Worse Retinopathy Of Prematurity Research Articles

Retinopathy of prematurity in Asian Indian babies weighing greater than 1250 grams at birth: Ten year data from a tertiary care center in a developing country

Retinopathy of prematurity (ROP) is an important cause of childhood blindness in developing countries. To report the spectrum of ROP and associated risk factors in babies weighing > 1250 g at birth in a developing country. Institutional, retrospective, non-randomized, observational clinical case series. Retrospective analysis (10 years) of 275 eyes (138 babies) with ROP. Qualitative data with the Chi-square test. Quantitative data using the unpaired t test or the ANOVA and further tested using multivariate logistic regression. The mean birth weight was 1533.9 g (range 1251 to 2750 g) and the mean period of gestation was 30.9 weeks (range 26 to 35). One hundred and twenty-four of 275 eyes (45.1%) had threshold or worse ROP. Risk factors for threshold or worse disease were, 'outborn babies' ( P P = 0.007) and exchange transfusion ( P = 0.003). The sensitivity of the American and British screening guidelines to pick up threshold or worse ROP in our study group was 82.4% and 77.4% respectively. Severe ROP is often encountered in babies weighing greater than 1250 g at birth in developing countries. Western screening guidelines may require modifications before application in developing countries.

Candida sepsis and association with retinopathy of prematurity.

To assess the association of Candida sepsis with retinopathy of prematurity (ROP) in extremely low birth weight infants. We prospectively identified 253 infants admitted to the Critical Care Nursery at Georgetown University Hospital with birth weights </=1000 g born between January 1, 1994, and June 30, 1996. Of these 253 infants, 62 died and 55 were transferred to other institutions before ophthalmologic screening for ROP. Clinical data on 98% (133/136) infants were reviewed. Candida sepsis was defined as a positive blood culture for Candida species. Severity of ROP was staged by the International Classification for ROP. Data were analyzed using the chi2 test for nominal data, unpaired t test for continuous data, Mann-Whitney U test for ordinal data, and logistic regression. The mean birth weight (+/-SD) of the population studied was 777 g (+/-136 g), and the mean gestational age at birth was 26.0 weeks (+/-1.8 weeks). The overall incidence of ROP was 74%, and it correlated significantly with birth weight, gestational age, days on supplemental oxygen, and 5-minute Apgar scores. The incidence of ROP was significantly higher in the infants who had Candida sepsis (21/22 [95%]) compared with those who did not (77/111 [69%]). Using logistic regression to control for the influence of birth weight, gestational age, days on supplemental oxygen, and 5-minute Apgar scores, Candida sepsis was an independent predictor of stage 3 or worse ROP. In addition, 9 (41%) of 22 infants with Candida sepsis required laser surgery compared with 10 (9%) of 111 infants without Candida sepsis. This difference was significant independent of birth weight, gestational age, days on supplemental oxygen, and 5-minute Apgar scores. Candida sepsis is independently associated with increased severity of ROP and the need for laser surgery in extremely low birth weight infants.

Refractive errors in children born before 32 weeks gestation.

To document the refractive errors in a cohort of children born before 32 weeks gestation. All children born before 32 weeks gestation between 1 January 1990 and 31 December 1991 to mothers resident in the Northern Region of the National Health Service were examined at 2 years old (n = 558). Stage 3 or worse retinopathy of prematurity (ROP) was associated with myopia. In those not developing stage 3 or worse ROP, the refractive errors were myopia in 1.5%, hypermetropia > 4 dioptres (D) in 5.4%, anisometropia > 1 D in 1.1% and astigmatism > 1.25 D in 5.7%. The incidence of refractive errors in those not developing stage 3 or worse ROP was similar to that in the general population.