Retinopathy Of Prematurity In Infants Research Articles

Особенности течения ретинопатии недоношенных на фоне тяжелых внутриутробных и постнатальных инфекций

Особенности течения ретинопатии недоношенных на фоне тяжелых внутриутробных и постнатальных инфекций

Neurodevelopmental Outcomes after Bevacizumab Treatment for Retinopathy of Prematurity: A Meta-analysis

To evaluate neurodevelopmental outcomes after intravitreal bevacizumab (IVB) therapy in retinopathy of prematurity (ROP) infants compared with those not exposed to IVB. The primary concern regarding IVB treatment of ROP is the potential systemic side effects, especially the risk of causing severe neurodevelopmental impairment (sNDI). Results regarding neurodevelopmental outcomes after IVB therapy are conflicting. We conducted a meta-analysis and searched PubMed, Embase, and Web of Science for related publications from inception through March 12, 2020. The eligibility criteria were as follows: comparative studies of ROP patients that (1) included IVB as a treatment arm, (2) included a control group without bevacizumab treatment, and (3) reported on at least 1 neurodevelopmental outcome, such as sNDI, Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), composition scores, or cerebral palsy (CP). The primary outcome was sNDI, with the odds ratio (OR) calculated. Secondary outcomes were mean differences (MDs) for cognitive, language, and motor scores (Bayley III) and OR for CP. The quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach. Eight studies, 6 including laser-controlled ROP infants and 2 including ROP infants not requiring treatment, were included. The weighted OR for sNDI in the IVB group was 1.39 (95% confidence interval [CI], 0.98-1.97). The weighted MDs were -1.92 (95% CI, -4.73 to 0.88), -1.32 (95% CI, -4.65 to 1.99), and -3.66 (95% CI, -6.79 to -0.54) for cognitive, language, and motor scores in Bayley III, respectively. The OR for CP was 1.20 (95% CI, 0.56-2.55). No differences were observed between the preset subgroups comprising laser-controlled ROP infants and ROP infants not requiring treatment. The current quality of evidence was rated as low (sNDI and all Bayley III scores) to very low (CP). Risk of sNDI was not increased in ROP patients after IVB treatment. Bayley III scores were similar in the IVB and control groups, except for a minor difference in motor performance. These findings suggest that the risk of additional sNDI after IVB treatment is low. Randomized trials are warranted to provide a higher quality of evidence.

The Role of Retinopathy Anemia in the Pathogenesis of Retinopathy of Prematurity and the Effect of Erythropoietin Treatment on the Frequency and Severity of the Disease

Premature infants with extremely low birth weight are at high risk of developing severe disabling forms of retinopathy of prematurity. Nonsurgical therapy methods of treatment of retinopathy in prematurity are ineffective. Taking into consideration the multifactoriality of retinopathy in prematurity, studies aimed at analyzing accessory risk factors aiding the progression of active retinopathy of prematurity and the development in their pharmacological therapy are relevant for practical healthcare. Effective prevention of retinopathy of prematurity and prevention of severe disabling stages in premature infants at risk require timely diagnosis of the form and severity of anemia. This is the neonatologist’s task. The ophthalmologist should inform the neonatologist about the possibility of developing retinopathy of prematurity in a baby’s eye and about the necessity for diagnostic and remedial measure to treat anemia. The purpose of this study was to assess the impact of early anemia of prematurity on the frequency and severity of retinopathy of prematurity in infants at risk and the effectiveness of its treatment with erythropoietin. The frequency of anemia in preterm risk group (total 1603 children) and its treatment with the degree of prematurity were analyzed. Anemia was manifested in 99–100 % of children with retinopathy of prematurity. The comparative frequency and severity of retinopathy of prematurity was observed in three groups of infants: with extremely low birth weight and gestational age up to 28 weeks of pregnancy (245 children) group I, with gestational age 29–31 weeks of pregnancy (471 children) group II, and more than 31 weeks (581 children) group III. It was found that without treatment in group I retinopathy of prematurity developed in 100 % of cases and ended with adverse outcomes (IV–V degree of retinopathy of prematurity) in 13.64 %, which is significantly higher ( p < 0.01) than after treatment (1.78 %). Similar index was found in groups II and III. Conclusion. We traced the importance of early premature anemia in the pathogenesis of retinopathy of prematurity. It helped us to conclude that the lower the gestational age of the child at the time of birth stronger linked with the dependence of anemia and retinopathy of prematurity. Both of them are associated with the imperfection of the protective mechanisms of preterm infants. Early prescription of erythropoietin significantly improves the clinical course of retinopathy of prematurity and its prognosis.

Effect of early prophylactic low-dose recombinant human erythropoietin on retinopathy of prematurity in very preterm infants

BackgroundVery preterm infants are at risk of developing retinopathy of prematurity (ROP). Recombinant human erythropoietin (rhEPO) is routinely used to prevent anemia in preterm infants; however, the effect of rhEPO on ROP development is still controversial. The purpose of this study was to evaluate the effect of early prophylactic low-dose rhEPO administration on ROP development in very preterm infants.MethodsA total of 1898 preterm infants born before 32 weeks of gestation were included. Preterm infants received rhEPO (n = 950; 500 U/kg, rhEPO group) or saline (n = 948, control group) intravenously within 72 h of birth and then once every other day for 2 weeks.ResultsThe total incidence of ROP was not significantly different between the two groups (10.2% vs. 13.2%, p = 0.055). Further analysis showed that rhEPO group had lower rates of type 2 ROP than the control group (2.2% vs. 4.1%, RR 0.98; 95% CI 0.96–1.00; p = 0.021). Subgroup analysis found that rhEPO treatment significantly decreased the incidence of type 2 ROP in infant boys (1.8% vs. 4.3%, p = 0.021) and in those with a gestational age of 28–296/7 weeks (1.1% vs. 4.9%, p = 0.002) and birth weight of 1000–1499 g (1.2% vs. 4.2%, p = 0.002). There was a small increasing tendency for the incidence of ROP in infants with a gestational age of < 28 weeks after rhEPO treatment.ConclusionsRepeated low-dose rhEPO administration has no significant influence on the development of ROP; however, it may be effective for type 2 ROP in infant boys or in infants with gestational age > 28 weeks and birth weight > 1500 g.Trial registration The data of this study were retrieved from two clinical studies registered ClinicalTrials.gov (NCT 02036073) on January 14, 2014, https://clinicaltrials.gov/ct2/show/NCT02036073; and (NCT03919500) on April 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03919500.

Development of Screening Criteria for Retinopathy of Prematurity in Ulaanbaatar, Mongolia, Using a Web-based Data Management System.

To describe a process for identifying birth weight (BW) and gestational age (GA) screening guidelines in Mongolia. This was a prospective cohort study in a tertiary care hospital in Ulaanbataar, Mongolia, of 193 premature infants with GA of 36 weeks or younger and/or BW of 2,000 g or less) with regression analysis to determine associations between BW and GA and the development of retinopathy of prematurity (ROP). As BW and GA decreased, the relative risk of developing ROP increased. The relative risk of developing any stage of ROP in infants born at 29 weeks or younger was 2.91 (95% CI: 1.55 to 5.44; P < .001] compared to older infants. The relative risk of developing any type of ROP in infants with BW of less than 1,200 g was 2.41 (95% CI: 1.35 to 4.29; P = .003] and developing type 2 or worse ROP was 2.05 (95% CI: 0.99 to 4.25; P = .05). Infants in Mongolia with heavier BW and older GA who fall outside of current United States screening guidelines of GA of 30 weeks or younger and/or BW of 1,500 g or less developed clinically relevant ROP. [J Pediatr Ophthalmol Strabismus. 2020;57(5):333-339.].

Prediction of visual outcomes by an artificial neural network following intravitreal injection and laser therapy for retinopathy of prematurity

AimsTo construct a program to predict the visual acuity (VA), best corrected VA (BCVA) and spherical equivalent (SE) of patients with retinopathy of prematurity (ROP) from 3 to 12 years...

Postnatal Serum Insulin-Like Growth Factor I and Retinopathy of Prematurity in Latin American Infants

ABSTRACT Purpose Identifying at-risk infants for retinopathy of prematurity (ROP) is complex in countries with emerging economies as infants that lack conventional risk factors, such as low birth weight (BW) and young gestational age (GA), still go on to develop severe ROP. Potential biomarkers, like serum insulin-like growth factor 1 (IGF-1) and slow postnatal weight gain, have been identified as good predictors for ROP in developed countries. We sought to determine the relationship between IGF-1 levels and ROP in two Latin American countries where the burden of disease is still significant. Methods Prospective cohort study of infants in Guadalajara, Mexico and La Plata, Argentina. Filter-paper bloodspot IGF-1 assays were performed weekly from birth until hospital discharge or 40 weeks’ postmenstrual age (PMA). Results 112 infants were studied with a median BW of 1412 g (range 620 g-2390 g) and a median GA of 33 weeks (range 25–37). There was no significant difference in IGF-1 between infants who developed ROP and those who did not. Conclusion Low IGF-1 was not associated with ROP in these infants. The lack of an association between ROP and IGF-1 in Latin America supports the observation that growth-based predictive models do not perform as well in this setting where more mature babies still develop severe ROP.

Lens-sparing vitrectomy for stage 4A retinopathy of prematurity in infants with aggressive-posterior ROP: Anatomic and functional results.

To assess long-term anatomic and functional outcomes of early lens-sparing vitrectomy (LSV) for stage 4A retinopathy of prematurity (ROP) in infants with aggressive-posterior ROP (AP-ROP) which progressed to retinal detachment despite laser treatment. Chart review of infants who underwent early 25-gage LSV for stage 4A ROP. Outcomes were anatomic success, mean visual acuity (VA), development of postoperative complications, and refractive changes. Follow-up examinations were performed at 1, 3, 6, 12, and then every 6 months. Ten eyes of seven preterm infants who underwent LSV were included. Mean follow-up was 36 ± 13.4 months and mean postmenstrual age (PMA) at last follow-up was 37 ± 13.7 months. Mean gestational age (GA) and weight at birth was 26 ± 1.4 weeks and 639 ± 180 g. Two eyes had vitreous hemorrhage 4 and 14 days after surgery, respectively. At last follow-up anatomic success was 100%, mean VA was 20/80 and eight eyes (80%) had high myopic refractive correction (mean spherical equivalent -11.25 D). Early LSV for stage 4A ROP with AP-ROP and progression to retinal detachment is efficacious in terms of anatomic and functional outcomes. Anatomic success is associated with visual improvement despite possible myopic refraction changes during follow-up.

Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was...

For Effective, Earlier and Simplified Diagnosis of Retinopathy of Prematurity (RoP), a Probe through Digital Image Processing Algorithm in B-Scan

Eyes are the most vital sensory organ, which stimulates light and helps us to visualize the colorful world around us. Its internal structure is extremely minute and complex with various layers and chambers present. Retina and its layers, is the most important part of an eye that helps in viewing the objects. In certain ailments, if retina gets affected, the vision becomes challenging and may even lead to permanent blindness. One of such vision threatening diseases, affecting the infants is Retinopathy of Prematurity (RoP). Here, various latest, authentic methodologies and tools used for the diagnosis and management of RoP are reviewed and a novel algorithm has been proposed to measure the percentage deviation of retinal health with respect to prior ultrasonic B scan image. Also, to classify the level or stage of RoP based on the location and severity noticed in the ultrasonic B scan images. The proposed architecture and design would be effective and simplified and enable the Ophthalmologists for earlier and accurate diagnosis of RoP in infants.

Regional factors of somatic pathologies in pregnant women and predelivery risk factors for retinopathy in premature infants of the Altai region

Despite progress in medicine, the number of preterm births as a result of the use of new reproductive technologies is increasing. Preterm birth is a multifactorial process. The success of neonatal resuscitation in nursing children with extremely low birth weight leads to an increase in the number of surviving children with various ophthalmic pathologies. Retinopathy in premature infants remains one of the urgent problems of pediatric ophthalmology, being one of the leading causes of blindness and low vision in preterm neonates. Premature retinopathy is a multifactorial disease, the incidence and severity of which are due to the influence of many risk factors that adversely affect the immature retina of a premature infant and lead to a violation of its normal vasculogenesis.&#x0D; Aim. To evaluate the state of health of pregnant women and the connection of this factor with the development of retinopathy among retinopathy prematurity in the Altai Region.&#x0D; Material and methods. To achieve this aim, statistical compendiums of the Demographic Yearbook in the Altai Region over an 11-year period (from 2005 to 2016) were analyzed, as were the medical histories of infants hospitalized inThe Altai Regional Clinical Childrens Hospital during the same period.&#x0D; Results. Statistically significant differences (p 0.05) in the incidence of hepatitis and diabetes were discovered. In addition, the most apparent variations, confirming the existence of prenatal risk factors leading to retinopathy in premature infants, were obtained on such indicators as anemia among pregnant women, fetoplacental deficiency, gestational toxicosis, pyelonephritis among pregnant women, and others.&#x0D; Сonclusions. We detected a significant number of somatic pathologies in pregnant women in the Altai Region, which was considerably higher than the average rates in the Russian Federation. The most remarkable antenatal risk factors for the birth of premature babies developing retinopathy of the premature were highlighted, and these should be taken into account when organizing prophylactic screening measures for the early identification of retinopathy of prematurity in the Altai Region.

Risk factors for the development and progression of retinopathy of prematurity in preterm infants in Indonesia.

Risk factors other than supplemental oxygen might play a role in the development of retinopathy of prematurity (ROP). In Indonesia ROP occurs in infants up to 34 weeks and 2000 g. Risk factors for the development of ROP in Indonesian NICUs have not been evaluated. Our aim was to identify other risk factors than the use of oxygen in the development and progression of ROP in preterm infants in Indonesia. Data on 98 preterm infants with ROP and 77 controls were collected from four NICUs and two eye centers in Jakarta, Indonesia, between 2009 and 2014. We used multivariate logistic regression analysis to determine the relationship between infants and environmental variables and the development and progression of ROP. We obtained variables for ROP severity by using Cox regression analysis. Factors associated with the development of ROP were birthweight (BWt), intrauterine growth retardation (IUGR), exchange transfusion, duration of oxygen supplementation, minimum saturation monitor setting, and socioeconomic factors. Regarding the progression, gestational age (GA), out-born, duration of supplemental oxygen, minimum saturation monitor setting, and socioeconomic factors were identified as risk factors. The use and control of supplemental oxygen are the main risk factors for the development and progression of ROP in preterms in Indonesia. Additionally, we confirm that GA, BWt, and IUGR are risk factors. Moreover, we found exchange transfusion to be a risk factor, and we found a lower rate of ROP in infants from a lower socioeconomic background. These risk factors apply to infants with a GA up to 34 weeks and a BWt up to 2000 g.

Do extremely preterm infants need retinopathy of prematurity screening earlier than 31 weeks postmenstrual age?

To evaluate the utility of screening all extremely preterm infants for retinopathy of prematurity (ROP) at 4 weeks chronologic age, which is earlier than recommended by the 2018 AAP guidelines. Retrospective analysis of infants <27 weeks gestation from two tertiary NICUs between 2006 and 2018 who survived until first eye examination. 550 infants (gestational age 25.1 ± 1.2 weeks and birth weight 758 ± 323 g) had 1310 examinations performed by 32 weeks postmenstrual age (PMA), and 676 (51.6%) of these were prior to 31 weeks PMA. No examinations in infants prior to 31 weeks PMA met the criteria for laser therapy. Of 87/550 infants (15.8%) who required laser therapy, none did so prior to 32 weeks PMA. No infants born <27 weeks gestation were found to have severe ROP prior to 31 weeks PMA, supporting the most recent AAP recommendation of initiating ROP screening at 31 weeks PMA for extremely preterm infants.

Scope of telemedicine in neonatology.

There is a widespread shortage of physicians worldwide, especially in rural areas. This shortage is more prevalent when it comes to subspecialty care, even in developed countries. One way to provide access to specialty care is using technology via telemedicine. Telemedicine has evolved over the last two decades, and its use is becoming widespread in developed countries. However, its use in the neonatal population is still limited and practiced only in some centers. It is now apparent that telemedicine can be successfully used in the neonatal population for screening premature infants for retinopathy of prematurity, congenital heart disease, bedside clinical rounds, neonatal resuscitation with the support of a tertiary care hospital, and family support. This avoids unnecessary transfer and appears to provide the same quality of care that the baby would have received at the tertiary care facility. This approach also improves family satisfaction, as the baby and the mother are kept together, and reduces the cost of care. This review focuses on the use of telemedicine in neonatal care, concentrating on the main areas where telemedicine has been shown to be successful and effective, including the status of telemedicine in China.

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Screening premature infants for retinopathy of prematurity in a tertiary hospital in Saudi Arabia.

ABSTRACTBACKGROUND: Early detection of retinopathy of prematurity (ROP) in preterm infants is critical, especially with advancements in neonatal care and improved survival rates. However, a balance should be found between not missing any ROP requiring treatment and minimizing workload, saving resources, and reducing unnecessary examinations to fragile neonates.OBJECTIVE: Ascertain whether our current inclusion criteria in screening ROP could be modified to ≤1250 g (while keeping the gestational age at ≤30 6/7 weeks) to reduce the number of screened babies without missing any type I ROP requiring treatment.DESIGN: Retrospective, record-based study.SETTING: Referral center.MAIN OUTCOME MEASURES: ROP outcome and risk factors.PATIENTS AND METHODS: Neonates screened for ROP in the neonatal intensive care unit of our institution between January 2016 and November 2018 were included. Data collected for each neonate included demographics, ROP details and risk factors. We used a revised version of ROP screening guidelines by the American Academy of Pediatrics.SAMPLE SIZE AND CHARACTERISTICS: 155 neonates (median birth weight, 1035 g; range, 527–1982 g; and gestational age range, 23–39 weeks).RESULTS: Of 1393 live births, 155 babies met the inclusion criteria. ROP occurred in 60/155 (38.7%) screened babies while sixteen developed threshold ROP. All 16 babies who required treatment had both a birthweight ≤1000 g and a gestational age of ≤30 weeks. Using the screening recommendations of the Canadian Policy, more infants would have been screened without diagnosing a case of ROP of any stage, and no case of ROP requiring treatment would have been missed compared to the AAP recommendations.CONCLUSION: ROP requiring treatment is a rare occurrence in premature infants with a gestational age >30 weeks and body weight >1000 g at our institute. Nonetheless, this is not an attempt to alter national screening guidelines. A multicenter prospective study with an adequate sample size is needed to assess whether guidelines for ROP screening should be altered in this category of neonates.LIMITATIONS: Retrospective design.CONFLICT OF INTEREST: None.

Antenatal exposure to fenoterol is not associated with the development of retinopathy of prematurity in infants born before 32weeks of gestation.

Despite safety concerns, β2-sympathomimetics are still widely used as tocolytic agents. β-Blockers in turn are used to treat vasculo-proliferative diseases of the newborn such as retinopathy of prematurity (ROP), which may lead to visual impairment and blindness. The scope of this study was to investigate whether antenatal exposure to the β2-sympathomimetic fenoterol contributes to the development of ROP. For this single-center retrospective case-control study of prospectively collected clinical data, all infants born before 32weeks of gestation between 2001 and 2012 were included. The association of prenatal exposure to fenoterol and the development of ROP were analyzed by multivariate logistic regression. n = 1134 infants < 32weeks of gestation were screened for eligibility, out of which n = 722 met the inclusion criteria. Exposure to fenoterol (n = 505) was not associated with a higher rate of ROP (OR 0.721, 95% CI 0.463-1.122). Further, duration of exposure (days) did not alter the incidence of ROP (OR 1.001, 95% CI 0.986-1.016). Frequency distribution of different ROP stages and the need for therapeutic intervention was also not affected by prenatal exposure to fenoterol. Risk factors for the development of ROP like low birth weight, low gestational age, prolonged respiratory support and multiple gestation were confirmed in our large study cohort. β2-Sympathomimetic tocolysis does not increase the rate of ROP in premature infants born < 32weeks of gestation. Our results render fenoterol a safe tocolytic agent regarding neonatal ROP development.

Telemedicine for Retinopathy of Prematurity in 2020.

Purpose: Retinopathy of prematurity (ROP) is the leading cause of visual impairment in premature infants, and middle-income nations are currently experiencing the “third epidemic” of ROP. Screening programs are essential to prevent negative visual outcomes, but screening efforts require a great amount of resources from healthcare systems and are difficult to marshal, particularly in geographically isolated or resource-limited settings. Telemedical screening programs using remote digital fundus imaging (RDFI) systems hold the promise of alleviating many of the burdens that currently make screening for ROP logistically challenging. Methods: Literature review of the current evidence for RDFI telescreening for ROP, with editorial discussion and recommendations. Results: In this review, we summarize the robust body of literature regarding the efficacy of RDFI, the feasibility of telescreening programs, and experiences from current live telescreening programs. We discuss the strengths and limitations of the current evidence and of the screening programs and consider the best practices in developing de novo telemedical screening programs for ROP. The review concludes with a discussion of promising future areas of research and development. Conclusions: RDFI ROP screening programs can be accurate and reliable. They show promise in improving many current challenges in screening infants for ROP, may be able to improve some aspects of care, and have been demonstrated to be cost-effective.

Incidence and risk factors of retinopathy of prematurity and utility of the national screening criteria in a tertiary center in Iran.

To determine the incidence and risk factors of retinopathy of prematurity (ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34wk gestational age (GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit (NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP (i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight (BW) were significantly lower in ROP vs non-ROP infants (29±2wk vs 33±3wk, P<0.001; 1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus (P<0.05 for all). BW [relative risk (RR): 0.857 (0.711-0.873), P<0.001], GA [RR: 0.788 (0.711-0.873), P<0.001] and blood transfusion [RR: 1.888 (0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.

Early and late complications of hyperglycemic extremely low birth-weight infants

Introduction: During recent decades, the perinatal mortality of extremely low-birth weight infants has decreased. An important task is to recognize complications of prematurity. Aim: We made an attempt to explore the relationship between complications of prematurity and neonatal hyperglycemia. Method: From 1 January 2014 to 31 December 2017, 188 infants with birth weight below 1000 g were admitted. For each infant, the frequencies of hyperglycemia (blood glucose >8.5 mmol/l), retinopathy of prematurity, intraventricular hemorrhage, and bronchopulmonary dysplasia were determined. Animal studies were performed in Sprague Dawley rats. Hyperglycemia was achieved by intraperitoneal injection of streptozotocin (100 mg/kg). On the 7th day of life, aorta sections were prepared and stained with hematoxylin eosin. Wall thickness was measured using QCapture Pro 7 image analysis software. Results: The mean ± SD gestational age and birth weight were 27.1 ± 2.2 weeks and 814.9 ± 151.9 g; 33 infants (17.5%) died. Hyperglycemia was confirmed in 62 cases (32.9%), and insulin treatment was given to 43 infants (22.8%). The gestational age and birth weight of the hyperglycemic infants were significantly lower (p<0.001), the incidence of severe retinopathy (p = 0.012) and the mortality of insulin-treated patients were higher (p = 0.02) than in normoglycemic infants. Among survivors (n = 155), we found by logistic regression analysis that hyperglycemia was a risk factor for severe retinopathy (p<0.001). In the rat model, neonatal hyperglycemia caused significant thickening of the aortic wall. Conclusion: Our studies indicate that hyperglycemia is common in extremely low birth-weight infants. Monitoring of these infants for retinopathy of prematurity, kidney dysfunction, and hypertension is recommended. Orv Hetil. 2019; 160(32): 1270-1278.