Medical Treatment of Glaucoma Associated with Cicatricial Retinopathy of Prematurity

Kushner, Burton J.; Sondheimer, Stuart

doi:10.1016/0002-9394(82)90356-7

Cited by 29 publications

(5 citation statements)

References 7 publications

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“…However, these babies will still require periodic followup despite regression as the risk of other eye conditions like myopia and strabismus is known to be increased in them [2, 9, 10]. …”

Section: Discussionmentioning

confidence: 99%

“…Some eyes show a more aggressive course (“Rush” disease or the newer term aggressive posterior retinopathy of prematurity-(AP-ROP)) with neovascularization forming loops and arteriovenous shunts in Retinal zones 1 or 2, that often rapidly progresses to retinal detachment and blindness. ROP is one of the important causes of blindness in children in America [2, 6] and South Africa [7, 8] and has also been known to increase the risk of other eye conditions like strabismus, glaucoma, cataracts, and myopia later in life [2, 9, 10]. As smaller and younger babies are surviving from use of modern technology of neonatal life support, the incidence of ROP has increased [11, 12].…”

Section: Introductionmentioning

confidence: 99%

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Retinopathy of Prematurity in Port Harcourt, Nigeria

et al. 2014

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Purpose. With many preterm babies now surviving as a result of improvement in neonatal care in Nigeria, the incidence of visual impairment/blindness as a result of retinopathy of prematurity (ROP) may rise. We describe our findings after screening starts for the first time in a 15-year-old special care baby unit so as to establish the incidence and risk factors for developing ROP. Methods. A prospective study carried out at the Special Care Baby Unit (SCBU) and Pediatric Outpatient Clinics of the University of Port Harcourt Teaching Hospital between January 1 and October 31, 2012. Fifty-three preterm babies (of 550 neonates admitted within the study period) delivered before 32 completed weeks and weighing less than 1500 g were included in the study following informed consent and the main outcome measure was the development of any stage of ROP. Results. Mean gestational age at birth was 28.98 ± 1.38 weeks. Mean birth weight was 1411 ± 128 g. Out of 550 babies admitted at SCBU, 87 of 100 preterms survived with 53 included in study. Twenty-five (47.2%) had different degrees of ROP with prevalence found to be 47.2%. Prevalence was higher (75%) in babies weighing <1300 g and those delivered before 30-week gestation (58%). Twenty-one (84%) had stage 1 no plus disease and 3 (12%) had stage 2 no plus disease. Only 1 (4%) had threshold disease in Zone 1. None had disease at stage 4 or 5 or AP-ROP. Receiving supplemental oxygen (χ 2 = 6.17; P = 0.01), presence of sepsis (χ 2 = 7.47; P = 0.006), multiple blood transfusions (χ 2 = 5.11; P = 0.02), and delivery by caesarian section (χ 2 = 4.22; P = 0.04) were significantly associated with development of ROP. There were no significant differences with gender, apneic spells, jaundice, or phototherapy. Conclusions and Relevance. All live infants with ROP were noted to regress spontaneously in this study. Though it may not be cost effective to acquire treatment facilities at the moment (the only child with treatable disease died), facilities for screening preterm infants displaying high risk features may be essential as smaller babies are saved.

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“…However, these babies will still require periodic followup despite regression as the risk of other eye conditions like myopia and strabismus is known to be increased in them [2, 9, 10]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retinopathy of Prematurity in Port Harcourt, Nigeria

et al. 2014

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“…11,12 Occult CME and ERM may play a role in the decreased vision observed in this population. 9,12,13 Furthermore, longitudinal data on adults with a history of ROP show that these patients have a high risk for premature cataract formation, 14,15 glaucoma, [16][17][18][19] retinal tears, 20 and retinal detachments, [21][22][23] all of which may in part result from vitreous abnormalities. Some studies suggest that these complications occur with greater frequency with increasing severity of ROP, 15,19 yet severe complications can occur even in patients with regressed disease that never required treatment.…”

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confidence: 99%

Vitreous Bands Identified by Handheld Spectral-Domain Optical Coherence Tomography Among Premature Infants

et al. 2018

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IMPORTANCE Handheld spectral-domain optical coherence tomography (SD-OCT) can provide insights into the complex interactions occurring at the vitreoretinal interface in retinopathy of prematurity (ROP) to enhance our understanding of ROP pathology. OBJECTIVE To characterize vitreous bands in premature infants with use of handheld SD-OCT. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study conducted from July 7, 2015, to February 28, 2017, at 2 university-based neonatal intensive care units. Seventy-three premature infants who required routine ROP screening examination were recruited. Informed consent was obtained from all legal guardians. Trained graders who were masked to the clinical assessment analyzed each SD-OCT scan of the right eye for vitreoretinal findings. A third trained grader mediated disagreements. MAIN OUTCOMES AND MEASURES Associations between the presence of vitreous bands in premature infants with ROP diagnoses and the presence of other vitreoretinal SD-OCT findings were investigated. RESULTS Of the 73 infants recruited, 6 infants' parents withdrew their children from the study, and 2 infants were too hemodynamically unstable for imaging, leaving a total of 65 participants. Of these, 32 (49%) were female, 36 (55%) were white, 10 (15%) were Hispanic, 3 (5%) were Native American, 4 (6%) were African American, 4 (7%) were Asian/Pacific Islander, and 8 (12%) were other. The mean (SD) gestational age was 28 (2.7) weeks, the mean (SD) birth weight was 997 g (286 g), and the mean (SD) postmenstrual age at imaging was 34 (3) weeks (mean [SD] total of 3 [2] imaging sessions). Comparing the 24 infants (37%) who had a right eye vitreous band at any time with the 41 (63%) who did not, no difference in mean birth weight, gestational age, postmenstrual age at imaging, sex, or race/ethnicity was identified. No associations with ROP stage (eg, in 6 [25%] infants with vitreous bands vs 4 [9.8%] in those without; P = .23), presence of plus disease (2 [8%] vs 2 [5%]; P = .84), or type 1 ROP (3 [12%] vs 3 [7%]; P = .66) were identified. Vitreous bands were associated with epiretinal membrane detected on SD-OCT (P = .001) with an odds ratio of 9.4 (95% CI, 2.8-31.3) in 15 [62%] infants with vitreous bands vs 6 [15%] in those without. Vitreous bands were also associated with cystoid macular edema (in 15 [62%] infants with vitreous bands vs 1 [27%] in those without; P = .005) with an odds ratio of 4.5 (95% CI, 1.5-13.3). CONCLUSIONS AND RELEVANCE In this study, the development of vitreous bands was associated with both cystoid macular edema and epiretinal membrane. These findings suggest a tractional pathogenesis to these entities among premature infants. This study did not find a direct association between vitreous bands and severe ROP. Additional study is needed to determine whether vitreous bands represent subclinical hyaloidal organization leading to retinal detachment in advanced ROP.

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“…While anterior chamber narrowing without closure has been previously described after laser for other conditions, the laser-induced anterior shifting and inward rotation of the ciliary body is typically short lived in older children and adults ( 25 ). In a case series of secondary glaucoma in children with ROP, all of the patients had shallow anterior chambers before the onset of glaucoma symptoms, so these patients might have had an initial anatomic compromise of the aqueous outflow subsequently exacerbated by other factors leading to high intraocular pressures ( 26 ). Likewise, in another study, shallow anterior chambers were noted to be a feature of most stage 3 ROP eyes, as a result of arrested development of the anterior segment, but with notable higher and more significant prevalence in laser-treated eyes ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

et al. 2021

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Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that occurs due to incomplete development of retinal blood vessels in preterm infants. Glaucoma is an ocular comorbidity in some patients with ROP, and it may be associated with immature anterior chamber development, ROP itself, or the treatment for ROP. There have been a few reports of narrow-angle glaucoma after laser treatment for ROP. In this case report, we describe the course of a female infant born at 24 weeks and 5 days of gestational age with treatment-requiring ROP treated with laser photocoagulation who subsequently developed very elevated intraocular pressure and shallow anterior chambers without pupillary block. The patient required bilateral ab externo trabeculotomy for elevated intraocular pressure, which normalized after the procedure. The patient has remained stable at the last follow-up at 51 weeks postmenstrual age. Differing from previous glaucoma presentations in this setting, we illustrate a case of elevated intraocular pressure and anterior chamber narrowing after laser therapy without pupillary block or synechiae. The possible multifactorial etiology of glaucoma in this patient, including incomplete angle development, ischemia, and laser treatment, highlight the need for glaucoma screening in patients with ROP, both in the short and long term.

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Medical Treatment of Glaucoma Associated with Cicatricial Retinopathy of Prematurity

Cited by 29 publications

References 7 publications

Retinopathy of Prematurity in Port Harcourt, Nigeria

Retinopathy of Prematurity in Port Harcourt, Nigeria

Vitreous Bands Identified by Handheld Spectral-Domain Optical Coherence Tomography Among Premature Infants

Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

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