Objective To observe the clinical characteristics and treatment outcomes of aggressive posterior retinopathy of prematurity(AP-ROP). Methods Thirty-five eyes (18 patients) diagnosed with AP-ROP were studied from January 2006 to January 2011. All the patients were examined by 28 D optical lens, sclera compressor and wide-angle digital retinal imaging system (RetCamⅡ). Laser photocoagulation with 532 nm wavelength using binocular indirect ophthalmoscope was used in all the infants within 12 hours after confirmed diagnosis. Thirteen eyes (37.1%) progressed to retinal detachment after laser photocoagulations were surgically treated, while 22 eyes (62.9%) underwent laser photocoagulation alone. Followup ranged from 6 months to 5 years, with a mean of 23.5 months. Results All AP-ROP lesions are located in zone 1 and posterior zone 2, with substantial dilated and tortuous retinal vessels. It is difficult to distinguish between the retinal vein and small arteries. There are shunts from vessel to vessel within the retina and no clear boundary between the vascularized and non-vascularized retina. Neovascularization lesions are flat and hard to be identified. There are no demarcation ridges. After laser treatment, 22 eyes achieved good outcomes. Among 13 eyes who received vitrectomy, 8 eyes achieved retinal reattachment after surgery, while 5 eyes developed total retinal detachment. Conclusion AP-ROP has specific clinical manifestations. Timely laser photocoagulation and early surgical treatment is necessary for AP-ROP.
ObjectiveTo analyze the risk factors of severe retinopathy of prematurity (ROP) and provide consultable evidence for the rational establishment of screening standard.MethodsThe clinical data of 168 prematureinfants (gestational age less than 37 weeks) who was diagnosed in our department from Dec 2002 to Apr 2004 was analyzed retrospectively. Gender, birth count (BC), gestational age (GA), birth weight (BW), duration of oxygen therapy and vascularization devlopment of posterior and peripheral retina examined by binocular indirect ophthalmoscope after mydriasis were recorded. The results were recorded by the international classification of ROP (ICROP), and stage 1, 2 and 3 were mild ROP while threshold disease, stage 4 and 5 were severe ROP. Logistic regression was appliedto analyze the relationship of ROP and gender, BC, GA, BW, and oxygen therapy. ResultsSevere ROP was found in 91 eyes (27.1%) of 47 infants (28.0%) in 336 eyes of 168 premature infants, including threshold disease in 20 eyes (6.0%) and disease at stage 4 in 11 eyes (3.3%) in which the diseases at stage 4A was foundin 2 eyes (0.6%) and stage 4B in 9 eyes (2.7%). There were 60 eyes (17.8%) at stage 5. In all of the factors, GA, BW and oxygen therapy were found to have a significant impact on severe ROP (P=0.000, 0.000 and 0.015,α=0.05) while gender and BC were not (P=0.640 and 0.084, α=0.05). Statistic analysis of subgroupshowed that the risk of severe ROP in premature infants would increase significantly when GA≤30 weeks, BW≤1500 g or oxygen therapy gt;4 days. Conclusions Severe ROP relates to GA, BW and oxygen therapy instead of gender and BC. The risk of occurrence of severe ROP in premature infants increases significantly when GA≤30 weeks, BW≤1500g or oxygen therapy gt;4 days, so it is recommended to screen such premature infants carefully. (Chin J Ocul Fundus Dis,2005,21:271-274)
ObjectiveTo evaluate the prognosis of photocoagulation and (or) cryotherapy for prethreshold type 1 and threshold disease of retinopathy of prematurity (ROP).MethodsThe data of 29 eyes of 15 infants who were diagnosed as with prethreshold type 1 or threshold disease of ROP from Jan 30th, 2003 to Jan 13th, 2005 were retrospectively analysed. Pre- and post-operative conditions of ROP were compared in the follow up. Any related local and systemic complications were recorded.ResultsIn 29 eyes which had undergone photocoagulation and (or) cryotherapy, ROP regressed completely in 19 (65.5%), remained dragged retina was found in 7 (24.1%), and retinal detachment was seen in 3 (103%). ROP regressed completely in 12 eyes (41.4%) after the initial treatment and in 7 eyes (24.1%) after the secondary treatment. During the treatment, temporary corneal haze was found in 2 eyes, vitreous hemorrhage occurred in 1 eye, and inadvertent photocoagulation at macular area happened in 1 eye. No systemic complications were found in all cases.ConclusionTimely treatment of photocoagulation and (or) cryotherapy for prethreshold type 1 and threshold disease of ROP may lead to famous prognosis.(Chin J Ocul Fundus Dis,2005,21:278-281)
Objective To evaluate the prognosis of retinopathy of prematurity (ROP) following the screening and treatment guidelines of the Chinese Ministry of Public Health. Methods From December 2003 to December 2010, 1379 premature infants diagnosed with ROP were followed by binocular indirect ophthalmoscopy or fundus photography using RetcamⅡ digital camera. For the stage 1 ROP, eyes were followed every 2 weeks until the ROP regressed. For the stage 2 ROP or pre-threshold disease, eyes were followed weekly. If the ROP decreased, eyes were followed every two weeks until the ROP regressed completely. For the stage 3 ROP or acute progressive ROP (AP-ROP), eyes were followed 2-3 times weekly. If the ROP progressed to threshold or type 1 pre-threshold disease, laser therapy was performed within 72 hours. After laser treatment, eyes were followed every 1 -2 weeks. Laser or cryotherapy was conducted when the ROP progressed after first treatment. Scleral buckle and vitrectomy with closed triple incisions was conducted when the ROP progressed to stage 4 and stage 5. The period the infants were followed ranged from 6 months to 2 years (average 152.3 days). ResultsA total of 2758 eyes of 1379 infants were diagnosed with ROP. The gestational age range was 26 . 35 weeks (average 30.6 weeks) and the birth weight of 800-2200 grams (average 1424.6 grams). Four hundred eyes (14.5%) of 206 infants with threshold or type 1 pre-threshold disease were given laser treatment. Three hundred and forty-five eyes (86.2%) completely regressed, and 55 eyes (13.8%) progressed to unfavorable structural outcomes. All 2358 eyes that did not reach threshold or type 1 prethreshold disease regressed completely. The total regression rate of our study was 980%. The incidence of unfavorable structural outcomes was 2.0% including stage 4 in 32 eyes (1.2%) and stage 5 in 13 eyes (0.5%). The retina reattatched in all 6 eyes treated with scleral buckle but macular traction remained at the optic disc. In the 39 eyes treated using vitrectomy with or without lensectomy, the retina reattached completely in 17 eyes at stage 4a. In 15 eyes at stage 4b, the retina reattached completely in 10 and remained detached in 5 eyes. In the 13 eyes at stage 5, the retina reattached completely in 4, and reattached mostly in 1 eye. Conclusion The incidence of severe ROP leading to unfavorable structural outcomes can be effectively reduced by screening and timely treatment.