Evaluating retinopathy of prematurity screening guidelines for 24- to 27-week gestational age infants

Kennedy, Kathleen A.; Wrage, Lisa A.; Higgins, Rosemary D.; Finer, Neil N.; Carlo, Waldemar A.; Walsh, Michele C.; Laptook, Abbot R.; Faix, Roger G.; Yoder, Bradley A.; Schibler, Kurt; Gantz, Marie G.; Das, Abhik; Newman, Nancy S.; Phelps, Dale L.

doi:10.1038/jp.2014.12

Cited by 19 publications

(17 citation statements)

References 26 publications

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“…An examination is also recommended for those slightly larger (1500-<2000g BW) or more mature (>30 weeks GA) infants who have an "unstable clinical course" in the opinion of the attending neonatologist or pediatrician. (Fierson et al, 2013) These guidelines have been confirmed to satisfactorily identify extremely low birth weight infants at risk in the US (Kennedy et al, 2014). The timing of the initial and subsequent retinal examinations is critical for the detection of acute phase disease as intervention in serious disease is time-sensitive.…”

Section: Screening For Ropmentioning

confidence: 99%

Pathophysiology, screening and treatment of ROP: A multi-disciplinary perspective

Chan‐Ling

Gole

Quinn

et al. 2018

Progress in Retinal and Eye Research

129

107

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The population of infants at risk for retinopathy of prematurity (ROP) varies by world region; in countries with well developed neonatal intensive care services, the highest risk infants are those born at less than 28 weeks gestational age (GA) and less than 1 kg at birth, while, in regions where many aspects of neonatal intensive and ophthalmological care are not routinely available, more mature infants up to 2000 g at birth and 37 weeks GA are also at risk for severe ROP. Treatment options for both groups of patients include standard retinal laser photocoagulation or, more recently, intravitreal anti-VEGF drugs. In addition to detection and treatment of ROP, this review highlights new opportunities created by telemedicine, where screening and diagnosis of ROP in remote locations can be undertaken by non-ophthalmologists using digital fundus cameras. The ophthalmological care of the ROP infant is undertaken in the wider context of neonatal care and general wellbeing of the infant. Because of this context, this review takes a multi-disciplinary perspective with contributions from retinal vascular biologists, pediatric ophthalmologists, an epidemiologist and a neonatologist. This review highlights the latest insights regarding cellular and molecular mechanisms in the formation of the retinal vasculature in the human infant, pathogenesis of ROP, detection and treatment of severe ROP, the risks and benefits of anti-VEGF therapy, the identification of new therapies over the horizon, and the optimal neonatal care regimen for best ROP outcomes, and the benefits and pitfalls of telemedicine in the remote screening and diagnosis of ROP, all of which have the potential to improve ROP outcomes.

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Section: Screening For Ropmentioning

confidence: 99%

Pathophysiology, screening and treatment of ROP: A multi-disciplinary perspective

Chan‐Ling

Gole

Quinn

et al. 2018

Progress in Retinal and Eye Research

129

107

View full text Add to dashboard Cite

show abstract

“…This was a secondary analysis of the SUPPORT trial data with prespecified outcomes. Infants were examined by ophthalmologists trained in the diagnosis of ROP beginning at 31–33 weeks’ postmenstrual age (PMA) and continuing until severe ROP outcome was reached or resolution occurred 2 11. Resolution was defined as fully vascularised retinas or immature vessels in zone 3 on two consecutive examinations in each eye.…”

Section: Methodsmentioning

confidence: 99%

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms

Gantz

Carlo

Finer

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo identify achieved oxygen saturations (SpO2) associated with increased risk of severe retinopathy of prematurity (ROP).DesignThis is a secondary analysis of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT)randomised controlled trial. SpO2 was recorded up to 36 weeks’ postmenstrual age. Saturations through 9 postnatal weeks were explored graphically, and logistic regression models were created to predict severe ROP.Setting20 centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.Patients984 surviving infants of 24–27 weeks’ gestational age born in 2005–2009.InterventionsSUPPORT targeted SpO2 to a lower (85%–89%) or higher (91%–95%) range through 36 weeks’ postmenstrual age or off respiratory support.Main outcome measuresSevere ROP defined as threshold ROP, ophthalmological surgery or bevacizumab treatment.ResultsThere were statistically significant interactions between duration of oxygen supplementation and percentage of time in certain achieved saturation ranges. Specifically, for infants who spent at least 2 weeks on oxygen in postnatal weeks 1–5, a higher percentage of time at 91%–96% SpO2 was associated with increased odds of severe ROP. For infants who spent at least 3 weeks on oxygen in postnatal weeks 6–9, a higher percentage of time at 97%–100% SpO2 was associated with increased odds of severe ROP. Other significant risk factors were lower gestational age and birth weight, non-Hispanic white versus black race, prospectively defined severe illness, late-onset sepsis or meningitis, and clinical centre.ConclusionsAmong extremely preterm survivors to discharge, the association between SpO2 and severe ROP depended on the timing and duration of oxygen supplementation.

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“…After that, the second examination is performed after a week or two, depending on the local findings 8 . The screening takes place until blood vessels reach zone III in infants without ROP in the zones I and II 8,11,12 , or to the completed vascularization of the ora serrata after intravitreal application of anti-vascular endothelial growth factor or until week 50 postmenstrually for children with prior milder ROP forms or until ROP recedes 12 . A repeated ophthalmological examination of prematurely born babies at 12 months is of crucial importance, regardless of the presence of ROP, in order to identify amblyogenic factors such as strabismus or refractive disorders 11,13 .…”

Section: Introductionmentioning

confidence: 99%

Biometric features of the eyes of preterm born babies

et al. 2017

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Background/Aim. Preterm birth and retinopathy of prematurity (ROP) could affect optical and biometric features of eyes and cause refractive errors. The aim of this study was to compare the ocular axial length, anterior chamber depth and lens thickness changes during the first year in preterm born babies with and without ROP. Methods. This prospective longitudinal study included 87 preterm born babies. The examinations were performed at 3 and 12 months after birth and included fundus examination and measurements of the ocular axial length, anterior chamber depth and lens thickness. Based on the results of fundus examination at 3 months, the subjects were divided into two groups and the measurements of those with and without ROP were compared. Results. At 3 months 60.92% of infants had ROP. The mean values in the ROP group were: axial length 16.56 mm and 16.53 mm, chamber depth 2.34 mm and 2.38 mm and lens thickness 4.04 mm and 3.96 mm, in the right and the left eye, respectively. In the no ROP group these values were: axial length 17.06 mm and 17.08 mm, chamber depth 2.31mm and 2.39 mm and lens thickness 4.16 mm and 4.14 mm in the right and the left eye, respectively. At 12 months 28.74% of the children had a change in the ocular fundus as a result of the ROP therapy. In the ROP group the axial length was 19.94 mm in both eyes, chamber depth 3.01 mm and 2.99 mm and lens thickness 4.28 mm and 4.29 mm, in the right and the left eye, respectively. In the no ROP group the axial length was 20.64 mm and 20.29 mm, lens thickness 4.37 mm and 4.36 mm, in the right and the left eye, respectively and chamber depth 3.10 mm in both eyes. Conclusion. In the group of children with ROP axial length of the eye at 3 and 12 months was statistically significantly smaller in comparison to the group without ROP. Statistically significant difference was not found between these groups in the anterior chamber depth and lens thickness.

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Evaluating retinopathy of prematurity screening guidelines for 24- to 27-week gestational age infants

Cited by 19 publications

References 26 publications

Pathophysiology, screening and treatment of ROP: A multi-disciplinary perspective

Pathophysiology, screening and treatment of ROP: A multi-disciplinary perspective

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms

Biometric features of the eyes of preterm born babies

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