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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

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Neonatal Intensive Care Unit-based screening program for retinopathy of prematurity and its treatment in an Indian

Anubhav Goyal1, Ananthraman Giridhar1, Mahesh Gopalakrishnan1

  • 1Department of Vitreo-Retina, Giridhar Eye Institute, Kochi, Kerala, India.

Indian Journal of Ophthalmology
|May 25, 2019
PubMed

Insights

Retinopathy of prematurity (ROP) affects one-fourth of infants, with one-tenth requiring laser photocoagulation for excellent outcomes. Key risk factors include anemia and oxygen supplementation, suggesting targeted screening for high-risk infants.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Public Health

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
  • Early detection and treatment are crucial to prevent severe visual outcomes.

Purpose of the Study:

  • To determine the incidence and risk factors of ROP.
  • To evaluate anatomical outcomes following laser treatment for ROP.
  • To identify predictors for high-risk ROP in the Indian population.

Main Methods:

  • Retrospective observational study involving 1648 infants screened for ROP.
  • Infants admitted to NICUs in 12 referral hospitals between April 2016 and September 2017.
  • Screening followed Indian guidelines based on the International Classification of Retinopathy of Prematurity.

Main Results:

  • ROP incidence was 25.36% (418 eyes), with 9.95% (164 eyes) having high-risk prethreshold ROP (type 1).
  • Significant risk factors for type 1 ROP included decreased hemoglobin, oxygen requirement, and blood transfusions.
  • Aggressive posterior ROP (APROP) occurred in 20.73% of type 1 ROP eyes; laser photocoagulation yielded excellent outcomes.

Conclusions:

  • One-fourth of infants screened had ROP, and one-tenth required laser treatment with excellent results.
  • Anemia, high oxygen supplementation, multiple blood transfusions, and septicemia are significant risk factors for ROP.
  • ROP screening in infants ≥1700 g birth weight with systemic risk factors is recommended for the Indian population.
Abstract

Keywords:
Early treatment of retinopathy of prematurityInternational Classification of Retinopathy of PrematurityNeonatal Intensive Care Unithigh-risk prethreshold or type 1 retinopathy of prematuritylow-risk prethreshold or type 2 retinopathy of prematurity

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