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Retinopathy of prematurity in larger preterm infants
Po-Chiung Fang1, Hsi-Kung Kuo, Tan-Yung Ko
1Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China.
Insights
Severe retinopathy of prematurity (ROP) can affect larger preterm infants, not just those under 1500g. This study highlights the need to reassess screening criteria for all preterm infants to ensure timely detection and management of ROP.
Area of Science:
- Neonatology
- Ophthalmology
- Perinatal Medicine
Background:
- Severe retinopathy of prematurity (ROP) is typically associated with preterm infants weighing less than 1500g or with a gestational age under 31 weeks.
- Exceptions to these criteria exist, with ROP occurring in larger preterm infants.
Purpose of the Study:
- To report cases of stage III ROP in larger preterm infants (gestational age > 31 weeks, birthweight > 1500g) in southern Taiwan.
- To emphasize the importance of assessing ROP risk in larger preterm infants and suggest expanding screening criteria.
Main Methods:
- Retrospective review of six larger preterm infants diagnosed with stage III ROP at Chang Gung Memorial Hospital, Kaohsiung.
- Analysis of clinical data including birthweight, gestational age, sex, oxygen supplementation, and treatments received.
Main Results:
- Six male infants with gestational age > 31 weeks and birthweight > 1500g presented with stage III ROP.
- All infants received oxygen supplementation; one had prior surgery and frequent blood transfusions.
- Three infants underwent laser photocoagulation or cryotherapy, with all cases achieving good outcomes irrespective of treatment.
Conclusions:
- Severe ROP can occur in preterm infants exceeding traditional screening criteria.
- Expanded screening protocols are warranted for larger preterm infants to ensure early detection.
- Prompt assessment and management are crucial for favorable outcomes in ROP, regardless of infant size.
Abstract:
Severe retinopathy of prematurity (ROP) usually occurs in preterm infants with birthweight<1500 g or gestational age<31 weeks. However, some exceptions occur in larger preterm infants. In southern Taiwan, six larger preterm infants with gestational age older than 31 weeks and birthweight>1500 g had stage III ROP in Chang Gung Memorial Hospital at Kaohsiung (Taiwan, Republic of China). All six infants were male and had received oxygen supplementation during hospitalization. Only one infant had received previous surgery and frequent packed red blood cell transfusions. Three infants received laser photocoagulation or cryotherapy, and all infants have good outcomes regardless of whether they received treatment. This report provides convincing evidence for expanding the screening criteria in our nursery and emphasizes the importance of assessing the risk of ROP for larger preterm infants.
