Akademik Veri Yönetim Sistemi
22nd EURETINA Congress 2022, Hamburg, Almanya, 1 - 04 Eylül 2022, ss.1
Purpose: To evalute the characteristics of preterm infants who needed two or more treatment for recurrent retinopathy of prematurity(ROP)
Setting/Venue: Clinical records of patients diagnosed with recurrent ROP were reviewed.
Methods: Clinical records were reviewed for gestastional age (GA), birth weight (BW), duration of invasive/noninvasive mechanical ventilation and oxygen therapy, intracranial haemorrhage (ICH), respiratory distress syndrome (RDS), surfactant treatment, bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC), patent ductus arteriosus (PDA) and neonatal sepsis. Maternal factors (maternal age, gestastional diabetes, preeclampsia, premature rupture of membranes[PRM]), and treatments (antenatal steroid, phototherapy, surgery for PDA and/or NEC, parenteral nutrition) were also reviewed. ROP was categorized as aggressive posterior ROP(APROP) and type 1 ROP. Zone and stage of ROP and plus disease, type and week of treatment (intravitreal anti-vascular endothelial growth factor[anti-VEGF] injection and/or laser), type of recurrence (APROP/type 1 ROP), requirement for pars plana vitrectomy(PPV) were recorded.
Results: Twenty-two preterm infants(15 girls,7 boys) were included.Median follow-up time of the patients was 38.5(10-292)weeks.Mean GA of the patients was 25.1±1.3(23-27)weeks. Mean BW of the patients was 752.5±172.1(550-1140)grams.77.3% of the patients had surfactant treatment.Mean duration of oxygen therapy was 115.9±39.2(41-210) days and mean duration of invasive mechanical ventilation was more than 28 days in 86.4% of the patients.All patients had RDS and neonatal sepsis. Of the patients, 86.4% had BPD, 68.2% had PDA,54.5% had ICH, 27.3% had NEC.Type 1 ROP was detected in 5(22.7%) patients and APROP was detected in 17(77.3%) patients.All patients treated with intravitreal injection of anti-VEGF at a mean of 34.2±2.1 weeks.Recurrence of ROP occurred in 15 patients as type 1 ROP and in 7 patients as APROP.Second treatment for ROP(14 laser,8 anti-VEGF) was performed at a mean of 45.1±7.1weeks.6 patients(12 eyes) were required third treatment for ROP.PPV was performed as the third treatment in 5 eyes of 3 patients who had previously undergone laser treatment.All but one of the remaining 7 eyes were previously treated with anti-VEGF injections and laser treatment was performed as the third treatment.Additional laser photocoagulation was performed for recurrency in one eye which had previously undergone laser treatment.
Conclusions: Severity of ROP increases with decreasing GA and BW. Preterm infants especially with a GA <28 weeks and a BW <1000 grams may have a higher risk not only for severe ROP but also for recurrent ROP. Comorbidities may be an additional risk factor for recurrency of ROP. Extremely preterm infants with comorbidities may require close follow-up for recurrence, even if treated for ROP.