Limitations in ROP Programs in 32 Neonatal Intensive Care Units in Five States in Mexico

Zepeda-Romero, Luz Consuelo; Gilbert, Clare

doi:10.1155/2015/712624

Cited by 16 publications

(15 citation statements)

References 14 publications

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“…Historically, the regional incidence and severity of ROP have been measured in developed countries [18, 19]. In our study, the overall incidence of any stage of ROP was higher than the incidence for the second largest neonatal intensive care unit in Canada [20].…”

Section: Discussionmentioning

confidence: 71%

Screening Retinopathy of Prematurity in Extremely Low Birth Weight Infants in China and the Need for Earlier Screening Times

Wang

Chen

et al. 2016

Journal of Ophthalmology

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Purpose. To convey the need for a revised screening strategy for retinopathy of prematurity (ROP) for extremely low birth weight (ELBW) infants in China. Design. A retrospective longitudinal study. Methods. The medical charts of infants with a birth weight (BW) of less than 1 kg were reviewed. The infants were divided into three groups: group A, without ROP; group B, with ROP but not up to type 1 prethreshold or threshold ROP; group C, with type 1 prethreshold or threshold ROP. Data collected included gender, gestational age (GA), BW, postmenstrual age (PMA), age of onset of ROP, and age at which treatment was carried out, if required. Results. A total of 77 infants were involved. Fifty-six infants developed ROP at any stage and 38 infants developed type 1 prethreshold or threshold ROP. The mean BW and GA of infants in group A were significantly different compared with groups B and C. The mean PMA of onset of ROP in infants who developed mild ROP was 37 weeks compared with 34 weeks for infants who developed severe ROP. Conclusion. ELBW infants have a higher incidence of ROP in China which highlights the need for optimizing neonatal care for these infants. In ELBW infants, ROP tends to develop more severely when it occurs earlier. It is necessary for ELBW infants, especially for those with a BW less than 800 g or a GA less than 25 weeks, to be initially screened at an earlier time.

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Section: Discussionmentioning

confidence: 71%

Screening Retinopathy of Prematurity in Extremely Low Birth Weight Infants in China and the Need for Earlier Screening Times

Wang

Chen

et al. 2016

Journal of Ophthalmology

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“…Antivascular endothelial growth factor (VEGF) agents have recently emerged as a therapeutic option. Bevacizumab (Avastin) is now used as a first-line treatment by up to a quarter of ophthalmologists following early studies suggesting superiority over laser in more central disease 40. However, the long-term neurodevelopmental and cardiovascular impact of the associated suppression of systemic VEGF levels, which can last for up to 8 weeks after intravitreous bevacizumab injection, is unclear.…”

Section: Retinopathy Of Prematuritymentioning

confidence: 99%

Epidemiology of blindness in children

2017

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An estimated 14 million of the world's children are blind. A blind child is more likely to live in socioeconomic deprivation, to be more frequently hospitalised during childhood and to die in childhood than a child not living with blindness. This update of a previous review on childhood visual impairment focuses on emerging therapies for children with severe visual disability (severe visual impairment and blindness or SVI/BL).For children in higher income countries, cerebral visual impairment and optic nerve anomalies remain the most common causes of SVI/BL, while retinopathy of prematurity (ROP) and cataract are now the most common avoidable causes. The constellation of causes of childhood blindness in lower income settings is shifting from infective and nutritional corneal opacities and congenital anomalies to more resemble the patterns seen in higher income settings. Improvements in maternal and neonatal health and investment in and maintenance of national ophthalmic care infrastructure are the key to reducing the burden of avoidable blindness. New therapeutic targets are emerging for childhood visual disorders, although the safety and efficacy of novel therapies for diseases such as ROP or retinal dystrophies are not yet clear. Population-based epidemiological research, particularly on cerebral visual impairment and optic nerve hypoplasia, is needed in order to improve understanding of risk factors and to inform and support the development of novel therapies for disorders currently considered 'untreatable'.

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“…Another limitation is the generalizability of the results outside the United States. Although variability in guideline adherence is not unique to the United States, 9,30 the burden of ROP disease is heavily weighted toward low-and middle-income countries 31 and often affects larger, more mature infants. Countries such as Mexico report difficulty with their ophthalmology coverage and access to equipment, leading to overall suboptimal compliance with their national guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Countries such as Mexico report difficulty with their ophthalmology coverage and access to equipment, leading to overall suboptimal compliance with their national guidelines. 30 The need for alternative solutions for ROP screening in developing countries was highlighted in 1 report investigating the use of a smart phone and a lens to provide remote screening. 32 A proposed "paradigm change" in the approach to ROP care has been made to address resource and personnel shortages, especially in low-and middle-income countries.…”

Section: Discussionmentioning

confidence: 99%