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Published on: April 2, 2021
Characteristic clinical features associated with aggressive posterior retinopathy of prematurity
1Department of Ophthalmology and Visual Science, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Insights
Infants born small for gestational age and with chorioamnionitis face a higher risk of aggressive posterior retinopathy of prematurity (APROP). The study highlights the impact of the maternal environment on APROP development in premature infants.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Aggressive posterior retinopathy of prematurity (APROP) presents unique challenges in management and outcomes.
- Understanding risk factors is crucial for early detection and intervention.
Purpose of the Study:
- To identify risk factors, clinical features, and treatment outcomes of APROP in Korean infants.
- To compare APROP with non-APROP treatment-requiring ROP.
- To analyze systemic and maternal risk factors associated with APROP.
Main Methods:
- Retrospective review of medical records of 105 premature infants treated for ROP.
- Analysis of 770 screened premature infants, identifying 24 with APROP and 81 with non-APROP.
- Comparison of gestational age, birth weight, and maternal factors between APROP and non-APROP groups.
Main Results:
- APROP infants had significantly lower gestational age and birth weight.
- Infants small for gestational age and those with chorioamnionitis showed higher APROP incidence.
- APROP required more intensive laser treatment and had higher retreatment rates.
Conclusions:
- Intrauterine growth restriction and chorioamnionitis are significant risk factors for APROP.
- Perinatal maternal environment may influence normal retinal vascular growth, increasing APROP risk.
- Effective management of APROP requires consideration of these associated perinatal factors.
Abstract:
PurposeTo identify the risk factors for, and clinical features and treatment outcomes of aggressive posterior retinopathy of prematurity (APROP) in Korean infants.MethodsAmong 770 premature infants who underwent screening, 105 infants (198 eyes, 13.63%) received treatment for ROP. A total of 24 infants (48 eyes, 3.12%) developed APROP while 81 infants (150 eyes, 10.52%) developed non-APROP treatment-requiring type. The medical records of ROP-treated infants were reviewed retrospectively. The associated systemic and maternal risk factors were analyzed and anatomical outcomes were compared according to the severity of ROP and treatment modalities.ResultsThe mean gestational age and birth weight at birth in the APROP group were significantly lower than those in the non-APROP group (P=0.019, P<0.001, respectively). Infants who were born small for their GA developed APROP more frequently than non-APROP patients (P<0.001). Chorioamnionitis-positive infants also showed higher incidence rate of APROP (APROP vs non-APROP; P<0.001 and zone I APROP vs posterior zone II APROP; P=0.036, respectively). Infants with APROP required heavier laser treatment with a higher retreatment rate compared to infants with non-APROP. Favorable anatomical outcomes were achieved in 95.3% from treatment-requiring non-APROP group, 85.7% from zone I APROP and 84.6% from posterior zone II APROP group.ConclusionIntrauterine growth restriction and chorioamnionitis were associated with development of APROP. These findings suggest that perinatal maternal environment inhibiting normal retinal vascular growth in utero may contribute to increasing the risk of APROP in premature infants.
