Speed of Retinal Vascularization in Retinopathy of Prematurity: Risk and Protective Factors.

OBJECTIVE: The objective was to study the risk and protective factors involved in retinal vascular development of preterm infants with retinopathy of prematurity. METHODS: Between 2000 and 2017, 185 preterm infants were included in the protocol for retinopathy of prematurity. Risk factors associated with speed of retinal vascularization <0.5 disc diameter/week were studied in each of them. RESULTS: The statistically significant variables related to retinal vascular development <0.5 DD/w were intubation days, degree 3 of bronchopulmonary dysplasia, weight gain at 4-6 weeks, avascular temporal area, gestational age, number of transfusions, sepsis, number of risk factors, apnea at birth, presence of ductus arteriosus, and days of continuous positive airway pressure therapy. After the multivariate logistic regression analysis, only three variables were found to be significant: intubation days (p=0.005), degree 3 of bronchopulmonary dysplasia (p=0.022), and weight gain at 4-6 weeks (p=0.031). CONCLUSION: In retinopathy of prematurity, degree 3 of bronchopulmonary dysplasia and intubation days cause delayed retinal vascular development, whereas greater postnatal weight gain favors an appropriate rate of retinal vascularization.

Retinal vascular speed <0.5 disc diameter per week as an early sign of retinopathy of prematurity requiring treatment.

PURPOSE: To analyse the speed of temporal retinal vascularisation in preterm infants included in the screening programme for retinopathy of prematurity. MATERIAL AND METHODS: A total of 185 premature infants were studied retrospectively between 2000 and 2017 in San Cecilio University Hospital of Granada, Spain. The method of binocular indirect ophthalmoscopy with indentation was used for the examination. The horizontal disc diameter was used as a unit of length. Speed of temporal retinal vascularisation (disc diameter/week) was calculated as the ratio between the extent of temporal retinal vascularisation (disc diameter) and the time in weeks. RESULTS: The weekly temporal retinal vascularisation (0-1.25 disc diameter/week, confidence interval) was significantly higher in no retinopathy of prematurity (0.73 ± 0.22 disc diameter/week) than in stage 1 retinopathy of prematurity (0.58 ± 0.22 disc diameter/week). It was also higher in stage 1 than in stages 2 (0.46 ± 0.14 disc diameter/week) and 3 of retinopathy of prematurity (0.36 ± 0.18 disc diameter/week). The rate of temporal retinal vascularisation (disc diameter/week) decreases when retinopathy of prematurity stage increases. The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.79-0.91) for retinopathy of prematurity requiring treatment versus not requiring treatment. The best discriminative cut-off point was a speed of retinal vascularisation <0.5 disc diameter/week, with a sensitivity and a specificity of 84.8% and 77%, respectively. CONCLUSION: The rate of temporal retinal vascularisation is a quantifiable observation that can help to alert a clinician that treatment of retinopathy of prematurity may be required. However, before becoming a new standard of care for treatment, it requires careful documentation, with agreement between several ophthalmologists.

Congenital Upper Eyelid Coloboma: Clinical and Surgical Management.

Purpose. The goal was to describe our experience in the surgical management and treatment of four patients with congenital upper eyelid colobomas. Methods. A descriptive, observational, retrospective study was performed including patients with congenital eyelid colobomas referred to Asociación para Evitar la Ceguera en México I.A.P. "Dr. Luis Sánchez Bulnes" between 2004 and 2014 and assessed by the Oculoplastics and Orbit Service. Results. The four cases required surgical treatment of the eyelid defects before one year of age and their evolution was monitored from the time of referral to the present day. One of the patients needed a second surgical procedure to repair the eyelid defect and correct the strabismus. Conclusions. Eyelid colobomas are a potential threat to vision at an early age, which requires close monitoring of the visual development of patients.