Spontaneous regression of retinopathy of prematurity: incidence and predictive factors.

AIM: To evaluate the incidence of spontaneous regression of changes in the retina and vitreous in active stage of retinopathy of prematurity(ROP) and identify the possible relative factors during the regression. METHODS: This was a retrospective, hospital-based study. The study consisted of 39 premature infants with mild ROP showed spontaneous regression (Group A) and 17 with severe ROP who had been treated before naturally involuting (Group B) from August 2008 through May 2011. Data on gender, single or multiple pregnancy, gestational age, birth weight, weight gain from birth to the sixth week of life, use of oxygen in mechanical ventilation, total duration of oxygen inhalation, surfactant given or not, need for and times of blood transfusion, 1,5,10-min Apgar score, presence of bacterial or fungal or combined infection, hyaline membrane disease (HMD), patent ductus arteriosus (PDA), duration of stay in the neonatal intensive care unit (NICU) and duration of ROP were recorded. RESULTS: The incidence of spontaneous regression of ROP with stage 1 was 86.7%, and with stage 2, stage 3 was 57.1%, 5.9%, respectively. With changes in zone III regression was detected 100%, in zone II 46.2% and in zone I 0%. The mean duration of ROP in spontaneous regression group was 5.65±3.14 weeks, lower than that of the treated ROP group (7.34±4.33 weeks), but this difference was not statistically significant (P=0.201). GA, 1min Apgar score, 5min Apgar score, duration of NICU stay, postnatal age of initial screening and oxygen therapy longer than 10 days were significant predictive factors for the spontaneous regression of ROP (P<0.05). Retinal hemorrhage was the only independent predictive factor the spontaneous regression of ROP (OR 0.030, 95%CI 0.001-0.775, P=0.035). CONCLUSION: This study showed most stage 1 and 2 ROP and changes in zone III can spontaneously regression in the end. Retinal hemorrhage is weakly inversely associated with the spontaneous regression.

Prevalence and risk factors for diabetic retinopathy in a high-risk Chinese population.

BACKGROUND: Lifestyle plays an important role in the development of diabetic retinopathy. The lifestyle in Guangzhou is different from other cities in China as the Cantonese prefer eating rice porridge, but not spicy foods. The objectives of this study were to investigate the prevalence and determinants of diabetic retinopathy in a high-risk population of Guangzhou. METHODS: Subjects (619 totals) aged over 45 years old, without known diabetes were recruited from five randomly selected Guangzhou communities in 2009-2010. All participants were invited to complete the Finnish Diabetes Risk Score (FINDRISC) questionnaire. Subjects with FINDRISC score ≥ 9 were included in the study, and underwent an investigation of demographic data, a standardized physical examination, ocular fundus examination, and laboratory analyses. The minimum criterion for diagnosis of diabetic retinopathy was the presence of at least one microaneurysm. RESULTS: Of 619 subjects, 208 eligible subjects (122 women) with FINDRISC score ≥ 9 were included in the study. The mean age was 69.2 ± 8.5 years. Diabetic retinopathy was detected in 31 subjects, and the prevalence of diabetic retinopathy in subjects with high risk for diabetes was 14.9%. In binary logistic regression analysis, risk factors associated with diabetic retinopathy were history of impaired glucose regulation [odds ratio (OR), 7.194; 95% confidence interval (CI): 1.083, 47.810], higher hemoglobin A1c (HbA1c; OR, 2.912; 95% CI: 1.009, 8.402), higher two-hour postprandial plasma glucose level (OR, 1.014; 95% CI: 1.003, 1.025), and presence of microalbuminuria (OR, 5.387; 95% CI: 1.255, 23.129). CONCLUSIONS: Diabetic retinopathy was prevalent in a high-risk Chinese population from Guangzhou. Histories of impaired glucose regulation and microalbuminuria were strong risk factors for diabetic retinopathy.

Outcomes of 957 preterm neonatal fundus examinations in a Guangzhou NICU through 2008 to 2011.

AIM: To take fundus examination in the preterm neonates to observe the common diseases and report the outcomes in a neonatal intensive care unit (NICU) in Guangzhou between May 2008 and May 2011. METHODS: Fundus examinations were performed with Retcam II in 957 prematures. RESULTS: There were 957 prematures in this study, including 666 males and 291 females, 2 triple births, 152 twins and 803 singletons. During the three years, 86 infants with any stage retinopathy of prematurity (ROP) (9.0%), 123 infants with retinal hemorrhage(12.9%), 10 infants with neonatal fundual jaundice(1.0%) and 3 babies with congenital choroidal coloboma (0.3%) were found. CONCLUSION: Early detection and prompt treatment of ocular disorders in neonates is important to avoid lifelong visual impairment. Examination of the eyes should be performed in the newborn period and at all well-child visits.

Risk factors for severe retinopathy of prematurity in premature infants: a single-center study.

OBJECTIVE: To evaluate the incidence and risk factors for severe retinopathy of prematurity (ROP) in preterm infants. METHODS: Between May, 2008 and May, 2011, a total of 957 preterm infants at 4-6 weeks of chronological age or 32 weeks of postmenstrual age underwent retinal evaluation by RetCamII in our center, and the data of infants with ROP in any stage were analyzed. RESULTS: Among the 957 preterm infants, we found 86 (8.99%) infants to have ROP in different stages, including 60 (6.27%) with mild ROP and 26 (2.72%) with severe ROP. The birth weight and gestational age of the infants with severe ROP averaged 1 420.40∓328.64 g and 29.88∓1.67 weeks, as compared to 1 593.28∓339.30 g and 31.78∓2.53 weeks in those with mild ROP, respectively, showing a significant difference between the two groups (P<0.005). The significant variables for severe ROP included gestational age (P=0.001), birth weight (P=0.035), 1 min Apgar score (P=0.001), 5 min Apgar score (P=0.005), number of blood transfusions (P=0.032), and the presence of apnea (P=0.04) and retinal hemorrhage (P=0.000). Gestational age and retinal hemorrhage were the independent risk factors for severe ROP (OR=0.353, 95%CI 0.163-0.763, P=0.008; OR=26.133, 95%CI 3.042-224.501, P=0.035). CONCLUSION: Severe ROP tends to have a decreasing incidence and occurs more often in more mature preterm infants. The affected infants have the characteristics of the first epidemics. Gestational age and retinal hemorrhage are independent predictive factors for severe ROP.

[Effects of anti-CD25 monoclonal antibody on the level of cytokines in aqueous humour after rat penetrating keratoplasty].

OBJECTIVE: To investigate the toxicity of anti-CD25 monoclonal antibody (mAb) to rat cornea and its effects on the cytokines in the aqueous humour after penetrating keratoplasty (PKP), thereby evaluating the effect of anti-CD25 mAb in preventing corneal allograft rejection. METHODS: The corneal toxicity of anti-CD25 mAb at 50, 100 and 200 microg administered via subconjunctival injection was evaluated in 12 SD rats by histological examination and transmission electron microscopy. Another 93 SD rats were randomized into 5 groups, and transplantation of corneal allograft from Wistar rats was performed in 4 groups with the other group as the normal control. The 4 allograft groups were treated with saline, 100 microg anti-CD25 mAb, 100 microg anti-CD25 mAb with 50 microg dexamethasone, and 50 microg dexamethasone, respectively. The graft rejection was observed, the aqueous humour levels of IFN-gamma and IL-4 were measured with ELISA, and IFN-gamma mRNA expressions in the grafts detected with RT-PCR. RESULTS: anti-CD25 mAb at 50 or 100 microg did not show significant toxicity on the cornea, but at 200 microg, the mAb caused swelling of the corneal stromal cells and endothelial cells. After corneal allograft transplantation, a significant delay in allograft rejection was observed in the 3 groups with mAb or dexamethasone treatment as compared with that in saline group (P<0.05). IFN-gamma mRNA expression in the allograft on days 11 after PKP and in the aqueous humour on days 6 and 11 was markedly increased in saline group compared with that in the 3 treatment groups (P<0.05). The mean IL-4 level in the aqueous humour was significantly higher in the mAb group than in saline group (P<0.05), but markedly lower in anti-CD25 mAb+dexamethasone and dexamethasone groups than in anti-CD25 mAb group (P<0.05). CONCLUSIONS: Anti-CD25 mAb at 20 and 100 microg does not obviously affect the rat corneas. Anti-CD25 mAb inhibits IFN-gamma expression and promotes IL-4 the expression to reduce corneal allograft rejection, whereas anti-CD25 mAb with low-dose dexamethasone inhibits both IFN-gamma and IL-4 expressions to more effectively promote the graft survival.