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Larger and near-term baby retinopathy: a rare case series
T R Padhi1, S Rath1, S Jalali2
1Retina-Vitreous Services, L V Prasad Eye Institute, Bhubaneswar, India.
Insights
Retinopathy of prematurity (ROP) can occur in larger, older newborns, especially those experiencing fetal distress. This finding expands current understanding of ROP screening criteria for at-risk infants.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) screening typically focuses on premature infants.
- Current guidelines may not fully capture all infants at risk for ROP.
Observation:
- Four infants with gestational ages (GA) of 36-39 weeks and birth weights (BW) of 2.4-3.0 kg were diagnosed with ROP during routine screening.
- These infants were larger and older than typically screened.
- All infants experienced fetal distress and significant neonatal comorbidities.
Findings:
- Retinopathy was observed in zone III (spontaneously regressed in three) and zone II (regressed after laser photocoagulation in one).
- Gestational age ranged from 36 to 39 weeks; birth weight ranged from 2.4 to 3.0 kg.
- Fetal distress and neonatal systemic comorbidities were common in all cases.
Implications:
- This case series highlights the potential for ROP in term or near-term infants with specific risk factors.
- It suggests a need to consider expanded screening criteria for ROP, particularly in infants with fetal distress and neonatal complications.
- Awareness of ROP in larger, older newborns is crucial for timely diagnosis and management.
Purpose:
To report retinopathy in a series of four babies unusually beyond the screening standards reported so far in the literature.
Methods:
During routine screening for retinopathy of prematurity, we detected retinopathy in four babies who were surprisingly bigger and older than the screening standards. The gestational age (GA), birth weight (BW), post menstrual age at first examination and significant perinatal events were noted. The retinopathy details imaged by the RetCam were classified as per ICROP revisited standards.
Result:
The GA ranged from 36 to 39 weeks and BW from 2.4 to 3.0 kg. Three of them had retinopathy in zone III that regressed spontaneously and one had marked plus with vascular arcades and shunts in zone II that regressed after laser photocoagulation. All of them had fetal distress and multiple systemic comorbidities in the neonatal period.
Conclusion:
This report makes one aware of the possibility of retinopathy in newborn of older GA and larger BW especially with fetal distress and stormy neonatal course.
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