Despistaje de la retinopatía del prematuroNuestra experiencia sobre los límites de peso al nacer, edad gestacional y otros factores de riesgo

  1. F.J. Rodríguez-Hurtado
  2. J.M. Cañizares
Journal:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Year of publication: 2006

Volume: 81

Issue: 5

Pages: 275-280

Type: Article

DOI: 10.4321/S0365-66912006000500006 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Archivos de la Sociedad Española de Oftalmologia

Abstract

Purpose: To assess the features of Retinopathy of Prematurity (ROP) in a Neonatal Intensive Care Unit during 8 years, analyzing the usefulness of the criteria in the screening protocol and the risk factors relating to the disease. Methods: A retrospective study of the infants included in the screening program for ROP. The sensitivity of the criteria of birth weight (BW) < 1,500 g, post-conceptional age (PCA) < 32 weeks and subjective pediatric criteria (SPC) in the screening program were evaluated and compared with the incidence of ROP, and the need for treatment in these patient groups. Statistical analysis for ROP and no-ROP was then applied to the risk factors BW, PCA, oxygen therapy, and intercurrent diseases. Results: Forty of 303 infants studied had ROP (13.2%). In ROP cases, 31 (77.5%) had spontaneous regression and 9 (22.5%) needed treatment. The screening program included 144 children with BW < 1,500 g and 159 children with BW > 1,500 g. The incidence of ROP was 26.4% in the first group and 1.3% in the second group (p<0.001). Two cases were detected with a BW > 1,500 g but with a PCA < 32 weeks, and neither required treatment. There were 84 cases included because of SPC (27.7%); no cases of ROP were detected in these. The only independent risk factor found in a multivariant analysis was birth weight. Conclusions: None of the children included with a BW > 1500g required treatment for ROP, but several cases of ROP could be missed by using this criteria only. SPC must be restricted in the screening program.

Bibliographic References

  • Gibson, DL, Sheps, SB, Schetcher, MT, Wiggins, S, Mc Cormick, AQ. (1989). Retinopathy of prematurity: a new epidemic?. Pediatrics. 83. 486-492
  • (2001). Section on Ophthalmology: screening examination of premature infants for retinopathy of prematurity. Pediatrics. 108. 809-811
  • Askie, LM, Henderson-Smart, DJ. (2001). Early versus late discontinuation of oxygen in preterm or low birth weight infants. The Cochrane Library. 4. 1-8
  • Huchetson, KA. (2003). Retinopathy of prematurity. Curr Opin Ophthalmol. 14. 286-290
  • Reynolds, JD, Dobson, V, Quinn, GE, Fielder, AR, Palmer, EA, Hardy, RJ. (2002). Evidence-based screening criteria for retinopathy of prematurity: natural history data from the CRYO-ROP and LIGHT-ROP Studies. Arch Ophthalmol. 120. 1470-1476
  • Shalij-Delfos, NE, Zijlmans, BL, Wittebol-Post, D, Tan, KE, Cats, BP. (1996). Screening for retinopathy of prematurity: do former guidelines still apply?. J Pediatr Ophthalmol Strabismus. 33. 35-38
  • Fonseca Sandomingo, A, Peralta Calvo, J, Abelairas Gómez, J. (1996). Retinopatía del prematuro. Allergan. Madrid.
  • Corcóstegui, B. (1999). Cirugía vitreorretiniana: Indicaciones y técnicas. Tecnimedia Editorial. Madrid.
  • Olea Vallejo, JL, Corretger Ruhi, FJ, Salvat Serra, M, Frau Rotger, E, Galiana Ferre, C, Fiol Jaume, M. (1997). Factores de riesgo en la retinopatia del prematuro. An Esp Pediatr. 47. 172-175
  • Martin Begue, N, Perapoch López, J. (2003). Retinopatía de la prematuridad: incidencia, severidad y resultados. An Pediatr (Barc). 58. 156-161
  • Holmstrom, G, Broberger, U, Thomassen, P. (1998). Neonatal risk factors for retinopathy of prematurity: a population-based study. Acta Ophthalmol Scand. 76. 204-207
  • Rush, R, Rush, S, Nicolau, J, Chapman, K, Naqvi, M. (2004). Systemic manifestations in response to mydriasis and physical examination during screening for retinopathy of prematurity. Retina. 24. 242-245
  • Aguirre Rodríguez, FJ, Bonillo Perales, A, Díez-Delgado Rubio, J, González-Ripoll Garzón, M, Arcos Martínez, J, López Muñoz, J. (2003). Paro cardiorrespiratorio relacionado con el exámen oftalmológico en prematuros. An Pediatr. 58. 502-510
  • Mathew, MR, Fern, AI, Hill, R. (2002). Retinopathy of prematurity: are we screening too many babies?. Eye. 16. 538-542
  • Chow, LC, Wright, KW, Sola, A. (2003). Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants?. Pediatrics. 111. 339-345
  • Rowlands, E, Ionides, AC, Chinn, S, Mackinnon, H, Davey, CC. (2001). Reduced incidence of retinopathy of prematurity. Br J Ophthalmol. 85. 933-935
  • Brown, BA, Thach, AB, Song, JC, Marx, JL, Kwun, RC, Frambach, DA. (1998). Retinopathy of prematurity: evaluation of risk factors. Int Ophthalmol. 22. 279-283
  • Noyola, DE, Bohra, L, Paysse, EA, Fernandez, M, Coats, DK. (2002). Association of candidemia and retinopathy of prematurity in very low birthweight infants. Ophthalmology. 109. 80-84
  • Christiansen, SP, Fray, KJ, Spencer, T. (2002). Ocular outcomes in low birth weight premature infants with intraventricular hemorrhage. J Pediatr Ophthalmol Strabismus. 39. 157-165
  • Englert, JA, Saunders, RA, Purohit, D, Hulsey, TC, Ebeling, M. (2001). The effect of anemia on retinopathy of prematurity in extreme low birth weight infants. J Perinatol. 21. 21-26