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Retinopathy of prematurity like retinopathy in full-term infants
Dhanashree Ratra1, Lala Akhundova2, Manmath Kumar Das3
1Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, 18, College Road, Chennai, Tamil Nadu, India.
Insights
Retinopathy of prematurity-like changes can affect full-term infants, potentially causing vision loss. Early screening for risk factors like oxygen use and respiratory distress syndrome is crucial for prevention.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is typically associated with premature infants.
- ROP-like retinal changes have been observed in some full-term infants, necessitating further investigation.
Purpose of the Study:
- To evaluate the clinical characteristics, risk factors, and management outcomes of ROP-like retinopathy in full-term infants.
- To identify key factors associated with the development of this condition.
Main Methods:
- Retrospective review of 46 eyes from 23 full-term or near full-term infants diagnosed with active or sequelae of ROP-like retinopathy.
- Analysis of clinical data including birth weight, gestational age, and treatment interventions.
Main Results:
- ROP-like retinopathy presented with varying stages, including threshold disease and advanced stages like retinal detachment.
- Significant associations were found between ROP-like retinopathy and low birth weight, multiple births, respiratory distress syndrome, phototherapy, and oxygen administration.
- A favorable structural outcome was observed in 63% of eyes, with 56.2% achieving favorable visual outcomes where assessed.
Conclusions:
- ROP-like retinopathy can occur in full-term infants and may lead to permanent visual impairment.
- Screening infants with identified risk factors, irrespective of gestational age, is recommended to mitigate visual impairment.
Purpose:
The purpose of this study is to assess clinical characteristics, risk factors, and management outcomes of retinal changes similar to retinopathy of prematurity (ROP), seen in full-term infants.
Patients And Methods:
This is a retrospective review of 46 eyes of 23 patients, born at full term or near full term and diagnosed to have active ROP-like retinopathy or sequelae of ROP-like retinopathy.
Results:
Mean birth weight (BW) and gestational age (GA) were 2342 ± 923 g (range, 1200-4160 g) and 38.5 ± 1.85 weeks (range, 37-40 weeks). Mean age at the time of diagnosis was 3.5 ± 8.75 years (range, 1 month-16 years). Stage 1 and 2 of retinopathy was seen in 10 eyes (21.7%), threshold disease with plus disease in 12 eyes (26%) and Stage 4 or 5 in 14 eyes (30.4%). Involutional sequelae were noted in 10 eyes (21.7%). Twenty-one eyes (45.6%) underwent appropriate treatment in the form of laser, cryotherapy, or retinal detachment surgery. Eight eyes (17.4%) with advanced sequelae such as total closed funnel retinal detachment and macular fold were not treated. Mean follow-up was 3 years (range, 1 month to 12 years). At the last follow-up, 29 eyes (63%) had a favorable structural outcome (P < 0.001). Among the patients in whom visual acuity could be assessed (16 eyes), favorable visual outcome was noted in 9 eyes (56.2%). Low BW (P = 0.038), multiple births (P = 0.013), respiratory distress syndrome (RDS) (P = 0.001), phototherapy (P = 0.001), and oxygen administration (P < 0.001) were significantly associated with the development of ROP-like retinopathy in these full-term infants.
Conclusions:
ROP-like retinopathy can occur in full-term and near full-term infants and can potentially lead to permanent visual impairment. Screening of infants with risk factors such as oxygen administration, RDS, multiple births, and low BW, regardless of GA, may reduce visual impairment.
