Purpose:
To analyze the weekly rate of retinal vascular growth in treatment-naïve babies with various stages of retinopathy of prematurity (ROP) and validate if this could be a predictor of treatment need.
Methods:
Retrospective review of medical charts and retinal images of babies with various stages of ROP. The images were enhanced using red-green image enhancement software. Using the length of the horizontal disc diameter (DD) of each eye, the vessel growth was measured from the disc margin up to the vessel tip in fixed quadrants. The rate of vessel growth was the ratio of vessel length to the number of weeks it took to reach this length. The babies were divided into treatment warranting ROP (group 1), low-risk pre-threshold (type II) ROP (group 2,), and no-ROP (group 3) for analysis. The “no-ROP” group acted as normal control. Group 1 was further subdivided into 1A (threshold ROP), IB (aggressive posterior ROP), 1C (hybrid ROP), and ID (high-risk pre-threshold ROP).
Results:
Out of 436 eyes, groups 1, 2, and 3 had 238, 108, and 90 eyes, respectively. The mean rate of vascular outgrowth along with 95% confidence interval (CI) was 0.490 [0.487,0.520], 0.612 [0.599, 0.638], and 0.719 [0.703, 0.740] DD/week, respectively, for babies with “treatment warranting,” “low risk pre-threshold” and “no ROP” groups, respectively. In our estimate, more than 80% of eyes with a vessel growth rate of 0.54 DD/week or less required treatment
Conclusion:
A rate of retinal vascular growth less than 0.54 DD/week can be used to determine treatment requirements in babies with ROP.
Presented here is a case of hybrid retinopathy of prematurity (ROP) with features of both aggressive posterior ROP and ridge-like staged ROP with extensive candle wax-like preretinal deposits plastered on the surface of the retina from optic disc to vascular–avascular junction at a postmenstrual age (PMA) of 34 weeks. The baby was too sick for laser photocoagulation and so underwent intravitreal bevacizumab at half adult doses in both eyes. The deposits melted dramatically within 1–2 weeks of antivascular endothelial growth factor injection without any signs of recurrence till the last visit at 58 weeks of PMA.
In a prospective proof-of-concept study probing the role of para-inflammation in central serous chorioretinopathy (CSC) pathogenesis, eligible subjects with chronic CSC non-responsive to conventional treatment received a single dexamethasone (DEX) implant monotherapy. Six middle-aged males (mean age = 46.5 ± 10.8 years) with a mean disease duration of 4.5 ± 2.5 years, at the primary efficacy endpoint of six weeks, showed complete resolution of subretinal fluid (SRF) in four out of six eyes, significant reduction of SRF height (174 ± 86 μm to 22 ± 34 μm; P = 0.028) and central subfield thickness (347 ± 139 μm to 180 ± 47 μm; P = 0.003), indicating DEX as a promising treatment option for chronic CSC.
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