The Incidence and Course of Retinopathy of Prematurity: Findings From the Early Treatment for Retinopathy of Prematurity Study

Good, William V.; Hardy, Robert J.; Dobson, Velma; Palmer, Earl A.; Phelps, Dale L.; Quintos, Michelle; Tung, Betty

doi:10.1542/peds.2004-1413

Cited by 453 publications

(188 citation statements)

References 18 publications

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“…Its incidence and severity are highest among infants born most prematurely, decreasing with advancing GA at birth [14]. In more recent years, VLBW babies are reaching higher survival rates also in many middle-income countries, like Brazil, where the ascendant economy has brought improvements to the neonatal care for these babies with a high risk for morbidities [15, 16].…”

Section: Discussionmentioning

confidence: 99%

Score for Neonatal Acute Physiology and Perinatal Extension II as a Predictor of Retinopathy of Prematurity: Study in 304 Very-Low-Birth-Weight Preterm Infants

Filho¹,

Dill²,

Ishizaki³

et al. 2009

Ophthalmologica

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Aim: To evaluate the use of the Score for Neonatal Acute Physiology and Perinatal Extension (SNAPPE-II) at admission to predict the development of retinopathy of prematurity (ROP) among very-low-birth-weight preterm babies. Methods: A prospective cohort study included 304 infants screened for ROP from July 2004 to October 2007. The main outcomes were the development of any stage ROP and severe ROP. The main variable was the SNAPPE-II obtained at admission. Seventeen risk factors for ROP were studied by univariate analysis (χ² and Student’s t test). A simple descriptive analysis was used for the SNAPPE-II (mean, median, standard deviation and interquartile range: p25–p75). Logistic regression and receiver-operating characteristic (ROC) curve were calculated for SNAPPE-II. Ophthalmological examinations started at the 6th week of life and were repeated until the 45th week of corrected gestational age (GA). Results: The mean GA and mean birth weight of the whole cohort were 30.3 weeks (±2.2) and 1,209.2 g (±277.7), respectively. The median SNAPPE-II among non-ROP and ROP patients were 6.0 and 15.0, respectively (p = 0.001). When compared with severe ROP patients (25.0) there was also a significant difference (p = 0.003). After logistic regression, the SNAPPE-II adjusted odds ratio for ROP was 1.024. The area under the ROC curve was 0.62 (95% confidence interval: 0.55–0.70, p < 0.001). The best discriminative cutoff value was 8.5 (sensitivity: 68%; specificity: 54%; positive predictive value: 37.3%; negative predictive value: 80.6%). Conclusions: The SNAPPE-II values at admission were significantly higher among babies with ROP, suggesting a positive association between higher scores with the development of ROP, but after adjusted logistic regression and ROC curve results, the SNAPPE-II scores at admission did not enhance the assessment of risk for ROP.

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Section: Discussionmentioning

confidence: 99%

Score for Neonatal Acute Physiology and Perinatal Extension II as a Predictor of Retinopathy of Prematurity: Study in 304 Very-Low-Birth-Weight Preterm Infants

Filho¹,

Dill²,

Ishizaki³

et al. 2009

Ophthalmologica

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“…Thirty-three infants were classified as non-ROP, 10 infants were classified as having nonproliferative ROP, and 9 infants were classified as having proliferative ROP and were later treated with laser for ROP. The international recommendation was used for ROP treatment and was based on the following criteria: the stage of ROP, the zone in which ROP was detected, and whether plus disease was detected (25). All treated children had ROP stage 3 (zone II and III) with plus disease.…”

Section: Methodsmentioning

confidence: 99%

Serum concentrations of vascular endothelial growth factor in relation to retinopathy of prematurity

et al. 2015

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Background The role of vascular endothelial growth factor (VEGF) in the pathogenesis of retinopathy of prematurity (ROP) has been clearly established. However, little is known about temporal changes in circulating VEGF concentrations in the preterm infant. The objective was to determine the longitudinal serum concentrations of VEGF in relation to ROP. Methods This study included 52 infants born at <31 wk gestational age (non-ROP n = 33, nonproliferative ROP n = 10, treated for ROP n = 9). VEGF concentrations were analyzed in blood samples collected at birth, at 3 d postnatal age, and then weekly until at least a gestational age of 35 wk. Results VEGF concentrations at birth did not differ between groups, independent of later ROP status. In contrast, VEGF serum concentrations were significantly higher at first detection of ROP in infants who were later treated for ROP compared to infants without ROP. At the time of laser therapy, serum VEGF concentrations did not differ between groups. Conclusion Circulatory concentrations of VEGF, in infants who later developed severe ROP, were elevated at the time when ROP first was detected but not at the time when current treatment most often occurred. This supports the need for further studies of circulating VEGF in relation to the timing of ROP treatment.

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“…D -Penicillamine has also been suggested to lower ROP incidence in high-risk preterm infants [25]. Clinical trials have focused more on mitigating ROP progression (Cryotherapy for ROP Cooperative Group, Supplemental Therapeutic Oxygen for Prethreshold ROP and Early Treatment for ROP [4]) than prevention, although it appears that reducing inspired oxygen concentrations and administering antioxidants represents a logical approach to significantly reducing the risk and severity of ROP in ELGANS.…”

Section: Discussionmentioning

confidence: 99%

“…ROP risk at ≤25 weeks is 10–20 times higher than in infants born at >28 weeks’ GA [1,2]. ROP risk at 23 weeks is double that at 25 weeks’ GA [3], and infants born at <28 weeks are at greater risk for more severe ROP [4]. …”

Section: Introductionmentioning

confidence: 99%

Reduction of Retinopathy of Prematurity in Extremely Low Gestational Age Newborns Treated with Recombinant Human Cu/Zn Superoxide Dismutase

Parad

Allred²,

Rosenfeld³

et al. 2012

Neonatology

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Background: Reactive oxygen species have been implicated in the pathogenesis of retinopathy of prematurity (ROP). Extremely low gestational age (GA) newborns (ELGANs) have the highest risk of ROP and might benefit most from treatment with antioxidants. Objectives: To determine whether recombinant human Cu/Zn superoxide dismutase (rhSOD) decreases the incidence or severity of ROP in ELGANs. Methods: A previous multicenter trial of intratracheal rhSOD for prevention of bronchopulmonary dysplasia randomized 302 preterm infants to receive intratracheal rhSOD or placebo at birth and every 48 h for 1 month. An analysis of the incidence and severity of ROP was performed in ELGANs. Results: The risk of ROP increased with decreasing GA. Within the entire cohort, no significant differences in ROP were found in the placebo versus rhSOD groups. Subgroup analysis on infants born at <26 weeks (n = 72) revealed a 22% reduction in ROP from 85% (placebo) to 66% (rhSOD) (p = 0.06). In subjects born at <25 weeks (n = 24), ROP was reduced by 53% from 85% (placebo) to 40% (rhSOD) (p = 0.03). ROP severity above stage 2 was found in 42% of placebo-treated infants but only 25% of rhSOD-treated subjects with ROP. Conclusions: This post hoc analysis suggests that rhSOD reduces the risk of developing ROP in ELGANs, although further studies are required to confirm this observation.

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The Incidence and Course of Retinopathy of Prematurity: Findings From the Early Treatment for Retinopathy of Prematurity Study

Abstract: ROP remains a common important problem among infants with birth weights of <1251 g. The incidence of ROP, time of onset, rate of progression, and time of onset of prethreshold disease have changed little since the CRYO-ROP natural-history study.

Cited by 453 publications

References 18 publications

Score for Neonatal Acute Physiology and Perinatal Extension II as a Predictor of Retinopathy of Prematurity: Study in 304 Very-Low-Birth-Weight Preterm Infants

Score for Neonatal Acute Physiology and Perinatal Extension II as a Predictor of Retinopathy of Prematurity: Study in 304 Very-Low-Birth-Weight Preterm Infants

Serum concentrations of vascular endothelial growth factor in relation to retinopathy of prematurity

Reduction of Retinopathy of Prematurity in Extremely Low Gestational Age Newborns Treated with Recombinant Human Cu/Zn Superoxide Dismutase

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