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At least 19 recordsLinked to original sources
PubMed1996

Outcome of prematurity and retinopathy of prematurity.

Retinopathy of prematurity is a disease that manifests soon after birth in the premature infant and may lead to a lifelong disability. More infants at risk for developing the retinopathy are surviving, and the ophthalmologist must be aware of possible vision abnormalities, such as decreased acuity, strabismus, nystagmus, retinal scarring, and retinal detachment, that occur during childhood and in adult life. These abnormalities may occur in children who developed only mild forms of retinopathy of prematurity during early life.

Adult↗
PubMed1990

[Premature retinopathy: recommendations for a screening policy].

Few data exist from which an optimal strategy for retinopathy of prematurity (ROP) screening can be deduced. This strategy should compromise between the dual purpose of screening, to wit monitoring the incidence of ROP and determining an optimal moment for therapeutic intervention. We recorded the timely incidence and course of ROP in all except four premature infants admitted during a 1-year period. The study results indicated that a single screening moment is not likely to detect more than 70% of all cases. When relying, however, on a single screening the investigation should be performed between the 7th and 9th week. The unpredictable course of ROP, varying between early starting, rapidly progressing forms and very late starting, usually benign forms, probably precludes the possibility of 100% ROP detection. Screening during the 4th to 5th, 8th and 11th week probably gives the best chances for determination of an optimal moment for treatment and approximation of the incidence.

Follow-Up Studies↗
PubMed2005

Retinopathy of prematurity.

Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina that occurs in premature and low birth weight babies. Stages of ROP are 1, 2, 3, 4A, 4B and 5. There are three zones I, II and III. Screening is essential to detect ROP. Whom, when and how to screen ROP has been narrated in a nutshell. Once threshold ROP is detected, it is essential to treat within 72 hours. Retinal ablation of the avascular retina is done using laser photocoagulation or cryotherapy. Rush disease is primarily a zone I ROP with extraretinal proliferation. It requires aggressive laser treatment with larger number of high intensity closely applied spots to stop the progression. Surgical management is advocated in stages IVA and IVB ROP by scleral buckling. Stage V requires complex vitreoretinal surgery. It is important to promote awareness about the disease and to ensure timely management to prevent blindness.

Clinical Trials as Topic↗
PubMed1989

Increased survival of low birth weight infants: impact on the incidence of retinopathy of prematurity.

Retinopathy of prematurity is a retinal vascular disease that occurs only in premature infants. Because of concern that the occurrence of this potentially blinding disease is increasing, a retrospective chart review was undertaken to compare the incidence of retinopathy of prematurity at the University of Washington during the years 1981 to 1984 with previously published data collected at the same institution during the years 1968 to 1980. During 1981 to 1984, there was an increase in the annual numbers of admissions and survivors weighing 1750 g at birth; the survival rate increased significantly (P less than .000001). A trend toward an increased risk for proliferative retinopathy of prematurity (P = .057) during 1981 to 1984 period was noted, but the number of "excess cases" was calculated to be only 6 per year. The remainder of the additional cases, 19 annually, were due to increased survival of infants at risk. Thus, the "second epidemic" of retinopathy of prematurity is largely due to improved survival of low birth weight infants rather than to new iatrogenic factors. In infants with proliferative retinopathy of prematurity, there was a previously unreported association between increased severity of disease and lower birth weight (P = .015). There were four children with severe bilateral visual loss due to retinopathy of prematurity identified during the 1981 to 1984 period, whereas only one bilaterally blind infant was noted during the preceding 12.7 years.

Birth Weight↗
PubMed2001

Low IGF-I suppresses VEGF-survival signaling in retinal endothelial cells: direct correlation with clinical retinopathy of prematurity.

Retinopathy of prematurity is a blinding disease, initiated by lack of retinal vascular growth after premature birth. We show that lack of insulin-like growth factor I (IGF-I) in knockout mice prevents normal retinal vascular growth, despite the presence of vascular endothelial growth factor, important to vessel development. In vitro, low levels of IGF-I prevent vascular endothelial growth factor-induced activation of protein kinase B (Akt), a kinase critical for endothelial cell survival. Our results from studies in premature infants suggest that if the IGF-I level is sufficient after birth, normal vessel development occurs and retinopathy of prematurity does not develop. When IGF-I is persistently low, vessels cease to grow, maturing avascular retina becomes hypoxic and vascular endothelial growth factor accumulates in the vitreous. As IGF-I increases to a critical level, retinal neovascularization is triggered. These data indicate that serum IGF-I levels in premature infants can predict which infants will develop retinopathy of prematurity and further suggests that early restoration of IGF-I in premature infants to normal levels could prevent this disease.

Base Sequence↗
PubMed1990

Retinopathy of prematurity.

Retinopathy of prematurity has reappeared in the neonatal nursery after largely disappearing 35 years ago. The major factor in its reemergence is the progressive improvement in neonatal care, resulting in salvage of infants who formerly would have been lost. Oxygen is now recognized to be but one of many interacting factors in the development of retinopathy of prematurity, with extreme immaturity being the primary factor. Methods of examination, classification and treatment of retinopathy of prematurity are discussed.

Humans↗
PubMed2006

Oxygen and retinopathy of prematurity.

Retinopathy of prematurity is on the rise and a third epidemic has been identified. In spite of extensive research and progress in the understanding of this disease in recent years, 50 000 children worldwide are blinded by this condition each year. The relation between hyperoxia, low-gestational age, growth retardation, oxygen dependent growth factors, and oxidative stress are now being understood more clearly. We know that in the first phase of retinopathy of prematurity, hyperoxia inhibits vascular endothelial growth factor. In the second phase, vascular endothelial growth factor rises, and when insulin-like growth factor-1 reaches a threshold around 32 to 34 weeks postconceptional age, uncontrolled neovascularization may occur. It is not known whether this new knowledge will have implications for future therapy. However, by strictly avoiding hyperoxia, that is, SaO2>92-93% and avoiding fluctuations in SaO2, it is possible to control and prevent severe retinopathy of prematurity in most cases.

Angiogenesis Inducing Agents↗
PubMed2005

[Emphasizing the prevention and treatment for retinopathy of prematurity].

Retinopathy of prematurity (ROP) (previously called retrolental fibroplasia), is a proliferative retinopathy of premature and low birth weight infants related with receiving oxygen therapy. ROP is the leading cause of children blindness in the developed countries. With the improvement of health level in our country, perinatal medicine has obtained much development. With the improvement of life support systems, the survival rate of premature in our country is becoming higher and the incidence of ROP is increasing accordingly. The children blindness caused by this illness is increasing, which should obtain the ophthalmologists highly attention. In this article, we discuss the data of ROP incidence in the world; the history of ROP prevention and treatment; the development of the retina, the histopathology of ROP; the international classification of ROP and the timing limit of treatment of ROP. ROP is the leading cause of children blindness in the developed countries. ROP incidence is related with the NICU's treatment and the application of relevant medical laws.

Humans↗
PubMed2004

[Recent advances in retinopathy of prematurity].

Retinopathy of prematurity (ROP) is a vasoproliferative retinopathy. Worldwide, ROP is a major cause of blindness in children. This chapter describes its risk factors, etiology, diagnosis, treatment and recent advances.

Blindness↗
PubMedDate not supplied

Retinopathy of prematurity.

Retinopathy of prematurity (ROP) is a bilateral retinal disease found in premature infants born at less than 36 weeks gestation or weighing less than 1,600 g. Several recent studies have suggested a multifactorial basis for ROP development. Risk factors include apnea treated by mask or bag ventilation, repeated blood transfusions, prolonged parenteral nutrition, hypoxemia, hypercarbia, hypocarbia, and supplemental oxygen administration. Disease stages are: stage 1--demarcation line; stage 2--intraretinal ridge; stage 3--ridge plus extraretinal fibrovascular proliferation; and stage 5--total retinal detachment.

Cryosurgery↗
PubMed1999

[Indirect diode laser treatment and cryotherapy in retinopathy of prematurity].

Retinopathy of prematurity (ROP) is a major cause of blindness in babies. To explore the incidence, treatment and short-term outcome of the disease in Romania, a small scale study on 24 preterm infants with gestational age < 32 weeks and birthweight < 1500 g was undertaken. Gestational age was < 28 weeks in 66.6% and birthweight was < 1000 g in 70.8% of the children. The average age at the first examination with the indirect ophthalmoscope was 31.8 weeks, only two children having been seen at less than 6 weeks of age. 66.6% of the babies had ROP in various stages with 93.8% of these having bilateral (symmetrical or asymmetrical) abnormalities. 37.5% of the babies with ROP were in stage 5. 12.5% (2 patients) had bilateral threshold disease: one infant was treated with diode laser delivered with the laser indirect ophthalmoscope and the other with cryotherapy. In three eyes of these two infants the disease regressed. No major short term complications were noted and no second session of treatment was necessary. In our patients, the well-recognised correlation between the incidence and severity of the disease and gestational age and, to a lesser extent, birthweight was confirmed. Lack of equipment was the main reason for the delay in diagnosis. The extent of the disease in our patients, in a country where the number of surviving preterm babies is expected to increase in the coming years, warrants the initiation of a national screening programme for retinopathy of prematurity in Romania.

Cryosurgery↗
PubMed2005

[Surgical treatment of late tractional retinal detachment appearing on the basis of retinopathy of prematurity].

Retinopathy of prematurity (ROP) is a proliferative retinopathy affecting predominantly immature children and children with low birth weight under 2500 g in 5-6%. During 11 years we operated on 15 eyes of 15 patients aged 5-31 years, because of late tractional retinal detachment (TRD) appearing on the basis of ROP. The average follow-up period was 37.2 months; the minimal follow-up period was 1 year. In all patients, the personal medical history revealed the pre-term birth at the gestation age of 28-34 weeks. The birth weight was in the range 850-1600 grams. According to the extend of vitreoretinal traction and type of retinal defect we indicated: a) primary cryosurgical procedure (CP) with episcleral silicone implants. The operation was indicated in 6 eyes: cerclage, segmental perilimbal plombage in the temporal half and puncture of the subretinal fluid; b) pars plana vitrectomy (PPV). In total in 9 eyes the PPV was indicated, in 5 eyes it was supplemented with relaxing retinotomy, and in 7 eyes with silicone oil (SO) implantation. Three eyes were re-operated by means of PPV with SO implantation. The final anatomical success of the surgical treatment of the prognostic unfavorable TRD, including re-operations was achieved in 12 eyes (80%), which we consider as a good one. The visual acuity improved or remained the same also in 12 eyes (80%) and visual acuity 6/60 and better (20/200 or 0.1) in 8 out of 15 eyes (53%).

Adolescent↗
PubMed2000

Avoidance and treatment of retinopathy of prematurity.

Retinopathy of prematurity is a blinding eye disease of premature infants. It is increasing in incidence as more babies of lower birth weights survive. Although in the 1940s and 1950s the major predisposing factor was high oxygen exposure, the main risk factor now is birth weight less than 1,000 g. Retinopathy of prematurity can be classified into several distinct stages, which progress in a typical manner. Once the stage of threshold is reached, the eye has a 50% chance of becoming blind. At this stage, laser peripheral retinal photo ablation or peripheral cryo ablation may cause the neovascularization to regress and preserve vision. The treatment is not effective in all cases, however, and a large number of children continue to become blind each year because of this devastating disease. New microsurgical techniques such as lens-sparing vitrectomy and modified scleral buckle for tiny eyes have improved the outcome for some children. Prevention is the best hope to eradicate blindness caused by this disorder, and manipulations of the metabolic and neonatal intensive care unit environment are currently being studied.

Cryotherapy↗
PubMed1999

Results of screening low-birth-weight infants for retinopathy of prematurity.

Retinopathy of prematurity (ROP) continues to be an important cause of potentially preventable blindness worldwide. The pattern of visual impairment from ROP in some middle-income countries--high rates affecting larger and more mature infants--resembles that seen in more developed countries two decades ago and has been called a "third epidemic" of the disease. Expert bodies in the United Kingdom and the United States have recently issued new guidelines for screening for ROP that utilize both birth weight and gestational age criteria. Studies in both countries suggest these criteria might be further revised to decrease time spent on screening without missing any significant disease. Population-based follow-up studies of extremely preterm infants suggest that although more preterm infants are surviving, with adequate screening and treatment, rates of blindness from ROP may be declining. Further information on the longer-term impact of ROP comes from a number of studies and particularly the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study. The risk of both myopia and strabismus is increased with any and each higher stage of ROP. Evidence is emerging that laser therapy for threshold disease may be associated with better visual outcome than cryotherapy, although complications following the former remain a concern. The fight against ROP may be enhanced by new information on the pathogenesis, including possible genetic predisposition and the role of vascular endothelial growth factor.

Blindness↗
PubMed1995

Retinopathy of prematurity.

Retinopathy of prematurity is a common disorder among extremely low-birthweight preterm infants and may cause total vision loss in as many as 2% to 4% of those weighing less than 2 pounds at birth. Regular examinations begun in the neonatal intensive care unit permit early detection and treatment of progressive ROP and allow a reduction in visual impairment. Infants whose ROP has regressed should continue to receive regular ophthalmologic follow-up for the detection and treatment of myopia and strabismus and, if they have cicatricial sequelae, late retinal detachments as teens or adults. Early intervention and special education programs are important for the children whose vision loss is significant.

Adolescent↗
PubMed1995

Transcutaneous oxygen levels in retinopathy of prematurity.

Retinopathy of prematurity (ROP) is a potentially blinding disease of preterm infants. 21 days of computer-recorded transcutaneous oxygen (TcPO2) data were compared in 31 infants with stage 3 or greater ROP and 38 infants with no ROP or stage 1 or 2. In a multiple logistic regression adjusted for significant perinatal factors (birthweight, gestation, and intraventricular haemorrhage), babies with stage 3 or higher ROP showed an increased variability of TcPO2 in week 1 (p < 0.01) and 2 (p = 0.012) but not week 3. Variability of TcPO2 in the first 2 weeks of life is a significant predictor of severe ROP.

Blood Gas Monitoring, Transcutaneous↗
PubMed2003

Retinopathy of prematurity.

Retinopathy of prematurity (ROP) is a relatively new condition. Only in the last 60 years have children survived who were born prematurely enough to have a significantly immature retinal vasculature. This article describes the classification and physiology of ROP, the interventions now available, and possible future therapies.

Endothelial Growth Factors↗
PubMed2003

Pathogenesis of retinopathy of prematurity.

Retinopathy of prematurity (ROP) is a major cause of blindness in children in developed countries. ROP, a two-phase disease, is initiated with delayed retinal vascular growth after premature birth (phase I). Insufficient vascularization of the developing retina creates hypoxia, which precipitates the release of factors stimulating new and abnormal blood vessel growth (phase II). ROP develops because of abnormalities in both oxygen-regulated and non-oxygen-regulated factors, which affect both phases of the disease. Vascular endothelial growth factor (VEGF) is an important oxygen-regulated factor that, if suppressed, inhibits normal vessel growth, but in excess, precipitates retinal neovascularization. A critical non-oxygen-regulated growth factor is insulin-like growth factor (IGF-1). Similar to VEGF, low levels of IGF-1 prevent normal vessel growth (phase I), and higher levels allow neovascularization (phase II). We found that premature infants who develop ROP have low levels of serum IGF-1 compared with age-matched infants without disease. IGF-1 is critical to normal vascular development. Low IGF-1 predicts ROP, and restoration of IGF-1 to normal levels might prevent ROP.

Child↗