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1.
Turk J Ophthalmol ; 49(4): 230-234, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31486615

RESUMO

Congenital toxoplasmosis and retinopathy of prematurity (ROP) are two devastating clinical entities of the newborn. There is little information in the literature about the interaction between congenital infections and retinal vascular development at the fetal stage, and none regarding the relationship between ROP and congenital toxoplasmosis. In this report, we present two premature newborns diagnosed with congenital toxoplasmosis with ocular involvement, accompanied by ROP with interrupted retinal vascularization, peripheral avascular regions, and retinal detachment. The aim of this paper is to emphasize the possibility of ROP and congenital toxoplasmosis coexistence wherein one condition may mask the other and make it difficult to distinguish the cause of retinal detachment. Timely management with medical and surgical treatment of congenital toxoplasmosis and ROP could save eyes and vision in those cases.


Assuntos
Retinopatia da Prematuridade/complicações , Toxoplasmose Congênita/complicações , Toxoplasmose Ocular/complicações , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino
2.
Biomed Res Int ; 2019: 2095730, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31380413

RESUMO

Currently, the use of assisted reproductive technology (ART) is increasing. Because of the poor prognosis of retinopathy of prematurity (ROP), the association between ART and the ROP has been explored in several studies, but the result was still inconclusive. Conducting a meta-analysis, we evaluated the risk of ROP in relation to the ART. Subgroup analysis as well as groups with different embryo numbers and different ROP stages was further analyzed. The PubMed, Embase, and Cochrane Library databases were searched for studies recording data about both the use of ART and ROP occurrence simultaneously. Odds ratios (ORs) and 95% confidence interval (95%CI) were calculated to analyze the association by using random- or fixed-effect models based on heterogeneity test. In total 15 observational studies containing 10392 ART cases and 39474 spontaneous conception cases were included. Results showed that there was a significant association between the use of ART and ROP occurrence in the offspring (OR = 1.34, 95% CI: 1.05 to 1.73, P = 0.02). With subgroup analysis, we found that the influence actually came from a subgroup of ART, the in vitro fertilization (IVF). Moreover, there was a significant association between ART and ROP in singletons. Though insignificant, the ORs were larger than 1 in the analysis between ART and stage 1 and 2 ROP. But ART showed significant association with stage 3 ROP. Our study preliminarily indicated that the use of IVF was associated with higher risk of ROP occurrence. And ART is more likely to result in severe ROP and ROP in singletons. Further specific, high-quality studies with large sample size are still needed to draw more precise conclusion.


Assuntos
Fertilização In Vitro/efeitos adversos , Reprodução/fisiologia , Técnicas de Reprodução Assistida/efeitos adversos , Retinopatia da Prematuridade/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/fisiopatologia , Fatores de Risco
3.
Indian J Ophthalmol ; 67(6): 726-731, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124480

RESUMO

Many of the causes of childhood blindness are avoidable, being either preventable or treatable. Retinopathy of prematurity (ROP) remains one of the most preventable causes of childhood blindness worldwide. Currently, India is facing the third epidemic of ROP. In India, the health system involving the mother and child health services needs to be strengthened with a policy to cover the existing inadequacies in neonatal care and implementation of program covering newborn, especially premature. The access, availability, and affordability of services related to the care of premature babies need strengthening in India. ROP-trained ophthalmologists and neonatal care pediatricians and a professional togetherness is a big issue. Inadequacies in awareness of ROP among the parents, health care workers, counsellors add up to the problem. Community-based health workers such as Accredited Social Health Activist are a good dependable force in India and are needed to be trained in awareness and establishing a proper identification for prompt referral. ROP prevention needs a multidisciplinary team approach. ROP management stands as a good example of all the strategies for prevention, which includes primary prevention (improving obstetric and neonatal care), secondary prevention (screening and treatment programs), and tertiary prevention (treating complications and rehabilitation to reduce disability). Given its demographic and cultural diversity, India faces numerous challenges, with significant rural-urban, poor-rich, gender, socioeconomic, and regional differences. So, we need to gear up to face the present challenge of the third epidemic of ROP and prevent ROP-related childhood blindness as it is the need of the hour.


Assuntos
Cegueira , Triagem Neonatal/métodos , Retinopatia da Prematuridade/epidemiologia , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/prevenção & controle , Humanos , Incidência , Índia/epidemiologia , Recém-Nascido , Prevalência , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico
4.
Indian J Ophthalmol ; 67(6): 816-818, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124493

RESUMO

Purpose: Retinopathy of prematurity (ROP) is now emerging as one of the major causes of preventable childhood blindness. The proportion of preterm babies has increased dramatically over the past decade. Our study aims to emphasize the need for ROP screening and management services in these preterm infants. Methods: ICD-coded medical records of children less than 10 years of age presenting to a subspecialty eye hospital from 2000 to 2017 were reviewed. ROP, congenital cataract, congenital glaucoma, and vitamin A deficiency were the most common diagnoses. We evaluated the trend of these diseases from 2000 to 2017. Results: Our data suggested a 20-fold increase in the attendance of children with a diagnosis of ROP who now make over 2% of outpatient children. Vitamin A deficiency has declined over time whereas cataract and glaucoma have remained stable. Conclusion: Our data indicate a need to scale up ROP screening integrated with neonatal care, as well as to build capacity for the treatment of acute and late-stage ROP in India.


Assuntos
Cegueira/epidemiologia , Triagem Neonatal/métodos , Retinopatia da Prematuridade/epidemiologia , Medição de Risco/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Acuidade Visual , Cegueira/etiologia , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Prevalência , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Fatores de Risco
5.
Indian J Ophthalmol ; 67(6): 819-823, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124494

RESUMO

Purpose: To describe the prevalence, characteristics including risk factors, and pattern of severe ROP from eastern Madhya Pradesh region of India. Methods: In this 5-year retrospective study, Baseline characteristics, systemic risk factors, and findings of ROP screening were noted. Factors associated with severe ROP including aggressive posterior ROP (APROP), stage IV and V ROP were analyzed. Statistical analysis was done using SPSS version 20. Results: Of 763 babies screened, 30% were diagnosed to have ROP. Prevalence of severe ROP was 14.2% (109) of which 60 (55.5%) were classic and 30 (27.7%) were APROP. Eighteen (16.6%) were diagnosed as advanced ROP (stage IV and V). Mean gestational age (GA) and birth weight (BW) for severe ROP were 31.05 weeks and 1.34 kg, respectively which were inversely associated with severe ROP. But a significant 10% of severe ROP were seen in late preterm babies, >34 weeks. Low GA and respiratory distress syndrome (RDS) were significant risk factors for APROP. Most important factor for stage IV and V ROP was late presentation for screening. Conclusion: The study found a high prevalence of severe ROP including APROP. Almost 7% severe ROP cases were outside screening guidelines of NNF. Late presentation for screening is the most important factor associated with ROP related blindness.


Assuntos
Triagem Neonatal/métodos , Retinopatia da Prematuridade/epidemiologia , Medição de Risco/métodos , Cegueira/epidemiologia , Cegueira/etiologia , Progressão da Doença , Feminino , Seguimentos , Idade Gestacional , Humanos , Índia , Lactente , Recém-Nascido , Masculino , Prevalência , Prognóstico , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo
6.
Indian J Ophthalmol ; 67(6): 889-895, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124510

RESUMO

Purpose: To analyze and report outcomes of microincision vitrectomy surgery (MIVS) for Stage 4 and 5 retinopathy of prematurity (ROP). Methods: Medical records of 202 eyes of 129 premature children undergoing MIVS for Stage 4/Stage 5 ROP between January 2012 and April 2015 were evaluated. The primary outcome measure was the proportion of eyes with anatomical success (defined as attached retina at the posterior pole at last follow-up). Complications associated with MIVS were noted and analysis of risk factors associated with poor anatomical outcome was also done using logistic regression. Results: Mean age of presentation of babies with Stage 4 ROP (2.9 ± 1.75 months) was lower than those with stage 5 disease (5.62 ± 2.55 months) (P < 0.005). One hundred seventeen eyes (56% or 58%) had Stage 5, 38 (19%) had Stage 4a, and 47 (23%) Stage 4b. Ninety-four eyes (47%) had received prior treatment (laser and/or anti-vascular endothelial growth factors [VEGF]). Lens-sparing vitrectomy (LSV) was performed in 58 (29%) eyes while lensectomy with vitrectomy (LV) was performed in 144 (71%) eyes. At a mean follow-up of 32.5 weeks, 102 (50.5%) eyes achieved anatomical success, including 74% eyes in Stage 4a and 4b and 33% in Stage 5. Complications included intraoperative break formation (19%), postoperative vitreous hemorrhage (28%), raised intraocular pressure (12.7%), and cataract progression (2.4%). Factors significantly associated with favorable anatomical outcome were Stage 4 disease (vs. Stage 5) (odds ratio [OR] 5.8; confidence interval [CI] =2.6-13.8, P < 0.005), prior treatment (laser ± anti-VEGF) (OR 2.5; CI 1.4-4.7, P < 0.005) surgery with 25G MIVS (vs. 23G) (OR: 1.7; CI = 0.98-3.00, P = 0.05) and LSV (vs. LV) (OR 7; CI = 3.4-14.6, P < 0.005). Retinal break was significantly associated with poor anatomical outcome (OR 0.21; CI = 0.09-0.5, P < 0.005). Conclusion: MIVS along with wide angle viewing systems allow surgeons to effectively manage ROP surgeries while at the same time reducing complication rate in these eyes which have complex pathoanatomy and otherwise grim prognosis.


Assuntos
Microcirurgia/métodos , Descolamento Retiniano/cirurgia , Retinopatia da Prematuridade/complicações , Acuidade Visual , Vitrectomia/métodos , Pré-Escolar , Feminino , Seguimentos , Idade Gestacional , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Oftalmoscopia , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/etiologia , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
7.
Indian J Ophthalmol ; 67(6): 896-902, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124511

RESUMO

Purpose: To report the anatomical and functional outcomes of vitreoretinal surgery in eyes with "regressed ROP" presenting with rhegmatogenous retinal detachment (RRD). Methods: In this retrospective interventional case series, twenty-two eyes (of 22 patients) with regressed ROP, who underwent surgery for RD. Primary outcome measures were final anatomical and visual outcome for scleral buckling and pars plana vitrectomy (PPV). Visual outcomes were categorized into three groups: improved, remained stable, and deteriorated. Univariate binary logistic regression analysis was used to determine the risk factors for RD. Results: Of 22 eyes in the study, overall anatomic success was achieved in 16 of 22 eyes (72.7%). The macula was attached in 17 of 22 eyes (77.3%) at final visit. In the scleral buckle (SB) group, overall anatomical success was achieved in six of seven eyes (85.7%). Overall, in the PPV group, anatomical success was seen in 10 of 15 eyes (66.7%) at final visit. At final follow-up, significant improvement in best-corrected visual acuity from baseline was seen in 11 cases (50%, P = 0.02), stable in 5 cases (22.7%), and significant visual deterioration was seen in 6 cases (27.3%, P = 0.02). The total mean follow-up duration of the patients was 45.5 months (range: 2.1 months to 11.2 years). Conclusion: Early recognition and surgical intervention in such cases can lead to a high rate of anatomical success and can prevent the development of profound visual impairment in some patients.


Assuntos
Descolamento Retiniano/cirurgia , Retinopatia da Prematuridade/complicações , Acuidade Visual , Cirurgia Vitreorretiniana/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Oftalmoscopia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Retinopatia da Prematuridade/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
Indian J Ophthalmol ; 67(6): 908-911, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124513

RESUMO

Purpose: To report anatomical and functional results of vitreoretinal surgery in our case series of late cicatricial retinopathy of prematurity (ROP) patients with subtotal retinal detachment. Methods: This is a retrospective, consecutive case series. Eleven eyes of 10 patients presented with partial tractional retinal detachment secondary to late cicatricial ROP (cicatricial stage 4B) who underwent vitreoretinal surgery were retrospectively reviewed. Anatomical and functional outcomes were evaluated. Results: The mean gestational age at birth was 28.6 (26-32) weeks. The mean age at surgery was 79 (4-213) months. Patients were followed up for 21.7 (6-40) months. Six eyes (55%) had lens-sparing vitrectomy and five eyes (45%) had lensectomy + vitrectomy. Anatomical success was achieved in 10 eyes (91%). Improvement in visual acuity was noted in nine eyes (82%). Conclusion: Eye grows but fibrotic tissue does not grow with age, and during this period retinal traction may get worse. Relieving these tractions may lead to good anatomical and visual outcomes in selected late cicatricial ROP cases.


Assuntos
Cicatriz/cirurgia , Descolamento Retiniano/cirurgia , Retinopatia da Prematuridade/cirurgia , Acuidade Visual , Cirurgia Vitreorretiniana/métodos , Criança , Pré-Escolar , Cicatriz/diagnóstico , Cicatriz/etiologia , Progressão da Doença , Feminino , Seguimentos , Idade Gestacional , Humanos , Lactente , Masculino , Oftalmoscopia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento
9.
Indian J Ophthalmol ; 67(6): 928-931, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124517

RESUMO

Purpose: To explore the knowledge of retinopathy of prematurity (ROP) and habilitation services for children with visual loss from ROP, among health care professionals (HCPs) involved in care of preterm children and to explore their attitudes and practices in relation to referral for habilitation. Methods: A modified knowledge, attitude and practice questionnaire were administered to ophthalmologists and paediatricians associated with ROP care. Data were collected about their knowledge, beliefs and practices of ROP and referral to rehabilitation facilities. Data were analysed to establish level of knowledge, type of attitude and practices and its association with speciality. Results: Response rate was 78% (25/32). Most (14/25, 56%) were ophthalmologists. All (100%) participants knew that ROP can cause blindness. Knowledge about Indian ROP screening criteria was poor among a third (8/25, 32%), more so in paediatricians (5/11, 45.5%). Most (21/25, 84%) did not have knowledge of what a habilitation service entails and where such facilities are located. More than two-thirds (18/25, 72%) believed that special education should be preferred over inclusive education. Overall, 10/25 (40%) of the HCPs had never referred a child for rehabilitation. More than a half (13/25, 52%) were not confident of counselling parents of blind children. All agreed that rehabilitation services are not part of but should be included in medical curriculum. Conclusion: Indian guidelines for ROP screening are not universally known among HCPs. Educating medical undergraduates, providing counselling training to professionals and integration of rehabilitation into the health system will ensure continuity of care for children with visual loss and their families.


Assuntos
Cegueira/reabilitação , Conhecimentos, Atitudes e Prática em Saúde , Triagem Neonatal/métodos , Pediatras/normas , Retinopatia da Prematuridade/reabilitação , Acuidade Visual , Adolescente , Adulto , Distribuição por Idade , Cegueira/epidemiologia , Cegueira/etiologia , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/fisiopatologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
11.
Zhonghua Yan Ke Za Zhi ; 55(4): 246-249, 2019 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-30982286

RESUMO

With the rapid development of perinatology in China and the implementation of the two-child policy, the survival rate of premature and low weight infants is obviously improved, and the incidence of retinopathy of prematurity (ROP) in preterm infants has been increasing year by year. ROP can lead to blindness when it is serious. It is the first cause of blindness of children in our country, and it is a heavy burden on family and society. With novel insights in the pathogenesis of the disease, anti-vascular endothelial growth factor pharmacotherapy has blated its way into ophthalmological practice and significantly changed the management of ROP. However, facing such promising drugs, we still need to take caution with the safety and long-time efficacy, investigate more reasonable dosing schedules and study the follow-up time. (Chin J Ophthalmol, 2019, 55: 246-249).


Assuntos
Retinopatia da Prematuridade/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Cegueira/etiologia , Criança , China , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Retinopatia da Prematuridade/complicações , Taxa de Sobrevida
12.
J Pediatr Ophthalmol Strabismus ; 56(2): 88-94, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30889262

RESUMO

PURPOSE: To determine the incidence of amblyopia risk factors during the first 3 years of life in premature children. METHODS: This prospective cohort included 145 premature children (gestational age of less than 37 weeks) who were evaluated for amblyopia risk factors every 6 months until age 3 years. The incidence rate, cumulative incidence, and prevalence of any amblyopia risk factor were assessed in retinopathy of prematurity (ROP) and non-ROP screened groups. Multivariate logistic regression was performed to evaluate variables associated with the development of an amblyopia risk factor. RESULTS: The 3-year incidence rates of amblyopia risk factors were similar between the non-ROP and ROP screened groups (18 versus 19 cases per 1,000 person-years, respectively). The 3-year cumulative incidence was also similar: 32% (95% confidence interval [CI]: 18 to 47) in the non-ROP and 14% (95% CI: 5 to 28) in the ROP screened group (P > .05). In the ROP screened group, the prevalence rates were 20% or greater at most time points. In the non-ROP screened group, the prevalence rates were 11% to 14% during the first 18 months and increased to more than 20% at 24 months and thereafter. Astigmatism was the most prevalent amblyopia risk factor in both groups (7% to 18%). CONCLUSIONS: The incidence of amblyopia risk factors was not significantly different between non-ROP and ROP screened children in our cohort. The prevalence of refractive errors among premature non-ROP screened children was higher than that reported in childhood in the literature. It may be appropriate to screen all children with a history of prematurity for refractive errors around 24 months of age. [J Pediatr Ophthalmol Strabismus. 2019;56(2):88-94.].


Assuntos
Ambliopia/epidemiologia , Doenças do Prematuro/epidemiologia , Recém-Nascido Prematuro , Retinopatia da Prematuridade/complicações , Medição de Risco/métodos , Ambliopia/etiologia , California/epidemiologia , Pré-Escolar , Feminino , Seguimentos , Idade Gestacional , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Prospectivos , Retinopatia da Prematuridade/epidemiologia , Fatores de Risco
13.
Ophthalmic Epidemiol ; 26(4): 223-230, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30821627

RESUMO

Purpose: Retinopathy of prematurity (ROP) is widely regarded worldwide as a major cause of childhood blindness, however until recently the disease has not been recognized in most of the African continent. As a result of changing economic conditions, there is growing evidence that the population at risk for ROP in Africa is increasing. This report aims to summarize the published literature on ROP from Africa. Methods: We performed a systematic literature review of the English and French online literature databases by applying a general search strategy initially on May 1, 2017 with repeat inquiry on May 20, 2018. Search phrases included multiple variants of terms including "ROP", "retinopathy of prematurity", in conjunction with each of the individual 54 recognized sovereign African states. Findings: A total of 25 individual studies from six African nations were identified: South Africa (10), Egypt (7), Nigeria (4), with the nations of Sudan, Rwanda, and Kenya each having one respective study. Two countries (South Africa and Kenya) have developed national ROP policies for primary and secondary prevention. Summary: Review of the published literature suggests that ROP is emerging in Africa, however, there are published data from 6/54 (11%) African nations. Blindness from ROP is often preventable with appropriate primary and secondary prevention. This report provides compelling evidence that these efforts should be undertaken to implement and evaluate regionally appropriate ROP prevention programs in a growing number of African countries.


Assuntos
Cegueira/epidemiologia , Retinopatia da Prematuridade/epidemiologia , África/epidemiologia , Cegueira/etiologia , Criança , Humanos , Incidência , Prevalência , Retinopatia da Prematuridade/complicações
15.
Invest Ophthalmol Vis Sci ; 60(1): 98-106, 2019 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-30640977

RESUMO

Purpose: The purpose of this study was to prospectively investigate the association between retinopathy of prematurity (ROP) and ocular growth in premature infants during the earliest weeks of life. Methods: Premature infants in the national ROP screening program were recruited and examined at 1- or 2-week intervals between 30 and 38 weeks of postmenstrual age. One hundred infants with gestational age (GA) between 24 and 35 weeks (30.04 + 2.13), and birth weight (BW) between 550 and 2060 g (1251.45 + 317.19) were included in the study. At each examination, the presence, stage, and zone of ROP were recorded along with axial length (AL), central corneal thickness (CCT), and weight gain. Biometric parameters were measured by A-scan biometry. Study variables included GA, BW, AL, CCT, weight gain, relative weight (RW), and dif_AL, dif_CCT, and dif_weight, which are the differences between two consecutive recordings of the same infant. Multiple regression analysis models were used to determine the association between the study variables and ROP. Results: dif_AL, dif_CCT, and RW were the most appropriate variables to detect the optimal threshold points that discriminate ROP: weekly increase of AL < 0.095 mm, weekly reduction of CCT < 0.5 µm, or weekly weight gain < 7% is associated with ROP development. Conclusions: ROP is associated with delayed ocular development, as eyes of premature infants with ROP have shorter axial lengths and thicker corneas than eyes of premature infants without ROP. The association of AL, CCT, and weight gain with ROP could be of value for future development of predictive models for ROP.


Assuntos
Olho/crescimento & desenvolvimento , Retinopatia da Prematuridade/complicações , Biometria , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Estudos Prospectivos , Retinopatia da Prematuridade/fisiopatologia
17.
JAMA Netw Open ; 2(1): e186801, 2019 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-30646195

RESUMO

Importance: Retinopathy of prematurity (ROP) can cause severe visual disability even in high-resource settings. A better understanding of the prevalence and processes leading to ROP-induced severe visual impairment may help health care professionals design preventive measures. Objectives: To determine the prevalence of severe visual disability among children born preterm in Sweden, evaluate adherence to best practice, and determine the health system's structural capacity. Design, Setting, and Participants: Population-based, nationwide cohort study of 1 310 227 children born between January 1, 2004, and December 31, 2015, in Sweden, of whom 17 588 (1.3%) were born very preterm (<32 weeks of gestation). Children born preterm with a verified diagnosis of severe visual disability had their medical records reviewed for evaluation of ROP screening, diagnosis, and treatment. In addition, a questionnaire on structural capacity was sent to all ophthalmology departments. Exposures: Stages 4 and 5 ROP. Main Outcomes and Measures: The primary outcome was prevalence of severe visual disability (visual acuity ≤20/200 for both eyes) associated with ROP stages 4 and 5. Secondary outcomes included adherence to national ROP guidelines using a predefined protocol with 15 key performance indicators for screening, diagnosis, and treatment; assessment of whether visual disability was deemed avoidable; and examination of structural capacity, including information on equipment and facilities, staffing, and patients. Results: Seventeen children (10 boys; mean [range] birth weight, 756 [454-1900] g; mean [range] gestational age, 25 [22-33] weeks) became severely visually disabled because of ROP, corresponding to a prevalence of 1 in 1000 very preterm infants (<32 weeks of gestational age) and 1 in 77 000 for all live births. Severe visual impairment was considered potentially avoidable in 11 of 17 affected children (65%) owing to untimely or no screening, missed diagnosis, or untimely and suboptimal treatment. Large variations in infrastructure (facilities, guidelines, staffing, and annual patient numbers) were also identified as potential contributors to these findings. Conclusions and Relevance: Retinopathy of prematurity still causes severe visual disability in Sweden, resulting in 1 affected infant per 1000 very preterm births. In most of these infants, noncompliance with best practice was identified, indicating that a significant proportion could have been avoided.


Assuntos
Fidelidade a Diretrizes/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Retinopatia da Prematuridade , Transtornos da Visão , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Recém-Nascido , Masculino , Registros Médicos/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Prevalência , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/terapia , Índice de Gravidade de Doença , Suécia/epidemiologia , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia , Transtornos da Visão/prevenção & controle
18.
Retin Cases Brief Rep ; 13(1): 72-74, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-28092313

RESUMO

PURPOSE: The tractional retinoschisis is a poorly understood, rare, and likely underappreciated entity in retinopathy of prematurity. The purpose of this article is to describe clinical findings and surgical management of tractional retinoschisis in retinopathy of prematurity, masquerading as Stage 4 retinopathy of prematurity retinal detachment. METHODS: A retrospective review of a single case with literature review and case discussion. RESULTS: In this report, we describe a child with retinopathy of prematurity and tractional schisis, who initially presented with vitreous hemorrhage and was effectively managed by vitrectomy and inner wall retinectomy. At 5 months after vitrectomy, the child demonstrated complete collapse of the retinoschisis with intact posterior pole and brisk light perception. CONCLUSION: Vitrectomy with or without inner wall retinectomy is effective in the management of tractional retinoschisis.


Assuntos
Retinopatia da Prematuridade/complicações , Retinosquise/cirurgia , Acuidade Visual , Vitrectomia/métodos , Hemorragia Vítrea/cirurgia , Humanos , Recém-Nascido , Masculino , Retinopatia da Prematuridade/cirurgia , Retinosquise/diagnóstico , Retinosquise/etiologia , Hemorragia Vítrea/diagnóstico , Hemorragia Vítrea/etiologia
19.
J Glaucoma ; 28(1): 20-26, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30461550

RESUMO

PURPOSE: The purpose of this study was to report presentation and outcomes of coexisting congenital glaucoma with retinopathy of prematurity (ROP) in "Indian Twin cities ROP study (ITCROPS)." METHODS: Children with ROP and congenital glaucoma were identified from ITCROPS (prospective digital database) between 1997 and 2016. The presentation, interventions, and outcomes for glaucoma and ROP were evaluated. RESULTS: Out of 15,000 premature-infants database, 3000 children had ROP, of these 87 eyes of 64 premature children had glaucoma. Five eyes (5.7%) of 3 children in the entire ROP cohort had coexisting congenital glaucoma (before any ROP intervention), 3 eyes of 2 children had primary congenital glaucoma and 2 eyes of one child had glaucoma with microspherophakia. The mean age at surgery was 2.7±0.6 months. At presentation, all eyes had corneal edema, mean corneal diameter was 10.3±0.75 mm and IOP was 20.4±1.67 mm Hg. Three eyes had stage-2 ROP and two eyes had stage-3 ROP. Four eyes received intravitreal Bevacizumab. All eyes underwent combined trabeculotomy with trabeculectomy. Post glaucoma surgery, 2 eyes underwent laser for ROP and 1 eye with stage-2 ROP was observed with no treatment. ROP regressed without any sequalae in all 5 eyes. Two eyes with microspherophakia and one eye with lens coloboma underwent lensectomy. One eye postlensectomy needed Ahmed glaucoma valve implant for IOP control. The mean IOP at last follow-up was 13.6±1.67 mm Hg and all eyes needed topical antiglaucoma medications for IOP control. CONCLUSIONS: Congenital glaucoma coexisting with ROP is a medical emergency. Intravitreal therapy can help tide over the vision-threatening fulminant phase of ROP while awaiting the effect of glaucoma surgery on corneal clarity. The need for medications even after glaucoma surgery suggests severe glaucoma phenotype. Close coordination between subspecialties is needed for best outcomes.


Assuntos
Hidroftalmia/complicações , Hidroftalmia/terapia , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/terapia , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Peso ao Nascer , Idade Gestacional , Implantes para Drenagem de Glaucoma , Humanos , Hidroftalmia/diagnóstico , Lactente , Recém-Nascido Prematuro , Pressão Intraocular/fisiologia , Injeções Intravítreas , Fotocoagulação a Laser , Masculino , Estudos Prospectivos , Retinopatia da Prematuridade/diagnóstico , Trabeculectomia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Cirurgia Vitreorretiniana
20.
J Pediatr Ophthalmol Strabismus ; 55(6): 403-406, 2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30452767

RESUMO

PURPOSE: To analyze the yearly refractive trend in patients with stage 3 retinopathy of prematurity (ROP) over a 7-year time period. METHODS: This was a retrospective review of 70 eyes of 35 patients with stage 3 ROP. RESULTS: Of the 70 eyes, 46 received laser ablation and 24 did not. There was a similar distribution between zone II and zone III disease in both groups (P = .87). The average final refraction in the laser group was -0.83 diopters (D) in comparison to +1.61 D in the no laser group. The final refractive change was -3.55 D in the laser group and -0.25 D in the no laser group. A greater myopic shift was observed in the first 2 years of life than between years 2 and 7 in both groups. CONCLUSIONS: Infants who underwent laser treatment for stage 3 ROP tended to have higher myopia than those with stage 3 ROP who did not require treatment. [J Pediatr Ophthalmol Strabismus. 2018;55(6):403-406.].


Assuntos
Bevacizumab/administração & dosagem , Refração Ocular/fisiologia , Erros de Refração/etiologia , Retinopatia da Prematuridade/complicações , Cirurgia Vitreorretiniana/métodos , Inibidores da Angiogênese/administração & dosagem , Progressão da Doença , Feminino , Humanos , Lactente , Recém-Nascido , Injeções Intravítreas , Masculino , Prognóstico , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Erros de Refração/diagnóstico , Erros de Refração/fisiopatologia , Retinopatia da Prematuridade/fisiopatologia , Retinopatia da Prematuridade/terapia
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