2012, Number 2
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Rev Invest Clin 2012; 64 (2)
Risk factors associated with retinopathy of prematurity and visual alterations in infants with extremely low birth weight
Martínez-Cruz CF, Salgado-Valladares M, Poblano A, Trinidad-Pérez MC
Language: English
References: 35
Page: 136-143
PDF size: 173.83 Kb.
ABSTRACT
Objective. Retinopathy of prematurity (RoP) is a retinal vascular disease and a frequent cause of blindness in infants. Our objective was to measure the frequency of RoP in infants with extremely low birth weight (ELBW, ‹ 1,000 g) at the National Institute of Perinatology, Neonatal Intensive Care Unit (NICU), weighing the association of RoP with several risk factors and their results, such as refractive errors and strabismus.
Material and methods. We carried out two cross-sectional observations of our prospective study: one near birth, and the second, after a long-term follow-up. Funduscopic examination was performed while the infants were in the NICU to detect RoP. Infants with RoP were followed up by means of visual examinations during an average 8-year period and results were compared with those of infants with ELBW without RoP.
Results. Of the 139 screened infants at the NICU, 24.4% were identified with RoP: 79% of these with grade I retinopathy; 18% with grade II, and one infant with grade III retinopathy. The zones involved were as follows: zone 1, 12%; zone 2, 79%, and zone 3, 9%. The following were associated with retinopathy: eclampsia (p = 0.003); gestational age (0.01); multiple gestation (0.03); days of stay at NICU (‹ 0.001); mechanical ventilation (0.001); hypoxia (0.01); oxygen therapy (‹ 0.001); apnea (0.005); acidosis (0.001), and hypercapnia (0.001). Retinopathy was self-limited in all children. We found no differences in frequency of refractive errors and strabismus between children with RoP and controls.
Conclusions. We observed a moderately high frequency of RoP in infants with ELBW in Mexico City and recommended early mandatory screening for early intervention.
REFERENCES
The International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of prematurity Revisited. Arch Ophthalmol 2005; 123: 991-9.
Spencer R. Long-Term Visual outcomes in extremely low-birthweight children (an American Ophthalmologic Society thesis). Trans Am Ophthalmol Soc 2006; 104: 493-516.
Larsson E, Rydberg A, Holmstrom G. Contrast sensitivity in 10 year old preterm and full term children: a population based study. Br J Ophthalmol 2006; 90: 87-90.
Graciano RM, Leone CR. Frequent ophthalmologic problems and visual development of preterm newborn infants. J Pediatr (Rio J) 2005; 81; s95-s100.
Hellstrom A, Ley D, Hansen-Pupp I, Niklasson A, Smith L, Löfqvist C, et al. New insights into the development of retinopathy of prematurity-importance of early weight gain. Acta Paediatr 2010; 99: 502-8.
Flores-Santos R, Hernández-Cabrera MA, Hernández-Herrera RJ, Sepúlveda-Cañamar F. Screening for retinopathy of prematurity: results of a 7-year study of underweigth newborns. Arch Med Res 2007; 38: 440-3.
Gilbert C, Foster A. Childhood blindness in the context of VISION 2020-the right to sight. Bull World Health Organ 2001; 79: 227-32.
Wani VB, Kumar N, Raizada S, Rashwan N, Shukku M, Harbi M. Results of screening for retinopathy of prematurity in a large nursery in Kuwait: incidence and risk factors. Indian J Ophtalmol 2010; 58: 204-08.
Martínez-Cruz CF, Poblano A, Fernández-Carrocera LA, Jiménez-Quiróz R, Tuyú-Torres N. Association between intelligence quotient scores and extremely low-birth weight in school-age children. Arch Med Res 2006; 37: 639-45.
Martínez-Cruz CF, Poblano A, Fernández-Carrocera LA. Risk factors associated with sensorineural hearing loss in infants at the neonatal intensive care unit: 15-year experience at the National Institute of Perinatology (México City). Arch Med Res 2008; 39: 686-94.
Papile LA, Burnstein J, Burnstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92: 529-34.
Shah PK, Narendran V, Saravanan VR, Raghuram A, Chattopadhyay A, Kashyap M. Screening for retinopathy of prematurity- a comparison between binocular indirect ophtalmoscopy and RetCam 120. Ind J Ophtalmol 2006; 54: 35-8.
The International Committee for the Classification of the Late Stages of Retinopathy of Prematurity. An international classification of retinopathy of prematurity. II. The classification of retinal detachment. Arch Ophthalmol 1987; 105: 906-12.
Lomuto CC, Galina L, Brussa M, Quiroga A, Alda E, Benitez AM, et al. Laser treatment for retinopathy of prematurity in 27 public services of Argentina (in Spanish). Arch Argent Pediatr 2010; 108; 136-40.
Wormald RLP. Preschool vision screening in Cornwall: performance indicators of community orthoptists. Arch Dis Child 1991; 66: 917-20.
Orozco-Gómez LP, Ruiz-Morfin I, Lambarri-Arroyo A, Morales- Cruz MV. Prevalence of retinopathy of premature. Twelve years of detection at the Medical Center 20th of November (in Spanish). Cir Ciruj 2006; 74: 3-9.
Poblano A, Arteaga C, García-Sánchez G. Prevalence of early neurodevelopmental disabilities in Mexico. A systematic review. Arq Neuropsiquiatr 2009; 67: 736-40.
CRYO-ROP. Multicenter Trial of Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results. Arch Ophthalmol 1988; 106: 471-9.
Chow LC, Wright KW, Sola A, CSMC Oxygen Administration Study Group. Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants? Pediatrics 2003; 101: 339-45.
Sato T, Kusaka S, Shimojo H, Fujikado T. Simultaneous analyses of vitreous levels of 27 cytokines in eyes with retinopathy of prematurity. Ophthalmology 2009; 116: 2165-9.
Tadesse M, Dhanireddy R, Mittal M, Higgins RD. Race, Candida sepsis, and retinopathy of prematurity. Biol Neonate 2002; 81: 86-90.
Dani C, Reali MF, Bertini G, Martelli E, Pezzati M, Rubaltelli FF. The role of blood transfusions and iron intake on retinopathy of prematurity. Early Hum Dev 2001; 62: 57-63.
Cuculich PS, DeLozier KA, Mellen BG, Shenai JP. Postnatal dexamethasone treatment and retinopathy of prematurity in very-low-birth-weight neonates. Biol Neonate 2001; 79: 9-14.
Reynolds JD, Hardy RJ, Kennedy KA, Spencer R, Van Heuven WA, Fielder AR. Lack of efficacy of light reduction in preventing retinopathy of prematurity. Light Reduction in Retinopathy of Prematurity (LIGHT-ROP) Cooperative Group. N Engl J Med 1998; 28; 338: 1572-6.
Suk KK, Dunmbar JA, Liu A, Daher NS, Leng CK, Lim P, et al. Human recombinant erythropoietin and the incidence of retinopathy of premaurity: a multiple regression model. J AAPOS 2008; 12: 233-8.
Section on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, and American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 2006; 117; 572-6.
Tabbara KF, Ross-Degnan D. Blindness in Saudi Arabia. JAMA 1986; 255: 3378-84.
Multicentric Colaborative Group of Work: Blindness Prevention in Infancy by Retinopathy of Prematurity. Retinopathy of prematurity in neonatology services in Argentina (in Spanish). Arch Argent Pediatr 2006; 104: 69-74.
Fortes-Filho JB, Eckert GU, Valiatti FB, da Costa MC, Bonomo PP, Procianoy RS. Prevalence of retinopathy of prematurity: an institutional cross-sectional study of preterm infants in Brazil. Rev Panam Sal Pub 2009; 26: 216-20.
Rivera-Rueda MA, Hernández-Trejo M, Hernández-Peláez G, Llano-Rivas I, Di Castro-Stringer P, Illescas-Medrano E, et al. Analysis of early mortality in the National Institute of Perinatology (1999-2001) (in Spanish). Perinatol Reprod Hum 2001; 19: 13-21.
Pucheta-Ramírez LA, Hernández-Pimentel MG, Vargas-Alvarez AM, Ibarra-Puig J, Poblano A. Visual evoked potentials in infants with congenital and post-hemorrhagic hydrocephalous (in Spanish). Perinatol Reprod Hum 1999; 13: 297-304.
Askie LM, Henderson-Smart DJ, Irwig L, Simpson. Oxygensaturation targets and outcomes in extremely preterm infants. N Engl J Med 2003; 349: 959-67.
Choi MY, Park IK, Yu YS. Long term refractive outcome in eyes of preterm infants with and without retinopathy of prematurity: comparison of keratometric value, axial length, anterior chamber depth and lens thickness. Br J Ophthalmol 2000; 84: 138-43.
O’Connor AR, Stephenson TJ, Johnson A, Tobin MJ, Moseley MJ, Ratib S, et al. Long term ophthalmic outcome of low birth weight children with and without retinopathy of prematurity. Pediatrics 2002; 109: 12-8.
Schalij-Delfos NE, de Graaf MEL, Treffers WF, Engel J, Cats BP. Long term follow up of premature infants: detection of strabismus, amblyopia, and refractive errors. Br J Ophthalmol 2000; 84: 963-7.