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One-year experience in the retinopathy of prematurity: frequency and risk factors, short-term results and follow-up

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International Journal of Ophthalmology(English edition) 2011年第6期4卷 634-640页

作者： Sariaydin Mehmet Atlihan Fusun Calkavur Sebnem Olukman Ozgur Ercan Gulten Ozturk Arif Taylan Kaya Kilic Fatma Gokaslan Filiz Altinyaprak Derya Malatyali Rana Department of Neonatology Trabzon Medical Faculty Department of Neonatology Dr. Behet Uz Children's Hospital Department of Ophthalmology Dr. Behet Uz Children's Hospital

· AIM: As a result of the increase in premature births and the advances in neonatal intensive care, retinopathy of prematurity (ROP) remains one of the most important causes of childhood blindness worldwide. The main factors in the development of ROP are gestational age, birth weight and oxygen therapy. ROP continues to gain importance due to the increasing survival rates of more immature babies. · METHODS: Between January 2007 and October 2008, 203 premature infants treated at the Neonatal Intensive Care Unit (NNICU) were prospectively enrolled and the relationship between known risk factors and the occurance of ROP was studied. · RESULTS: ROP in various stages developed in 86 cases (42.4%). Statistically significant correlations were found between the development of ROP and birth weight (P < 0.0001) gestational age (P <0.0001), oxygen treatment and its duration (P <0.0001 and P =0.002), mechanical ventilation (MV) and its duration (P =0,0001 and P =0.0001), apnea(P = 0.001), intraventricular hemorrhage (IVH) (P =0.046), sepsis (P =0.0001), use of erythropoietin (EPO) (P =0.003), the number of blood transfusions and frequency (P =0.0001 and P =0.0001), surfactant application (P =0.0001), the presence of patent ductus arteriosus (PDA) (P =0.001) or bronchopu- lmonary dysplasia (BPD) (P =0.0001). No significant correlations were found between the occurance of ROP and maternal pre-eclampsia (P =0.293), multiple pregnancy (P = 0.218), or hyperbilirubinemia (P =0.494). Severity of ROP was related significantly with birth weight (P =0.0001), but no significant correlation between severity of ROP and gestational age was present. · CONCLUSION: Early description and reduction of the risk factors related with the occurance of ROP with the help of routine screening programs may warrant the prevention of visual loss, however early ophthalmic diagnosis and treatment are still mandatory to provide better visual rehabilitation. ·

关键词： prematurity retinopathy risk factors gestational age birth weight oxygen therapy

Systemic changes and adverse effects induced by retinopathy of prematurity screening

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International Journal of Ophthalmology(English edition) 2016年第8期9卷 1148-1155页

作者： Jing-Bo Jiang Zhi-Wei Zhang Jia-Wen Zhang Yan-Li Wang Chuan Nie Xian-Qiong Luo Department of Neonatology Guangdong Province Women and Children's Hospital Department of Pediatric Cardiology Guangdong Cardiovascular Institute Guangdong General HospitalGuangdong Academy of Medical Sciences

AIM: To estimate the potential systemic events during and after retinopathy of prematurity (ROP) screening. ' METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24h before, during, and 72h after ROP screening. Control blood pressure (BP), saturation, pulse rate, and body temperature were routinely taken at various time internals before and after screening. Adverse effects pertain to cardiovascular system, respiratory system, gastric system, urinary system and nervous system were retrospect 0-72h after ROP screening at a 24-hour interval. RESULTS: Totally 1254 prematurity babies receiving ROP screening during Jan. 1st 2013 to Dec. 31th 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg (P=0.04) after 3 doses of mydriatic drops. Immediately after the examination, there was a further 12.64 mm Hg (Pprematurity with postconceptional age less than 31wk, the incidence of apnea (23.5%), necrotizing enterocolitis (NEC) (8.7%), gastric residual (25.4%) and upper digestive tract hemorrhage (6.4%) also demonstrated a significant rise (P<0.01). CONCLUSION: In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.

关键词： retinopathy of prematurity prematurity screening apnea necrotizing enterocolitis stress response mydriatic drops

Incidence and risk factors of retinopathy of prematurity and utility of the national screening criteria in a tertiary center in Iran

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International Journal of Ophthalmology(English edition) 2019年第8期12卷 1330-1336页

作者： Milad Khorshidifar Homayoun Nikkhah Alireza Ramezani Morteza Entezari NarsisDaftarian Hamid Norouzi Mansoor Shahiari Mitra Radfar Ramin Norinia Saeed Karimi Clinical Research Development Unit of Torfe Medical Center Shahid Beheshti University of Medical SciencesTehran***Iran Department of Ophthalmology Imam Hossein HospitalShahid Beheshti University of Medical SciencesTehran***Iran Ophthalmic Research Center Shahid Beheshti University ofMedical SciencesTehran16666Iran Ophthalmic Epidemiology Research Center Shahid BeheshtiUniversity of Medical SciencesTehran16666Iran

AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.

关键词： retinopathy of prematurity incidence risk factors screening Iran

The Alexandria retinopathy of prematurity model(Alex-ROP): postnatal weight gain screening algorithm application in a developing country

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International Journal of Ophthalmology(English edition) 2019年第2期12卷 296-301页

作者： Islam SH Ahmed Adham AO Badeeb Department of Ophthalmology Faculty of MedicineAlexandria Main University Hospital Department of Pediatrics and Neonatology Faculty of Medicine Alexandria University maternity Hospital

AIM: To suggest a novel retinopathy of prematurity(ROP) screening model in developing countries incorporating postnatal weight gain ratios(PWGR) to traditional parameters to maintain sensitivity and improve specificity in detecting ROP. METHODS: Analysis of weekly PWGR of infants from one tertiary referral center during six months to determine the age at which the PWGR with the highest predictability for ROP development which was referred to as the postnatal net weight gain ratio(NWGR). NWGR was added to conventional criteria to describe a new model(The Alex-ROP model). RESULTS: Of 560 infants were included. NWGR 28 d after birth was the most predictive factor for the development of ROP. A new model Alex-ROP recommending screening infants with gestational age(GA) ≤33 wk or birth weight ≤1500 g and NWGR at 28 d after birth <0.3 was suggested. A second screening model referred to as High-grade AlexROP(Hg Alex-ROP) model to detect worse grade ROP(Both type 1 and type 2) recommending a cutoff point of NWGR <0.15 between birth and 28^(th) day. CONCLUSION: Both Alex-ROP and Hg Alex-ROP models are easy to apply to improve the specificity of ROP screening in developing countries while maintaining high sensitivity.

关键词： screening retinopathy of prematurity postnatal weight gain

The process of retinal vascularization in retinopathy of prematurity after ranibizumab treatment in China

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International Journal of Ophthalmology(English edition) 2019年第7期12卷 1146-1150页

作者： Qing-Yu Meng Yong Cheng Ming-Wei Zhao Jian-Hong Liang Department of Ophthalmology & Clinical Center of Optometry Peking University People's Hospital Beijing 100044 China Eye Diseases and Optometry Institute Peking University People's Hospital Beijing 100044 China Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases Beijing 100044 China College of Optometry Peking University Health Science Center Beijing 100191 China

AIM: To explore the process of retinal vascularization and risk factors for retinopathy of prematurity(ROP) treated with intravitreal ranibizumab(IVR) as ***: Infants with type 1 ROP who received IVR as primary treatment from August 2014 to October 2016 at Peking University People’s Hospital’s Ophthalmology Department were included in the study. All eyes received 0.25 mg ranibizumab at initial treatment. Retinal vascularization was evaluated clinically. Potential risk factors were also recorded and ***: Retinal vascularization was completed in 126 eyes(62.7%), and retinal vascularization terminated in zone II and zone III with 16 eyes(7.9%) and 44 eyes(21.9%), respectively, after more than 1-year follow-up. In multivariate regression analysis, lower birth weight(BW), severity of ROP and repeated injections were found to be risk factors for peripheral avascular area(P<0.05). CONCLUSION: In our retrospective study, 29.8% of the ROP eyes treated with ranibizumab have peripheral avascular area at the last follow-up. Lighter BW and the severity of ROP are risk factors. Furthermore, repeated injections also increase the risk of retinal peripheral avascular area remaining in ROP patients.

关键词： retinal vascularization retinopathy of prematurity ranibizumab avascular retinal area

Fluorescein angiography of retinal vascular involution after intravitreal injection of ranibizumab for retinopathy of prematurity

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International Journal of Ophthalmology(English edition) 2019年第1期12卷 79-82页

作者： Yong Cheng Tie-Gang Liu Wei-Yi Li Ming-Wei Zhao Jian-Hong Liang Department of Ophthalmology Peking University People's Hospital Eye diseases and Optometry Institute Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases College of Optometry Peking University Health Science Center Clinical College of Ophthalmology Tianjin Medical University Tianjin Eye Hospital Tianjin Key Laboratory of Ophthalmology and Visual Science Tianjin Eye Institute Department of Ophthalmology Beijing Capital International Airport Hospital Eye Hospital China Academy of Chinese Medical Sciences College of Optometry Peking University Health Science Center

AIM: To describe the involution patterns of vessel growth of retina through fluorescein angiography(FA) of children, who had been under treatment up to 1 y previously intravitreal ranibizumab(IVR) as monotherapy for retinopathy of prematurity(ROP). METHODS: This is a retrospective study. The medical information and FA of 17 children(34 eyes) whose area of avascular retina from the ora serrata was more than two disc diameters(DD) were analyzed. RESULTS: Among 34 eyes, all were the presence of finger-shaped vessels and arteriolar-venular shunts(100%,34/34 eyes). Popcorn abnormalities were found in most of the eyes(94.1%, 32/34 eyes). Furthermore, in many cases(23.5%, 8/34 eyes), there were leakage persisting in the region of the junction between avascular and vascular retina. In contrast, just 2 eyes(5.9%) showed damage of retinal capillary bed and 3 eyes(8.8%) showed large area of retinal pigment epithelium(RPE) atrophy. CONCLUSION: Although IVR can be very effective in ROP, we should remain cautious as infants may remain avascular peripheral retinas and abnormal vessel. FA allows accurate visualization of vessel abnormalities in eyes with ROP, which will be helpful to affect assessment of disease activity and therapeutic effect.

关键词： retinopathy of prematurity fluorescein angiography anti-VEGF ranibizumab

Current understanding and management of aggressive posterior retinopathy of prematurity

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World Journal of Ophthalmology 2015年第2期5卷 73-79页

作者： Christine M Pulido Polly A Quiram Vitreo Retinal Surgery P.A.

Aggressive posterior retinopathy of prematurity(ROP), previously referred to as "Rush disease", is a rapidly progressive form of ROP. This form of ROP typically presents in very low birth weight babies of early gestational age. Historically, anatomical and functional outcomes have been poor with standard treatment. This review is designed to discuss current knowledge and treatment regarding this aggressive form of ROP. Recommendations regarding management of these difficult cases are detailed.

关键词： Bevacizumab Eliminates the Angiogenic Threat of Retinopathy of prematurity Photographic Screening for Retinopathy of prematurity Aggressive posterior retinopathy of prematurity Retinopathy of prematurity Intravitreal bevacizumab Early Treatment of Retinopathy of prematurity Study Stanford University Network for Diagnosis of Retinopathy of prematurity

Application and performance of artificial intelligence in screening retinopathy of prematurity from 2018 to 2024:a meta-analysis and systematic review

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Eye Science 2024年第3期1卷 206-223页

作者： Rui Liu Guina Liu Xiaoshuang Jiang Fang Lu Department of Ophthalmology West China HospitalSichuan UniversityChengduChina

Purpose:Artificial intelligence(AI)significantly enhances the screening and diagnostic processes for retinopathy of prematurity(ROP).In this article,we focused on the application and performance of AI in detecting ROP and distinguishing plus disease(PLUS)in ***:We searched PubMed,Embase,Medline,Web of Science,and Ovid for studies published from January2018 to July *** evaluating the diagnostic performance of AI with expert ophthalmologists’judgment as a reference standard were *** risk of bias was assessed using the QUADAS-2 tool and QUADAS-AI *** analysis included data pooling,forest plot construction,heterogeneity testing,and ***:Fourteen of the 186 studies were *** pooled sensitivity,specificity and the area under the curve(AUC)of the AI diagnosing ROP were 0.95(95%CI 0.93-0.96),0.97(95%CI 0.94-0.98)and 0.97(95%CI 0.95-0.98),*** pooled sensitivity,specificity and the AUC of the AI distinguishing PLUS were 0.92(95%CI 0.80-0.97),0.95(95%CI 0.91-0.97)and 0.98(95%CI 0.96-0.99),***’s Q test(P<0.01)and Higgins I2 heterogeneity index revealed considerable *** country of study,number of centers,data source and the number of doctors were responsible for the *** ROP diagnosing,researches conducted in China using private data in single center with less than 3 doctors showed higher sensitivity and *** PLUS distinguishing,researches in multiple centers with less than 3 doctors showed higher ***:This study revealed the powerful role of AI in diagnosing ROP and distinguishing ***,significant heterogeneity was noted among all included studies,indicating challenges in the application of AI for ROP diagnosis in real-world *** studies are needed to address these disparities,aiming to fully harness AI’s potential in augmenting medical care for ROP.

关键词： retinopathy of prematurity plus disease artificial intelligence diagnosis meta-analysis systematic review

Effects of Palivizumab Guideline Changes on RSV Admissions in Patients with Congenital Heart Disease and prematurity

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World Journal of Cardiovascular Diseases 2021年第1期11卷 34-44页

作者： John Pham Stephen Nageotte Jon Detterich Grace Kung Department of Pediatrics Children’s Hospital Los Angeles Los Angeles CA United States of America Division of Cardiology Department of Pediatrics Children’s Hospital Los Angeles Los Angeles CA United States of America

Background: Respiratory syncytial virus (RSV) causes significant morbidity and mortality in patients with a history of prematurity and congenital heart disease (CHD). In 2014, the guidelines for Palivizumab became more restrictive for this population. We hypothesized the percentage of RSV+ admissions would increase overall and in this target group (TG) specifically. Methods: We conducted a retrospective review of patients under age 2 years admitted with bronchiolitis two seasons prior to the change (Pre) and two seasons after (Post). Our TG included patients who were eligible prior to the 2014 changes but currently no longer eligible. We used chi-square analysis to answer the two main hypotheses: 1) Percent RSV+/total bronchiolitis Pre vs Post and 2) Percent of TG/RSV+ Pre vs Post. Results: 1283 patients (546 pre, 737 post) were admitted with the diagnosis of RSV between 2012-2016, 866 actually tested positive for RSV (367 Pre, 499 Post). There was no significant difference in the number of total patients admitted with RSV (Pre = 67.2%, Post = 67.7%) or in our TG (Pre 7.1% vs Post 8.2%). TG overall had a more complicated course: longer length of stay, median 5 days, IQR 2 - 12 vs 3 days, IQR 1

关键词： 2014 American Academy of Pediatrics Children Congenital Heart Disease Guidelines Infants Palivizumab prematurity Respiratory Syncytial Virus