Aims This study describes the development of a score based on cumulative risk factors for the prediction of severe retinopathy of prematurity (ROP) comparing the performance of the score against the birth weight (BW) and gestational age (GA) in order to predict the onset of ROP. Methods A prospective cohort of preterm infants with BWp1500 g and/or GAp32 weeks was studied. The score was developed based on BW, GA, proportional weight gain from birth to the 6th week of life, use of oxygen in mechanical ventilation, and need for blood transfusions from birth to the 6th week of life. The score was established after linear regression, considering the impact of each variable on the occurrences of any stage and severe ROP. Receiver operating characteristic (ROC) curves were used to determine the best sensitivity and specificity values for the score. All variables were entered into an Excel spreadsheet (Microsoft) for practical use by ophthalmologists during screening sessions. Results The sample included 474 patients. The area under the ROC curve for the score was 0.77 and 0.88 to predict any stage and severe ROP, respectively. These values were significantly higher for the score than for BW (0.71) and GA (0.69) when measured separately. Conclusions ROPScore is an excellent index of neonatal risk factors for ROP, which is easy to record and more accurate than BW and GA to predict any stage ROP or severe ROP in preterm infants. The scoring system is simple enough to be routinely used by ophthalmologists during screening examination for detection of ROP.

Aims To analyse the incidence and risk factors for retinopathy of prematurity (ROP) and survival rates among extremely low birth weight (ELBW) and very low birth weight (VLBW) preterm infants. Methods A prospective cohort study of 352 infants admitted at a teaching hospital, Hospital de Clinicas de Porto Alegre, Brazil, between October 2002 and December 2006, was screened for ROP. The ELBW group comprised infants whose birth weight (BW) was p1000 g and the VLBW group comprised those infants whose BW were 41000 g and p1500 g. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Results Of the 352 neonates screened, 88 were ELBW babies. Survival rates among ELBW and VLBW were 47.8 and 88.7%, respectively. ROP affected 48.9% of ELBW infants and 18.2% of VLBW babies. Threshold disease occurred in 21 patients, 15 of whom were born weighing o1000 g. Only 2.3% of the neonates born with more than 1000 g developed treatable disease. Univariate analysis showed that gestational age (GA), BW, use of indomethacin and erythropoietin, blood transfusions, and intraventricular haemorrhage were associated with ROP. After logistic regression, the most important adjusted risk factors were BW (OR: 1.002;95% CI: 1.001-1.003; P ¼ 0.003), GA (OR: 1.254;95% CI: 1.082-1.455; P ¼ 0.003), and use of erythropoietin (OR: 2.486;95% CI: 1.182-5.231; P ¼ 0.016). ConclusionThis study showed reduced survival rates, high incidence of ROP, and a greater need of treatment among ELBW infants as compared to VLBW babies admitted in this institution.

Purpose To determine the prevalence and features of the different types of involvement of the optic nerve in ocular toxoplasmosis. Methods Retrospective cross-sectional study. All patients with active ocular toxoplasmosis, consulting in the Uveitis Section of the Ophthalmology Department were selected. The involvement of the optic nerve was classified in the following categories: juxtapapillary retinochoroiditis, pure papillitis, neuroretinitis, distant lesion, and mixed lesion. Results The prevalence of involvement of the optic nerve found was 5.3%. The optic nerve involvement with the presence of a concurrent active distant lesion, occurred in 22 eyes (43.1%). A juxtapapillary lesion was found in 18 eyes (35.3%). Eight eyes (15.7%) presented lesions characterised as mixed. Isolated papillitis occurred in 3 eyes (5.9%). Fortyseven lesions (95.9%) were unilateral and two (4.1%) were bilateral. Twenty-eight eyes (54.9%) had pre-existing lesions and 23 (45%) were primary lesions. Visual acuity improved in 35 eyes (71.4%) and remained unchanged in 14 eyes (28.5%). Conclusion The involvement of the optic nerve most frequently found in ocular toxoplasmosis was optic nerve oedema with a concurrent distant active lesion. The second type of lesion most often found was juxtapapillary retinochoroiditis. Involvement was monocular in most cases and the visual prognosis was favourable.