No advanced retinopathy of prematurity stages 4 or 5 in a large high-risk German cohort

Muether, Philipp S.; Kribs, Angela; Hahn, Moritz; Schumacher, Jasmin; Eifinger, Frank; Kirchhof, Bernd; Roth, Bernhard; Fauser, Sascha

doi:10.1136/bjo.2011.203125

Cited by 15 publications

(14 citation statements)

References 34 publications

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“…In the Canadian study, 14 the earliest onset of Type 1 ROP was 6 weeks chronological age or 32.7 weeks PMA. In the study by Muether et al 15 that included 767 infants 22-35 weeks gestation, no infants required treatment before 8 weeks chronologic age or 33 weeks PMA. Together these studies provide no evidence that current screening guidelines should be changed to accommodate earlier (Type 1 ROP) treatment, although we still have limited data for 22-23 week GA infants.…”

Section: Discussionmentioning

confidence: 99%

“…A recent publication from Canada reported the age of onset of Type 1 ROP in a cohort of 214 infants ≤ 27 weeks gestation; 14 this cohort included only 24 infants with Type 1 ROP. A recent publication from a German cohort 15 reported that “No preterm infants required treatment before the 33rd postmenstrual week or 8th postnatal week, respectively”; the age distribution was not reported. We need updated information about the evolution of ROP in a large contemporary cohort to determine when screening must be initiated to capture all infants as Type 1 ROP develops.…”

Section: Introductionmentioning

confidence: 99%

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

Kennedy

Wrage²,

Higgins

et al. 2014

J Perinatol

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ObjectiveTo determine if current retinopathy of prematurity screening guidelines1 adequately identify treatable ROP in a contemporary cohort of extremely low gestation infants.Study DesignData from the Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial were used. Inborn infants 24 0/7 to 27 6/7 weeks gestational age with consent prior to delivery were enrolled in 2005-2009. Severe retinopathy of prematurity (Type 1 retinopathy of prematurity or treatment with laser, cryotherapy, or bevacizumab) or death was the primary outcome for the randomized trial. Examinations followed then current American Academy of Pediatrics (AAP) screening recommendations, beginning by 31-33 weeks postmenstrual age.2,3Results1316 infants were enrolled in the trial. 997 of the 1121 who survived to first eye exam had final retinopathy of prematurity outcome determined. 137 (14% of 997) met criteria for severe retinopathy of prematurity and 128 (93%) of those had sufficient data (without missing or delayed exams) to determine age of onset of severe retinopathy of prematurity. Postmenstrual age at onset was 32.1 to 53.1 wks. In this referral center cohort, 1.4% (14/997) developed severe retinopathy of prematurity after discharge.ConclusionOur contemporary data support the 2013 AAP screening guidelines for ROP for infants 24 0/7 to 27 6/7 weeks gestational age.1 Some infants do not meet treatment criteria until after discharge home. Post-discharge follow-up of infants who are still at risk for severe ROP is crucial for timely detection and treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Kennedy

Wrage²,

Higgins

et al. 2014

J Perinatol

View full text Add to dashboard Cite

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“…Differences in the study design, definition of severe ROP, comorbidity of infants, proportion of inborn infants, and disagreement on plus sign may explain the reason (18). As GA at birth decreases, incidence of severe ROP usually increases (10, 11, 13, 14). However, in this study, the incidence of type 1 ROP was not significantly different between 23 and 24 weeks GA groups.…”

Section: Discussionmentioning

confidence: 99%

“…The development of type 1 ROP before 31 weeks PMA was not reported in two recent studies including more than 100 preterm infants born before 25 weeks gestation. In a German cohort study, no preterm infants required treatment before the 33rd postmenstrual week (14). In a Swedish study, ROP at stages 2 and 3 was seen as early as 29.9 and 31.6 weeks, respectively (19, 20).…”

Section: Discussionmentioning

confidence: 99%

“…In many studies including the ET-ROP and CRYO-ROP studies, low birth weight was significantly associated with the development of severe ROP (22-24). In a German cohort study, the odds ratio for treatment increased by 1.22 per 100 g of decrease in body weight (14). However, in this study, birth weight was not associated with the development of type 1 ROP.…”

Section: Discussionmentioning

confidence: 99%

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Retinopathy of Prematurity in Infants Born before 25 Weeks Gestation in a Korean Single Neonatal Intensive Care Unit: Incidence, Natural History and Risk Factors

et al. 2012

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As younger preterm infants are able to survive, more extremely preterm infants are at risk of developing retinopathy of prematurity (ROP). To investigate the incidence, progression and risk factors of ROP in extremely preterm infants in Korea, the medical records of infants born before 25 weeks gestation were retrospectively reviewed. The criteria for laser treatment agreed with type 1 ROP as defined by the Early Treatment for Retinopathy of Prematurity study. Of the 121 infants included in the analysis, 119 (98.4%) infants developed any stage ROP, including 78 infants (64.5%) with type 1 ROP. The mean postmenstrual age (PMA) at the onset of any ROP and type 1 ROP were 33.5 and 36.1 weeks, respectively. All but one infant developed type 1 ROP after 31 weeks PMA. Univariate analysis showed that duration of total parenteral nutrition and onset of any ROP (PMA) were associated with the development of type 1 ROP. In conclusion, this study shows high incidence of ROP in extremely preterm infants and suggests that, although current screening protocols are feasible for most preterm infants born before 25 weeks gestation, earlier screening before 31 weeks PMA may be necessary in infants with an unstable clinical course.

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The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

et al. 2022

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ImportanceLiterature and anecdotal evidence suggest a relationship between male sex and retinopathy of prematurity (ROP). It is not known whether a difference, if present, is sex-related pathophysiologic predisposition or sex difference in meeting ROP screening criteria.ObjectiveTo evaluate the association of sex with the development of treatment-warranted ROP.Data SourcesPubMed, Embase, and Web of Science databases were searched from 2000 to 2022. The search strategy used keywords including retinopathy of prematurity or ROP or retrolental fibroplasia and treatment or anti-VEGF or bevacizumab or ranibizumab or aflibercept or conbercept or laser or cryotherapy and gender or sex or male or female and medical subject headings terms.Study SelectionAll studies reporting on treatment with anti–vascular endothelial growth factor, laser photocoagulation, and/or cryotherapy for ROP were identified. Studies reporting sex distribution in the treatment group were included in the meta-analysis. Exclusion criteria included case reports, case series of fewer than 10 treated patients, systematic reviews, conference abstracts, letters to the editor, animal studies, and non-English records.Data Extraction and SynthesisTwo reviewers independently screened and extracted the data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The proportions of treated male and female infants were combined using random-effects meta-analysis.Main Outcomes and MeasuresNumbers and percentages of male and female infants treated for ROP.ResultsOf 11 368 identified studies, 316 met inclusion criteria, yielding a total of 31 026 treated patients. A higher percentage of male infants were treated for ROP (55% [95% CI, 0.54%-0.55%]), with low heterogeneity between studies (I2 = 34%; P &lt; .001). Thirty-eight studies reported sex distribution in the screened population (170 053 patients; 92 612 [53%] male vs 77 441 [47%] female). There was no significant difference in the odds of receiving treatment between screened male and female infants (pooled odds ratio, 1.04 [95% CI, 0.91-1.18]; P = .67).Conclusions and RelevanceMore male infants are treated for ROP than female infants. This could be due to a known relative pathophysiological fragility of preterm male infants in addition to a difference in ROP screening rates, with more male infants meeting the criteria than female infants. These findings have implications for future studies and may prompt more careful clinical monitoring of male neonates.

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No advanced retinopathy of prematurity stages 4 or 5 in a large high-risk German cohort

Cited by 15 publications

References 34 publications

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

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

Retinopathy of Prematurity in Infants Born before 25 Weeks Gestation in a Korean Single Neonatal Intensive Care Unit: Incidence, Natural History and Risk Factors

The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

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