Retinopathy Of Prematurity Children Research Articles

Long-term follow-up of the cognitive function in children after intravitreal ranibizumab for retinopathy of prematurity.

To evaluate the long-term cognitive function in children treated with intravitreal ranibizumab (IVR) for retinopathy of prematurity(ROP), and the impact of IVR on the growth and ocular development. In this retrospective study, the premature children aged 4 to 9years who received monotherapy of IVR (IVR group, n = 25) or monotherapy of laser photocoagulation (LP) (LP group, n = 33) for ROP, and the same age premature children with no ROP (Control group, n = 26) were enrolled from 2020 to 2022 in the pediatric fundus clinic of Shenzhen Eye Hospital. Main outcome measures were full-scale intelligence quotient (FSIQ) and index score using the Chinese version of the Wechsler intelligence scale for children-fourth edition (WISC-IV) and Wechsler preschool and primary scale of intelligence-fourth edition (WPPSI-IV). All children were examined and analyzed for growth and ocular development by recording the height, weight, head circumference, spherical equivalent (SE), best corrected visual acuity (BCVA) and axial length (AL). There were 17 children in IVR group, 17 in LP group, and 11 in Control group who received the WISC-IV assessment. There were no significant differences in FSIQ, verbal comprehension index, perceptual reasoning index, working memory index, processing speed index, general ability index and cognitive efficiency index among the three groups. There were 8 children in IVR group, 16 in LP group, and 15 in Control group who received the WPPSI-IV assessment. There were no significant differences in FSIQ, verbal comprehension index, visuospatial index, fluid reasoning index, working memory index, non-verbal index, general ability index and cognitive efficiency index among the three groups. There was no significant difference in BCVA among the three groups (P = 0.74), however, there is an increase for AL in IVR group when compared with LP group (22.60 ± 0.58 vs. 22.13 ± 0.84, P = 0.003), and the ROP patients of IVR group have a significant increase in the AL compared to the Control group(22.60 ± 0.58 vs. 22.03 ± 0.71, P < 0.0001). Children with a history of IVR have a similar cognitive function outcomes compared to those with a history of LP or were premature without ROP. ROP children with a history of IVR has longer AL than those treated with LP.

Persistent Vascular Anomalies in Retinopathy of Prematurity Children: Ultrawide-field Fluorescein Angiography Findings until School Age.

To investigate vascular abnormalities, including persistent avascular retina (PAR), in a large cohort of patients with regressed or treated retinopathy of prematurity (ROP) through long-term follow-up until school age. Retrospective large cohort study. We included pediatric patients (< 18 years old) with a history of nontreated or treated ROP (treated with either photocoagulation or intravitreal injection [IVI]) and regularly followed up until2020. Upon enrollment, we categorized patients into 4 groups: prematurity, regressed ROP, and IVI and laser treatment ROP groups. All patients had undergone visual acuity examinations, OCT, and ultrawide-field fluorescein angiography. Percentage of eyes with PAR (greater than or equal to the area of 2 disc diameters from the ora serrata to vascular termini) and with vascular abnormalities in the peripheral and posterior retina. In total, we included 187 eyes of 95 patients. The prevalence of PAR was 0%, 33.33%, and 31.65% in eyes in the prematurity, regressed ROP, and IVI treatment groups, respectively (P<0.0001). There was no significant difference in the percentage of PAR eyes when comparing regressed ROP group (33.33%) with the IVI treatment group (31.65%). At least 1 type of vascular abnormality was noted until school age in all (100%) treated ROP eyes. Although multivariate analysis found a significant association between IVI treatment and PAR (odds ratio: 10.28, 95% confidence interval: 3.29-32.14) until the school age of 6 to 8 years old, there were no stage 3 eyes in the spontaneously regressed group, suggesting that stage 3 ROP in the IVI group could also drive the association. Approximately one-third of ROP eyes with spontaneous regression or IVI treatment still exhibit PAR when the child reaches school age. Several distinct vascular anomalies at the vascular-avascular juncture and within the vascularized retina can persist in these children. The clinical significance of these anomalies and the decision whether to treat them warrant further investigation to optimize their outcomes. The authors have no proprietary or commercial interest in any materials discussed in this article.

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.

Evaluation of macular microvascular structure with optical coherence tomography angiography in children with history of treatment for retinopathy of prematurity.

To compare macula vascular parameters in optical coherence tomography angiography (OCTA) of children with history of retinopathy of prematurity (ROP) who were treated with laser photocoagulation (LPC) or intravitreal Bevacizumab therapy. Forty eyes of 28 ROP children treated with LPC and 36 eyes of 22 ROP children treated with intravitreal Bevacizumab and 40 eyes of 40 age-gender matched term children were included the study. Capillary plexus densities in macula, FAZ parameters, outer retina and choriocapillaris flow rates, and central foveal thickness were measured. Foveal superficial and deep capillary plexus densities were found significantly higher in LPC and intravitreal Bevacizumab injection (IBI) groups compared to control group. FAZ area was found significantly lower in LPC and IBI groups compared to control group (p ‹ 0.001). Higher foveal superficial capillary plexus density, higher central foveal thickness, and lower FAZ area were found to be associated with poorer visual acuity in correlation analysis (p ‹ 0.05). In IBI group, earlier anti-VEGF therapy was found to be associated with lower foveal superficial capillary plexus density. Microvascular characteristics such as FAZ area and capillary plexus densities of macula are deteriorated in ROP. There is no significant difference between the treatment alternatives of ROP in terms of macular microvascular parameters.

Foveal structure changes in infants treated with anti-VEGF therapy or laser therapy guided by optical coherence tomography angiography for retinopathy of prematurity.

To evaluate foveal vessel density (VD) and foveal thickness using optical coherence tomography angiography (OCTA) in retinopathy of prematurity (ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor (VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children. This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes (14 patients) treated with anti-VEGF injection and twenty-nine eyes (17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina (centered on the fovea) using OCTA and cross-sectional OCT, respectively. Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation (P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina (P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group (P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study. In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70mo after the treatments.

Foveal structure, function and microvascular morphology in school-age children with laser-treated retinopathy of prematurity.

The purpose of this retrospective case-control study was to evaluate the relationship between foveal structure, function, microvascular morphology and visual acuity in school-age children with laser-treated retinopathy of prematurity (ROP). Foveal structural parameters, including the central foveal thickness (CFT), inner retinal thickness (IRT) and outer retinal thickness (ORT), were measured on B-scans using an Optovue XR Avanti optical coherence tomography device. Foveal microvascular parameters, including the foveal avascular zone (FAZ), superficial capillary plexus-vessel density (SCP-VD) and deep capillary plexus-vessel density (DCP-VD), were measured on optical coherence tomography angiography with a scan size of 3 × 3. The P1 amplitudes and P1 implicit times were recorded by a multifocal electroretinogram with 61 elements. Fifty-five eyes (26 eyes of school-age ROP children and 29 eyes of full-term controls) were analysed. The ROP children manifested a significantly smaller FAZ, higher SCP-VD and higher DCP-VD than the controls (p < 0.001). The CFT (p < 0.001), IRT (p < 0.001) and ORT (p = 0.001) were significantly increased in the ROP group. The P1 amplitudes in all five-ring retinal regions were significantly smaller in the ROP group (p < 0.001). Multivariable analysis indicated that best-corrected visual acuity was positively correlated with post-menstrual age (PMA) and negatively correlated with SCP-VD and CFT (R2 = 0.529, p < 0.001, 0.043 and 0.020, respectively). The foveal structure, function and microvascular morphology are affected in school-age children with laser-treated ROP. PMA, foveal structural anomalies and microvascular changes in ROP children were associated with impaired visual function.

STATE OF HEALTH OF PREMATURE CHILDREN: ACCORDING TO THE DATA OF KAZAN CITY CATAMNESIS CENTER

The article presents the analysis of the health status of children born prematurely during the first year of their life. There is the comparison of morbidity rates for five years of the operation of the catamnesis center of Kazan. Profoundly premature children demonstrated the highest level of morbidity with more frequent pathologies of the central nervous system, respiratory organs, eyes and anemia of premature children. In 2017 there was a decrease in the frequency and severity of respiratory diseases (bronchopulmonary dysplasia with chronic respiratory insufficiency 1.6 times), the nervous system (severe ischemic and hypoxic-hemorrhagic lesions of CNS 2.7 times), eyes and its adnexa (a complicated retinopathy of premature children 1.7 times) in extremely premature infants.

Foveal microvascular anomalies on optical coherence tomography angiography and the correlation with foveal thickness and visual acuity in retinopathy of prematurity.

To assess foveal microvascular structure and the correlation between foveal retinal thickness and best corrected visual acuity (BCVA) in children with retinopathy of prematurity (ROP). This is a retrospective case-control study. A total 42 eyes in 23 patients with history of anti-vascular endothelial factor (VEGF) agent treatment and 51 eyes of 27 healthy age-matched subjects as the control group were analyzed. Foveal avascular zone (FAZ) and foveal vessel density (VD) were measured by optical coherence tomography angiography (OCT-A). Foveal thickness was measured by cross-sectional OCT. Correlations between FAZ area, foveal VD, foveal thickness, BCVA, gestational age (GA), and birth body weight (BBW) were performed. ROP children had a significantly smaller FAZ area and higher foveal VD, and the foveal thickness was significantly higher as compared to controls (all P < 0.0001). We noted a significant negative correlation between FAZ area and foveal thickness. In addition, a significant positive correlation between foveal VD and foveal thickness was identified. With regard to prematurity status, gestational age and birth body weight were both significantly correlated with FAZ area, foveal VD, and fovea inner retinal thickness. Multivariable analysis showed that thicker inner retinal thickness and higher superficial vascular density were associated with suboptimal visual acuity. By using OCT-A, we identified significant foveal microvascular anomalies in ROP children. The correlation between the microvascular anomalies, central foveal thickness, and suboptimal visual acuity was also noted. Because of the retrospective nature, more studies are necessary to further establish the relationship.

Analysis on the refractive state after treatment of retinopathy of prematurity

Objective To analyze the refractive state of retinopathy of prematurity (ROP)after different methods of treatment . Methods The data of 114 eyes of 60 cases with ROP from 2013 to 2016 were analyzed retrospectively. All cases were divided randomly into laser treatment group and intravitreal injection group . The cycloplegic retinoscopy refraction data of children at 24 months were collected. The refractive status and related factors of the two groups were statistically analyzed. Results The incidence rate of high myopia and astigmatism in laser treatment group were higher than those of intravitreal injection group, the difference were significant between the two groups (χ2=7.828, 2.705; P=0.000, 0.007). In laser treatment group the spherical equivalent refraction were smaller, the average column mirror degree were smaller and the axial length was longer, the difference were statistically significant between the two groups (χ2=2.329, 0.384, 2.184; P=0.034, 0.007, 0.039) .The differences in the incidence of hyperopia and myopia after treatment were statistically significant between multiple intravitreal injection and single injection(χ2=2.274, 3.052; P=0.023, 0.002 ). The spherical equivalent refraction were smaller and the axial length were longer in multiple intravitreal injection group, the differences were statistically significant(χ2=0.944, 2.381; P=0.036, 0.042). Conclusion The incidence of myopia and astigmatism are lower after inteavitreal injection for the treatment of ROP, and the effect of vision acuity is small. The incidence of myopia and astigmatism in ROP children treated with intravitreal injection is higher than that of single vitreous body injection for ROP. Key words: Retinopathy , prematurity; Treatment , laser; Intravitreal injection; Refraction

Anterior Chamber Angle and Anterior Segment Structure of Eyes in Children With Early Stages of Retinopathy of Prematurity

To compare structural differences in the anterior chamber angle (ACA) and related optic components in children with or without retinopathy of prematurity (ROP). Prospective cross-sectional study. Setting: A referred medical center in Taiwan. The patients included preterm children with a history of ROP who had undergone laser therapy. The controls included age-matched healthy full-term children. The ACA structures were evaluated using gonioscopy. The angularity of the anterior chamber and associated anatomic changes. We examined 54 eyes of 29 preterm children with ROP and 134 eyes of 67 children born at term. The eyes of the ROP children exhibited a narrower ACA, steeper iris curvature, and more anteriorly inserted iris than those of the full-term children (P < .001, P=.002, and P= .08, respectively). The eyes of the ROP children also exhibited steeper corneas, shallower anterior chamber depths, thicker lenses, and higher degrees of refractive errors (all P < .001) than those of the full-term children. The axial lengths did not differ between the 2 groups (P= .15). The eyes of the ROP children presented a narrower ACA and a more anteriorly curved and inserted iris than those of the full-term children. A steeper cornea, shallower anterior chamber, and greater lens thickness were the main structural changes in the anterior segment components of these patients. Further research is needed to investigate the association between these structural changes and the development of certainocular diseases, such as glaucoma, in these patients.

Full-field flash electroretinogram following up for children with history of pre-threshold or threshold retinopathy of prematurity

Objective To evaluate the characteristics of electroretinagram (EGR) in children with history of pre-threshold or threshold retinopathy of prematurity (ROP).Methods A total of 24 children (48 eyes) with history of pre-threshold ROP or threshold ROP received F-ERG examination.Ten age and body weight-matched children with a history of premature birth (20 eyes) but without ROP were recruited as control group.The rod response,maximal rod-cone response and cone response of F-ERG were recorded respectively following the International Standard Protocal of ISCEV (2000 version).The latency and amplitude of a-wave and b-wave of various responses were analyzed.The trial was approved by the Ethic Committee of Hunan Children's Hospital and informed consent was obtained from the parents of patients prior to any medical procedure.Results There was significant difference between ROP and control group in rod response,the latency was longer (t=5.643,P＜0.05) and the amplitude was lower in ROP group(t=7.068,P＜0.05).In maximal rod-cone response both in a and b wave,the latency wave was longer(t=3.099,2.886;P＜0.05) and the amplitude was lower(t=5.614,2.850;P＜0.05) in ROP group.But there is no difference between ROP and control group in cone response latency(t=0.819,0.948)and amplitude (t=0.904,0.850).Conclusion ERG in ROP children with history of pre-threshold or threshold ROP is abnormal,which mainly in rod response,but the cone response remains normal. Key words: Vision, ocular/physiology; Retinopathy of prematurity/physiology; Electroretinography

Safety net for retinopathy of prematurity management

Retinopathy of prematurity (ROP) care has evolved greatly over the last two decades. Appropriately timed and well-documented screening can prevent a child with ROP from developing severe vision loss. A safety net for children with ROP includes commitment not only by the ophthalmologist certified for ROP screening, but also from the hospitals and parents associated with these individuals. The overlapping tasks from these three arms may prevent ROP children from slipping through the cracks and suffering not only significant loss of vision, but a decreased quality of life.

Ametropia in children with regressed retinopathy of prematurity

Abstract Purpose Main aims of this study were:(1)To identify the pattern of refractive changes in children with different degrees of pre‐threshold retinopathy of prematurity (ROP). and (2)To establish whether long term follow‐up is necessary for these children? Methods ROP screening notes of all premature babies born between Jan 2001 to Jan 2005(5 years) within a defined geographical area (Leicestershire) of the UK and fulfilling the national ROP screening guidelines were reviewed retrospectively. According to the severity, we graded the pre‐threshold ROP as follows: (1)Grade1‐ Any disease restricted to zone 3 or Stage I or II in zone 2, (2)Grade2‐ Stage II+ or III disease in zone 2, and (3)Grade3 ‐ Stage III+ disease in zone 2 Any zone 1 disease. Eyes of matched eyes were used as controls (same gestational age and weight matched children who were premature but without ROP). Cycloplegic refraction data (minimum follow up period‐ 24 months) on these children were then collected through the clinic notes. The results were compared statistically. Results Refractive status results (at 24 months age) were available for 116 eyes in 62 children (Electronic search + Case notes review). Eyes were assigned to our predefined grades: Grade1:60 eyes(32), Grade2:34 eyes(18), and Grade3:22 eyes(12). The results of cyclopegic refraction (Mean spherical equivalent, Range) were as follows: Grade1:0.59(‐1.75 to +3), Grade 2: ‐0.04(‐4.5 to +2.25), and Grade 3: ‐1.59 (‐7.5 to +1.75). Statistically, refractive outcome of Grade 2 and 3 ROP children were different from controls. Conclusion In pre‐threshold ROP, the trend of myopia is directly proportional to the severity of ROP. We recommend that regular follow up is necessary for Grade 2 and 3 ROP babies but no follow up required for babies with Grade 1 disease.