Retinopathy of Prematurity: Advances in the Screening and Treatment of Retinopathy of Prematurity Using a Single Center Approach

Berrocal, Audina M.; Fan, Kenneth C.; Al-Khersan, Hasenin; Negron, Catherin I.; Murray, Timothy G.

doi:10.1016/j.ajo.2021.07.016

Cited by 24 publications

(14 citation statements)

References 110 publications

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“…The most important risk factors related to ROP are the gestational age and the birth weight of the infants [15]. The others are long-term exposure to high concentration of oxygen and immature lungs [16].…”

Section: Discussionmentioning

confidence: 99%

The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

Eroglu¹,

Ünsal

Abdullayev

et al. 2022

Int Ophthalmol

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Purpose: To investigate the association of hepatic and renal parameters with the development of retinopathy of prematurity (ROP) in premature infants with a gestational age ≤ 32 weeks.Methods: Medical records of 240 preterm infants were reviewed retrospectively, 85 of them were grouped as type 1, type 2 ROP and control group. These groups test results of rst-month hepatic and renal function were compared for the risk of development of ROP and the development of type 1 ROP.Results: In this study, 12, 35 and 38 infants were enrolled in the type 1, type 2 ROP and control group, respectively. The average gestational age and birth weight were higher; however, the duration of oxygen treatment was lower in the control group (p<0.001). The blood glucose level was signi cantly higher in the type 1 ROP group than in the other groups (p=0.023). The mean of total serum bilirubin of the type 1 ROP group was signi cantly lower than those of the type 2 ROP and control group (p=0.032). Proteinuria was present in 85.7% of preterms with treatment-requiring ROP and proteinuria increased the risk of ROP by 3.9 times (OR with 95% CI: 3.9 (1.19-12.75), p=0.042).Conclusion: We found signi cantly higher blood glucose and lower total bilirubin level in the type 1 ROP group. Moreover, our ndings suggest that proteinuria seems to be a new and important risk factor for both ROP and type 1 ROP in preterm infants.

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Section: Discussionmentioning

confidence: 99%

The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

Eroglu¹,

Ünsal

Abdullayev

et al. 2022

Int Ophthalmol

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“…Inicialmente, se aprecia una línea de demarcación entre la conjunción de la retina vascular y avascular (I); la cual puede tornarse cresta (II) y asociar neovascularización extraretiniana hasta el vítreo (III). En los casos más severos se presenta DR, ya sea parcial que respete o involucre la fóvea (IV a y b, respectivamente), o completo (V) (19). Además, se puede clasificar según localización en zona I, cuando rodee de forma simétrica el nervio óptico hasta 2 veces la distancia del nervio y la fóvea; zona II, al extenderse de la I hasta la ora serrata en el lado nasal y ecuador del lado temporal; o III, al ser un área en media luna más anterior que la zona II (1).…”

Section: Presentación Clínicaunclassified

“…Por lo tanto, la presentación clínica varía desde la regresión espontánea de las alteraciones encontradas a nivel retiniano, hasta el DR completo que se muestra clínicamente como ceguera (19).…”

Section: Presentación Clínicaunclassified

“…A pesar de que los manejos mencionados anteriormente disminuían drásticamente la probabilidad de ceguera infantil, los mismos no estaban exentos de complicaciones, razón que ha impulsado a través de los años la exploración de nuevos tratamientos contra la RDP (19), por ejemplo, se observó que la fotocoagulación láser presentaba menos inflamación, menos dolor, así como menos efectos a nivel sistémico, y en general mejores resultados que la crioterapia, lo que hizo que este tratamiento se utilizara por encima de este último (1). Sin embargo, la fotocoagulación láser se acompaña de posibles complicaciones tales como, la disminución permanente del campo visual, así como un aumento en la incidencia de miopía, ambliopía y catarata (19). Por otro lado, la fotocoagulación láser se tiene que realizar bajo anestesia general, que siempre conlleva un riesgo, siendo un procedimiento que se puede prolongar hasta por más de 2 horas.…”

Section: Complicacionesunclassified

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Abordaje y nuevas propuestas terapéuticas en la retinopatía del prematuro.

Hine

Morera

Martínez

et al. 2022

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La retinopatía del prematuro (RDP) es la causa principal de ceguera en pacientes pediátricos. Se trata de una patología multifactorial del desarrollo de los vasos sanguíneos retinales en niños prematuros. Los factores de riesgo pueden clasificar en 3 grupos: factores maternos, factores infantiles y factores peri y prenatales. De los neonatos nacidos con bajo peso o muy bajo peso, hasta un 60% desarrollarán algún grado de retinopatía del prematuro, de los cuales hasta un 8% será severa y hasta un 6% requerirá tratamiento. Su diagnóstico se basa en el tamizaje a la hora del nacimiento. Actualmente se recomienda un tamizaje no solo de RDP, sino también de sus factores de riesgo. La RDP debería tener un seguimiento multidisciplinario que incluya un tamizaje sistemático, tratamiento individualizado y un seguimiento a largo plazo. Su fisiopatología ocurre en dos etapas. La primera, la fase isquémica, se caracteriza por la interrupción de la progresión del lecho capilar. La segunda fase, llamada fase proliferativa, se secretan factores vasculogénicos en respuesta a la hipoxia neuronal. Pueden ocurrir complicaciones que comprometen el pronóstico visual del paciente, como desprendimiento de retina y hemorragias retinianas. Su presentación clínica comprende 5 estadios, desde la regresión espontánea de las alteraciones encontradas a nivel retiniano hasta el desprendimiento completo que se muestra clínicamente como ceguera. Pueden ocurrir complicaciones que comprometen el pronóstico visual del paciente, como desprendimiento de retina y hemorragias retinianas.

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“…Collyrium administration is a common procedure in the neonatal ward. In fact, preterm babies are routinely screened for retinopathy of prematurity, while at term newborns undergo ophthalmological evaluation in case of abnormal red reflex test [1,2]. Anti-parasympathetic drugs (such as tropicamide and cyclopentolate) and sympathetic agonist (mainly phenylephrine), whether alone or combined, are commonly used to induce mydriasis and cycloplegia.…”

Section: Introductionmentioning

confidence: 99%

Acute drug reaction to phenylephrine and tropicamide collyrium in a late-preterm newborn: a case report

Baldo

2022

BMC Pediatr

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Background Collyrium administration is a common procedure in the neonatal ward, both in preterm and at term babies. Various molecules are used to induce mydriasis and cycloplegia: among them, phenylephrine and tropicamide are the most popular, and their administration is generally considered safe. Case presentation A 35 + 2 weeks-old, 2510 g, well-appearing male newborn required an ophthalmologic evaluation after a doubtful red reflex test. A collyrium with 1% phenylephrine and 0.95% tropicamide was administered prior to the consult, one drop per eye. Two minutes after the administration, the baby developed a severe apnea that required tactile stimulation. Moreover, the area around his eyes became visibly pale. Three minutes later, the baby became severely bradycardic (59 bpm), but remained in good general condition, so that resuscitation maneuvers were not required. Bradycardia lasted for almost three hours and then gradually resolved. Conclusions Cardiopulmonary manifestations, such as bradycardia and even cardiopulmonary arrest, are severe complications that can happen after phenylephrine collyrium administration in preterm newborns. However, they have been described in babies below 1500 g or with concurrent respiratory manifestations. Our patient, on the other hand, was late preterm, and never required a ventilatory support prior to the collyrium administration. Practitioners who deal with premature babies, even if late preterm, must be aware of these possible complications and administer phenylephrine collyrium carefully, where cardiopulmonary resuscitation equipment and personnel are available.

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Retinopathy of Prematurity: Advances in the Screening and Treatment of Retinopathy of Prematurity Using a Single Center Approach

Cited by 24 publications

References 110 publications

The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

Abordaje y nuevas propuestas terapéuticas en la retinopatía del prematuro.

Acute drug reaction to phenylephrine and tropicamide collyrium in a late-preterm newborn: a case report

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