification of visual impairment and type of reading media. We identified 287 children (137 girls and 150 boys) that had received braille education over the last 40 years. Of these, 262 (91.3%) children were born in Norway, 145 (53.7%) were diagnosed within the first year of life and 59 (20.6%) from age of one to five. The most frequent diagnoses were Retinopathy of Prematurity (ROP), Juvenile Ceroid Lipofuscinoses (JNCL), Lebers Congenital Amaurosis (LCA) and Retinitis Pigmentosa (RP). Among the children, 63% (N = 170) used braille only, 9% (N = 25) braille and print, but priority braille, and 27% (N = 73) braille and print, priority print. The number of children with ROP using braille had a peak in 1977, then the number declined. The number diagnosed with LCA increased from 1987 to 1992. The number of braille users among children diagnosed with JNCL tended to increase substantially after 1992. Braille education seemed to be dependent of trends in diagnoses as well as trends in recommendations from professional educators.

Visual impairment is common in children born before 25 gestational weeks—boys are more vulnerable than girls

Children born extremely preterm have high risk of visual impairment due to retinopathy of prematurity (ROP) and cerebral lesions. The aim of this study was to investigate the frequency of ROP and visual impairment as defined by the World Health Organization (WHO), with respect to gender in two hospital-based groups of children born at the limit of viability. A retrospective chart review was conducted for all children (n = 114), born before 25 gestational weeks and screened for ROP at Karolinska hospital in Stockholm and Sahlgrenska hospital in Gothenburg between 1990 and 2002. Maximal ROP stages, treatment for ROP and visual acuity (VA), with correction when needed at latest available visit, were recorded. Altogether 97.4% had ROP, 74.6% developed proliferative disease (stage >/= 3) and 63.2% were treated with retinal ablation. Normal VA (>/=0.8) in at least one eye was found in 50.5% of all and in significantly more girls (61.5%) than boys (34.8%) (p = 0.006), while visual impairment (VA < 0.33) was more common in boys (32.6%) than in girls (9.2%) (p = 0.004). A large proportion of children, especially boys, born at the level of viability are visually impaired with low vision or blindness. Development of preventive measures is urgent.

Screening for Retinopathy of Prematurity in a Tertiary Care Newborn Unit in Turkey: Frequency, Outcomes, and Risk Factor Analysis

To report the frequency, risk factors, and outcomes of screening for retinopathy of prematurity (ROP). Data of neonates with a gestational age of 34 weeks or less were analyzed and the predictors on the development of ROP were determined by using logistic regression analysis. Of the 318 neonates, the frequency of ROP was 37.1% for any stage and 7.2% for stage 3 or greater. Treatment was needed in 16.1% of neonates with ROP. No treatment was required in neonates with a gestational age of greater than 32 weeks. Oxygen therapy, sepsis, gestational age of 32 weeks or less, and birth weight of less than 1,250 g were determined as the independent risk factors. Although frequency of ROP in Turkey is similar to that in the United States, the rate of severe ROP necessitating treatment seems to be higher in Turkey. Neonates with a gestational age of 32 weeks or less, a birth weight of less than 1,250 g, sepsis, and oxygen therapy may have a greater risk of developing ROP and screening should be intensified in the presence of these risk factors.

The Incidence and Course of Retinopathy of Prematurity: Findings From the Early Treatment for Retinopathy of Prematurity Study

To estimate the incidence of retinopathy of prematurity (ROP) in the Early Treatment for Retinopathy of Prematurity (ETROP) Study and compare these results with those reported in the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) Study. The ETROP Study, as part of its protocol, screened 6998 infants at 26 centers throughout the United States. Serial eye examinations were conducted for infants born weighing <1251 g, making it possible to estimate the frequency of ROP in different birth weight and gestational age categories. ROP was categorized according to the International Classification for ROP. The incidence of any ROP was 68% among infants of <1251 g. The findings were compared with those for infants born in 1986 and 1987 in the CRYO-ROP Study. The overall incidences of ROP were similar in the 2 studies, but there was more zone I ROP in the ETROP Study. Among infants with ROP, more-severe ROP (prethreshold) occurred for 36.9% of infants in the ETROP Study and 27.1% of infants in the CRYO-ROP Study. The gestational age of onset of ROP of different severities has changed very little since the CRYO-ROP Study was conducted. ROP remains a common important problem among infants with birth weights of <1251 g. The incidence of ROP, time of onset, rate of progression, and time of onset of prethreshold disease have changed little since the CRYO-ROP natural-history study.