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[Indirect diode laser treatment and cryotherapy in retinopathy of prematurity]
C Nascutzy1, J A McNamara, T Ciomârtan
1Institutul pentru Ocrotirea Mamei şi Copilului.
Insights
Retinopathy of prematurity (ROP) affects many premature infants in Romania, with high incidence and severity linked to low gestational age. Early diagnosis and treatment are crucial, highlighting the need for a national screening program.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Context:
- Retinopathy of prematurity (ROP) is a significant cause of infant blindness.
- Romania faces increasing numbers of surviving preterm infants.
- Limited resources impact timely diagnosis and treatment of ROP.
Purpose:
- To investigate the incidence, treatment, and short-term outcomes of ROP in Romanian preterm infants.
- To assess the correlation between ROP severity and factors like gestational age and birthweight.
- To advocate for a national ROP screening program in Romania.
Summary:
- A study of 24 preterm infants (<32 weeks GA, <1500g BW) in Romania found a high incidence (66.6%) of ROP, often bilateral and severe (Stage 5 in 37.5%).
- Two infants with threshold disease received laser or cryotherapy, showing positive short-term outcomes with no major complications.
- Delayed diagnosis, attributed to equipment limitations, was noted, emphasizing the need for improved screening protocols.
Impact:
- Confirms the known association between prematurity (gestational age, birthweight) and ROP incidence/severity.
- Demonstrates the feasibility of ROP treatment with available methods, yielding positive short-term results.
- Underscores the urgent need for a national ROP screening program in Romania to prevent childhood blindness.
Abstract:
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.