Retinopathy Of Prematurity In Preterm Infants Research Articles

Deep Learning Models and Fusion Classification Technique for Accurate Diagnosis of Retinopathy of Prematurity in Preterm Newborn

اعتلال الشبكية الخداجي (ROP) هو السبب الأكثر شيوعًا لعمى الأطفال الذي لا رجعة فيه، ويعتمد تشخيصه وعلاجه على الدرجات الذاتية بناءً على سمات الأوعية الدموية في شبكية العين. ومع ذلك، فإن هذه الطريقة شاقة وعرضة للخطأ، لذا فإن الأساليب الآلية مرغوبة لمزيد من الدقة والإنتاجية. تهدف هذه الدراسة إلى تطوير نهج قائم على التعلم العميق للتشخيص الدقيق لمرض اعتلال الشبكية الخداجي الزائد عند الأطفال الخدج باستخدام نماذج التعلم التحويلية وتقنية تصنيف الاندماج. زودنا مركز الأمل للعيون في العيادة الخاصة في بغداد، العراق، بـ 2776 صورة لقاعدة فحص مرضى اعتلال الشبكية الخداجي بين عامي 2015 و2020، واستخدمنا هذه الصور لتدريب ثلاثة نماذج للشبكات العصبية التلافيفية العميقة (ResNet50 وDensenet161 وEfficientNetB5). تم استخدام نهج مصنف الاندماج لدمج النماذج الثلاثة من أجل تشخيص شامل ودقيق. تتميز النماذج الثلاثة بمعدلات دقة نسبية تبلغ 69.78٪ و80.57٪ و81.29٪ في تصنيفاتها الخاصة. ومع ذلك، زادت الدقة الإجمالية إلى 90.28 في المائة عند استخدام مصنف الاندماج. هذا يدل على أن الطريقة المقترحة مفيدة لتحديد اعتلال الشبكية الخداجي عند الخدج. تشير نتائج الدراسة إلى أن الطريقة المقترحة لديها القدرة على تعزيز الدقة والسرعة التي يتم بها تشخيص اعتلال الشبكية الخداجي بشكل كبير، مما قد يؤدي بدوره إلى الكشف المبكر عن المرض وعلاجه وتقليل احتمالية الإصابة بعمى الأطفال.

Preterm Retinopathy of Prematurity and risk factors from a tertiary health care unit: A descriptive study

Abstract Introduction: Retinopathy Of Prematurity (ROP), is the major preventable blindness in infants. A study was conducted to find the risk factors of ROP in premature infants with gestational age (GA) < 36 weeks. Methods: It was a descriptive study conducted in Kakatiya Medical College, Hanumakonda. Babies with major congenital, chromosomal anomalies were excluded. One hour before screening, a drop of Tropicamide was instilled for every 10 – 15 minutes for 4 times followed by a drop of Phenylephrine just before examination. ROP screening was carried out by a senior ophthalmologist in NICU. First, the anterior segment was examined. This was followed by sequential examination of all clock hours of the peripheral retina and findings were recorded. Association between variables was analysed by using Chi-Square test. P < 0.05 was considered to be statistically significant. Results: ROP was detected in 31.4%; statistically there was no significant difference between gender. Apnoea, hyperbilirubinemia, anaemia, respiratory distress were found to be the risk factors for ROP; statistically there was significant difference, respectively. Conclusion: Preventing prematurity is the best way to reduce ROP. Proper coordination between obstetrician, neonatologist and ophthalmologist can help to reduce the incidence.

The Effects of Early Enteral and Parental Nutrition on Retinopathy of Prematurity: A Systematic Review.

The management of preterm newborns must consider the severe problem of retinopathy of prematurity (ROP). A systematic review has been conducted to effectively acknowledge how enteral and parenteral early nutrition affect the growth and progression of ROP. The study summarizes recent findings from various sources to give insight into the relationship between dietary practices and ROP risks. When untreated, retinopathy of prematurity (ROP) may cause severe vision loss or blindness in premature newborns. The latter two phases of ROP progression are the most serious. A child's early nutrition, both orally and intravenously, significantly impacts the severity and progression of ROP. This systematic review aims to examine the evidence linking early nutrition to ROP in premature infants. The study used Embase, Scopus, and PubMed to conduct our search. ROP, premature newborns, and nutrition were keywords used to find relevant papers. Nine research studies made it through the screening process and offered important information on the impact of diet on ROP. These studies support the idea that poor nutrition is a driving force behind the onset of ROP. The risk of ROP has been associated with postnatal development, hyperglycemia, polyunsaturated fatty acid levels, and the presence of breast milk. The outlook for ROP has also been discovered to be affected by the length of time the patient has received parenteral feeding. The incidence and severity of ROP may be mitigated by providing better nutrition to premature newborns. This comprehensive study concludes that early nutrition, both enteral and parenteral, substantially influences the development and progression of ROP in premature newborns. The significance of nutrition in newborn care is highlighted by the possibility that improved dietary methods might aid in preventing and treating this vision-threatening illness.

Childhood blindness from surge of advanced stage retinopathy of prematurity in premature infants during the COVID-19 pandemic: a case series

Background Retinopathy of prematurity (ROP) is a proliferative disease of the ocular retinal vasculature in premature infants, being a leading cause of preventable childhood blindness. The COVID-19 pandemic serves as an additional barrier to access to care and referral, potentially leading to more cases of advanced stage ROP. Although surgery can be done, ROP at this stage is highly associated with poor functional outcome irrespective of surgery. This case series aims to report advanced stage (stage 5) ROP in premature infants during the COVID-19 pandemic. MethodsA retrospective case series of medical records of paediatric patients with ROP was performed at Cipto Mangunkusumo National Referral Hospital between March 1, 2020 and December 31, 2021. This case series included new patients that presented to our clinic from March 2020 to December 2021 with stage 5 ROP. ResultsA total of 19 eyes of 10 patients with stage 5 ROP were included in this study. Mean chronologic age at presentation to our referral centre was 7.0 4.0 months. Upon presentation, all had stage 5 ROP with negative blink reflex to light, and none of the eyes in this cohort underwent surgical intervention. Mean gestational age was 30.3 3.2 weeks and mean birth weight was 1,276.7 366.4 g. ConclusionThere was an observable surge of stage 5 ROP at our referral centre with irreversible blindness. This highlights the need for proper ROP screening in all hospitals in Indonesia to prevent delay in detection and care of advanced stage ROP.

Early Hyperglycemia Is Associated with Increased Incidence of Severe Retinopathy of Prematurity in Extremely Low Birth Weight Infants.

Preterm infants have a higher rate of hypoglycemia and hyperglycemia, both of which have been associated with increased neonatal morbidities. The aim of this study was to evaluate the incidence of abnormal glucose homeostasis during the first 72 hours of life and study its association with major morbidities in infants admitted to our neonatal intensive care unit (NICU). This was a retrospective single-center study. We extracted demographic, maternal, and patient information and blood glucose levels for the first 72 hours of life for all infants with birth weight ≤1,000 g admitted to the NICU from January 2017 to December 2019. Continuous data were presented as mean ± standard deviation or as median with interquartile range. Categorical data were presented as frequency and percentage. Student's t-tests and Mann-Whitney U test were used to analyze continuous data and chi-squared test or Fisher's exact test were used to analyze categorical data. Logistic regression analysis was performed to study the relation between hyperglycemia and various morbidities after controlling for gestational age (GA). Statistical significance was set at p < 0.05. Of the 235 infants included in the study, 49% were hypoglycemic at admission to the NICU. Infants that were small for GA and those with history of maternal β-blocker use had a higher incidence of hypoglycemia. Hypoglycemia at admission was not associated with increased mortality or any major morbidities. Seventy-three percent infants who were hypoglycemic or euglycemic at birth developed iatrogenic hyperglycemia during the first 72 hours of life. The incidence of retinopathy of prematurity (ROP) and severe ROP was higher in infants with hyperglycemia on univariate analysis. However, on multivariate analysis, after adjusting for GA, no difference was noted in the incidence of ROP between the two groups. Multivariate analysis could not be performed for severe ROP due to inadequate sample size. Hyperglycemia in the initial 3 days of life is associated with an increased incidence of severe ROP in preterm infants. Neonatologists should aim to maintain euglycemia in these infants to decrease the risk of adverse outcomes. · Preterm infants have a high rate of both hypoglycemia and hyperglycemia.. · Majority of infants who were euglycemic or hypoglycemic at birth develop iatrogenic hyperglycemia.. · Hyperglycemia in the initial 3 days of life is associated with an increased incidence of severe ROP in preterm infants..

Is There a Relationship Between First-Trimester Aneuploidy Screening Serum Biomarker Values and Nuchal Translucency Measurements and the Development of Retinopathy of Prematurity (ROP) in Premature Infants?

Purpose The purpose of this study is the evaluation of serum biomarker and nuchal translucency (NT) values measured during first-trimester aneuploidy screening in terms of the development of retinopathy of prematurity (ROP) in premature infants and investigation of whether the development of ROP is associated with these parameters. Methods In this retrospective cohort study, 3,750 premature infants who underwent ROP screening from 2016 to 2021 were identified from the hospital medical record system. Among 2,130 premature babies screened for first-trimester aneuploidy, 166 babies whose mothers had single pregnancieswere screened by the same methodand showed the same clinical course in both eyes were included in the study. The infants were divided into two groups according to the presence of ROP, and those with ROP were further evaluated in two groups according to the presence of proliferation. The groups were compared in terms of the serum values of human chorionic gonadotropin and pregnancy-associated plasma protein A, among aneuploidy screening biomarkers, and NT measurements. Results There was no significant difference in the evaluated serum biomarker values and NT measurements between the ROP and non-ROP groups or between the proliferative ROP, non-proliferative ROP, and non-ROP groups. Conclusion Our results showed that first-trimester aneuploidy screening serum biomarker values and NT measurements were not associated with the development of ROP in premature infants.

Effect of blood sampling management on reducing blood transfusions in very preterm infants.

Effect of blood sampling management on reducing blood transfusions in very preterm infants.

Influence of maternal factors on retinopathy of prematurity: A cross-sectional Study from a tertiary care centre

Retinopathy of prematurity (ROP) is a serious condition affecting premature infants and identifying maternal risk factors is essential for its prevention. This study aimed to identify maternal risk factors associated with ROP in preterm newborns at a tertiary care center.This cross-sectional study was conducted between August 2021 and September 2022 at a tertiary care center. All preterm and low birth weight neonates attending the ROP clinic or admitted to the neonatal intensive care unit (NICU) were included, while term neonates and those weighing ≥2.5 kgs with anterior segment/posterior segment pathology other than ROP were excluded. Data on maternal and neonatal characteristics were obtained and inferential analysis was conducted using the chi-square test and Student’s t-test.Out of 410 preterm newborns included, 109 were diagnosed with ROP, indicating an institutional incidence of 26.58%. Advanced maternal age, low socio-economic status, urinary tract infection, chorioamnionitis, multiple pregnancy, pre-eclampsia, maternal anemia, history of asthma and steroid use during pregnancy were significantly associated with ROP.This study highlights the importance of addressing modifiable maternal risk factors to reduce the incidence of ROP in premature infants. Screening for ROP should be prioritized for neonates born to mothers with these risk factors to improve visual outcomes.

Vitreoretinal biomarkers of retinopathy of prematurity using handheld optical coherence tomography: a review.

Retinopathy of prematurity (ROP) is caused by abnormal retinal vascularization in premature infants that has the potential for severe long-term vision impairment. Recent advancements in handheld optical coherence tomography (OCT) have enabled noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. The use of handheld OCT devices in the diagnosis of ROP in premature infants has furthered our understanding of disease state and progression. This review discusses the known and novel biomarkers of ROP severity in premature infants identified through handheld OCT and potential for future directions.

INCIDENCE AND RISK FACTORS FOR RETINOPATHY OF PREMATURITY IN A LEVEL 3 NICU OF A TEACHING INSTITUTE IN MAHARASHTRA.

Background: Retinopathy of prematurity (ROP) is a serious complication seen in premature babies post treatment which can lead to blindness unless and until it is recognized and treated early. The objective was Objective: to estimate the incidence of ROP in preterm infants in Neonatal Intensive Care Unit (NICU) and to identify the risk factors which predispose to ROP. : ROP prospective screening survey was performed enrolling all premature Materials and Methods babies admitted to the NICU for a period of six months, with a gestational age of 34 weeks or less at birth and a birth weight of 2000gm or less. Those with a BW&gt;2000g or GA&gt;34 weeks with an unstable clinical course were included in the study as per recent IAP guidelines. The incidence of ROP in our study was 18.6%. Among babies with Results: gestational age less than 34 weeks had ROP incidence 31.1 %. No ROP was found in infants those who had weight of ≥ 2000g. Maximum babies had stage 2 ROP; only 1 baby had stage 1 ROP and all regressed spontaneously. Two babies had stage 3 ROP and required laser ablative therapy. Pearson Chi-Square test showed that there was a significant relationship between the occurrence of ROP and gestational age (P = 0.015) and low birth weight (P = 042) and number of days the baby was exposed to oxygen (p=0.0324). The incidence of ROP in our study was 18.6%. Low gestational Conclusion: age, low birth weight, oxygen therapy, were significant risk factors for ROP. Screening for early identification of retinal damage done soon after birth is important to prevent this blindness.

Characteristic and risk factors of retinopathy of prematurity in Sanglah Hospital Denpasar: 3-years retrospective study

Introduction: Retinopathy of prematurity (ROP) is one of the important causes of blindness in children. ROP is characterized by abnormal retinal neovascularization of premature infants. Purpose: This study aimed to estimate the prevalence of ROP in preterm infants at Sanglah Hospital Bali from 2015-2017 and identify the risk factors predisposing them to ROP. Methods: This was a retrospective study, observational analysis on premature infants diagnosed as ROP at Sanglah Hospital Bali from January 2015 to December 2017, with a gestational age of 30 weeks or less at birth and a birth weight of 1500 grams or less. Infants whose gestational age was &gt;30 weeks or whose birth weight was &gt;1500 grams were also included. The ophthalmological examinations were initiated between the fourth and sixth weeks of chronological age or 34 weeks of corrected age, whichever was earlier, and were repeated weekly or biweekly as per Indonesian guidelines for ROP screening, until full vascularization of the retina reached zone 3. Results: Out of 31 infants diagnosed as ROP, 3 (9.7%) cases developed ROP in one eye, and 28 (90,3%) cases in both eyes. They were classified as 23 (74.2%) cases stage 1, and 8 (25,8%) cases stage 2. None of the studied infants presented ROP at stage 3, 4, or 5. The risk for ROP was not significantly associated with birth weight (OR 0.375; 95% CI 0.030 – 4.635), gestational age (OR 0.897; 95% CI 0.792 – 1.015), sepsis (OR 1.111; 95% CI 0.089 – 13.835), blood transfusion (OR 1.111; 95% CI 0.089 – 13.835), and HMD (OR 1.118; 95% CI 0.977 – 1.443). Conclusions: The data of this study showed that low gestational age, low birth weight, sepsis, oxygen therapy, and blood transfusion may be contribute to the development of ROP, but not significant statistically. Clinicians should be aware of the presence of the additional risk factors when monitoring preterm infants,especially when giving supplemental oxygen therapy.

PRENATAL MATERNAL CHARACTERISTICS ASSOCIATED WITH RETINOPATHY OF PREMATURITY

Determine whether prenatal maternal characteristics such as sociodemographic characteristics, comorbidities, or pregnancy complications affect retinopathy of prematurity (ROP) development. Medical records of 236 mother-infant dyads from our institution were reviewed, only including dyads in which infants were born at 30 weeks gestational age or earlier. The primary outcome measure was the risk of ROP (defined Stage 1 or greater in either eye) and its association with prenatal maternal variables. Maternal Medicaid insurance, smoking during pregnancy, and chorioamnionitis were associated with an increased risk of ROP. For Medicaid insurance and chorioamnionitis, these risks were not appreciably altered by adjustment for potential confounders. These results suggest that several prenatal maternal factors may independently affect the risk of ROP in preterm infants. Validation of our findings could aid in the identification of infants at high risk for ROP based on prenatal clinical features.

GSDMD deficiency ameliorates hyperoxia-induced BPD and ROP in neonatal mice

Bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) are among the most common morbidities affecting extremely premature infants who receive oxygen therapy. Many clinical studies indicate that BPD is associated with advanced ROP. However, the mechanistic link between hyperoxia, BPD, and ROP remains to be explored. Gasdermin D (GSDMD) is a key executor of inflammasome-induced pyroptosis and inflammation. Inhibition of GSDMD has been shown to attenuate hyperoxia-induced BPD and brain injury in neonatal mice. The objective of this study was to further define the mechanistic roles of GSDMD in the pathogenesis of hyperoxia-induced BPD and ROP in mouse models. Here we show that global GSDMD knockout (GSDMD-KO) protects against hyperoxia-induced BPD by reducing macrophage infiltration, improving alveolarization and vascular development, and decreasing cell death. In addition, GSDMD deficiency prevented hyperoxia-induced ROP by reducing vasoobliteration and neovascularization, improving thinning of multiple retinal tissue layers, and decreasing microglial activation. RNA sequencing analyses of lungs and retinas showed that similar genes, including those from inflammatory, cell death, tissue remodeling, and tissue and vascular developmental signaling pathways, were induced by hyperoxia and impacted by GSDMD-KO in both models. These data highlight the importance of GSDMD in the pathogenesis of BPD and ROP and suggest that targeting GSDMD may be beneficial in preventing and treating BPD and ROP in premature infants.

Prevalence of retinopathy of prematurity in a urban based tertiary hospital in central India

Background: Retinopathy of prematurity (ROP) is an important cause of preventable blindness in children. It is a serious and underestimated complication of prematurity treatment among preterm and low-birth weight babies and is preventable cause of blindness unless recognized and treated early. Objective: The objective of this study was to estimate the prevalence of ROP in preterm infants and low-birth weight in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital and to increase the awareness of early screening of ROP among parents and doctors. Materials and Methods: A ROP prospective screening survey was performed enrolling all prematures and low-birth-weight Neonates delivered at Index Medical College Hospital &amp; Research Centre from July 2018 to June 2021, with a gestational age of 37 weeks or less at birth and a birth weight of 1700 g or less. One Hundred and Eighty Six(186) preterm infants (i.e.372 eyes) were included for ROP screening .Out of these 186 preterm infants (372eyes), Forty eight (48)preterm infants (i.e.96 eyes) developed Retinopathy of Prematurity. Descriptive statistics included the mean and standard deviation for numerical variables, and the percentage of different categories for categorical variables.

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.

Oral Ibuprofen Versus Oral Paracetamol in Pain Management During Screening for Retinopathy of Prematurity

Screening examinations for retinopathy of prematurity (ROP) are critical to reduce ROP-related vision loss; however, the procedure is painful and uncomfortable, and topical anesthetics do not completely suppress the pain responses. The number of safe and effective pharmacological options to reduce pain during eye examinations for ROP screening in preterm infants is limited. This study compared the efficacy of oral ibuprofen and oral paracetamol in reducing pain during screening for ROP in preterm infants. This prospective observational study was conducted at a tertiary-care neonatal intensive care unit. Forty-four preterm infants with gestational age of 32 weeks and less undergoing ROP screening were included. Each enrolled infant received either oral ibuprofen 10 mg/kg (n = 22) or oral paracetamol 10 mg/kg (n = 22) 1 hour before eye examination. The primary outcome measure was pain assessed by the Neonatal Pain, Agitation, and Sedation Scale (N-PASS). Secondary outcome measures were tachycardia, bradycardia, desaturations, and crying time. The groups were similar for gestational age, birth weight, and postnatal age at examination (P > .05). The mean N-PASS scores were not significantly different between the oral ibuprofen and oral paracetamol groups (8.64 ± 1.57 vs 8.50 ± 1.71, respectively, P = .605). Moreover, no significant intergroup differences were observed in the crying time and the incidence of tachycardia/bradycardia and desaturation (P > .05). Ibuprofen or paracetamol administered orally before ROP screening in preterm infants had similar analgesic effects and did not significantly alleviate pain during eye examination.

Effect of Enteral Long-Chain Polyunsaturated Fatty Acids on Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Background: Long-chain polyunsaturated fatty acids (LCPUFA) are critical for the maturation of the brain and retina. Retinopathy of prematurity (ROP) is a preventable cause of blindness in preterm infants. LCPUFA have anti-inflammatory, antioxidant, and antiangiogenesis effects. Supplementation of enteral LCPUFA might mitigate the incidence of ROP in these infants. Available limited randomized studies showed promising results. We aimed to assess the effect of enteral supplementation of LCPUFA on ROP in preterm infants. Methods: We followed PRISMA guidelines and searched MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Embase, and Cochrane Registry from 1990 to 2021 for the studies that examined the effects of enteral LCPUFA and ROP in preterm infants. We included the studies that satisfied the predefined inclusion criteria. RevMan 5.3 software derived the forest plot of pooled relative risk. We assessed the quality of all the included studies using GRADE recommendations. Results: Nine studies were eligible for the meta-analysis involving 2,482 infants. Of the nine RCTs, six studies provided LCPUFA (DHA/AA) as a separate intervention in different concentrations, and three studies provided formula milk enriched with LCPUFA. In addition, five studies recruited infants below 32 weeks of gestational age. Supplementation of LCPUFA did not reduce the incidence of severe ROP (RR 0.71, 95% CI: 0.50–1.01, 5 studies, 1,822 infants) with very low CoE or any ROP (RR 0.95, 95% CI: 0.73–1.12, 6 studies, 1,177 infants) with very low CoE or ROP requiring treatment (RR 0.92, 95% CI: 0.62–1.38, 4 studies, 1,395 infants) with very low CoE. Regarding safety outcomes, enteral LCPUFA did not increase the risk of necrotizing enterocolitis or mortality. Discussion/Conclusion: Supplementation of enteral LCPUFA to preterm infants did not reduce ROP incidence; however, there was a trend toward benefit in mitigating severe form of ROP. More well-designed, large, randomized controlled studies are warranted.

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.

Dysregulated genomic and coding-transcriptomic factors in retinopathy of prematurity

Retinopathy of prematurity (ROP) is a type of vitreous retinopathy in premature children that leads to visual impairment and blindness at early ages. ROP is a lifetime disease that can impose a tremendous economic and psychological burden on the government and society. ROP is characterized by abnormal neovascularization in the retina. ROP is a multifactorial disease that means many factors are involved in the pathogenesis of ROP, such as low birth weight, short gestational age as a primary risk factor for ROP, anemia, intraventricular hemorrhage, inflammation, sepsis, underlying diseases, maternal preeclampsia, and other factors. Some studies suggest that genetic factors play an essential role in ROP pathogenesis and development. In addition, monitoring genetic factors such as genetic polymorphism may pave the way for diagnosis and prognosis ROP, leading to prevention and stopping disease progression in time. Understanding the genomics of diseases opened a new door for treatment. Genetic-based therapeutic approaches are preventive strategies that can effectively prevent the progression of ROP and improve infants' lives. In this study, we reviewed some genetic factors involved in ROP pathogenesis and development, and in the following, we survey some new genetic-based therapeutic approaches for treating ROP in preterm infants.

Perspective noi asupra retinopatiei de prematuritate

Retinopathy of prematurity (ROP) is a comorbidity associated with premature birth, with an incidence that varies depending on gestational age, treatment applied in neonatal intensive care unit and risk factors related to each newborn. Retinopathy has been studied since the use of free-flowing oxygen in the incubator when this condition was first mentioned. Studies published over time have tried to identify the optimal levels for oxygenation in favor of ROP prevention but without affecting survival, a topic that is still widely debated today. Gradually, various risk factors were identified regarding the occurrence of severe forms of ROP. Screening for retinopathy prematurity has been identified as one of the most effective measures to prevent blindness in former premature infants. The correct identification of the categories of newborns that should benefit from this dynamic follow-up fully contributes to limiting the cases of retinal detachment. The ongoing study of risk factors and their inclusion in studies to verify the correlation with the incidence of ROP has the potential to improve outcomes in the fight against ROP in preterm infants.