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The retinal vascular growth rate in babies with retinopathy of prematurity could indicate treatment need
Tapas Ranjan Padhi1, Utpal Bhusal1, Srikanta Kumar Padhy1
1Retina and Vitreous Services, LV Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Odisha, India.
Insights
A slower rate of retinal vascular growth in premature infants may indicate a need for treatment for retinopathy of prematurity (ROP). A growth rate below 0.54 disc diameters per week can predict treatment necessity in ROP patients.
Area of Science:
- Ophthalmology
- Neonatology
- Vascular Biology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Early detection and intervention are crucial for managing ROP and preventing vision loss.
- Assessing the rate of retinal vascular growth may offer insights into ROP progression and treatment needs.
Purpose of the Study:
- To analyze the weekly rate of retinal vascular growth in treatment-naïve infants with varying stages of ROP.
- To determine if retinal vascular growth rate can predict the need for treatment in ROP cases.
Main Methods:
- Retrospective review of medical charts and retinal images from 436 eyes of infants with ROP.
- Retinal images were enhanced using red-green image enhancement software.
- Vessel growth was measured from the optic disc margin to the vessel tip in quadrants, calculated as vessel length divided by the number of weeks.
- Infants were categorized into treatment-warranting ROP, low-risk pre-threshold ROP, and no-ROP (control) groups.
Main Results:
- The mean vascular outgrowth rates were 0.490 DD/week for treatment-warranting ROP, 0.612 DD/week for low-risk pre-threshold ROP, and 0.719 DD/week for the no-ROP group.
- Over 80% of eyes with a vessel growth rate of 0.54 DD/week or less required treatment.
- Significant differences in vascular growth rates were observed across the different ROP severity groups.
Conclusions:
- A retinal vascular growth rate below 0.54 DD/week is a potential indicator for treatment in infants with ROP.
- This metric could aid in timely and appropriate intervention decisions for ROP management.
- Further research may validate this finding and integrate it into clinical practice for ROP screening.
Purpose:
To analyze the weekly rate of retinal vascular growth in treatment-naïve babies with various stages of retinopathy of prematurity (ROP) and validate if this could be a predictor of treatment need.
Methods:
Retrospective review of medical charts and retinal images of babies with various stages of ROP. The images were enhanced using red-green image enhancement software. Using the length of the horizontal disc diameter (DD) of each eye, the vessel growth was measured from the disc margin up to the vessel tip in fixed quadrants. The rate of vessel growth was the ratio of vessel length to the number of weeks it took to reach this length. The babies were divided into treatment warranting ROP (group 1), low-risk pre-threshold (type II) ROP (group 2,), and no-ROP (group 3) for analysis. The "no-ROP" group acted as normal control. Group 1 was further subdivided into 1A (threshold ROP), IB (aggressive posterior ROP), 1C (hybrid ROP), and ID (high-risk pre-threshold ROP).
Results:
Out of 436 eyes, groups 1, 2, and 3 had 238, 108, and 90 eyes, respectively. The mean rate of vascular outgrowth along with 95% confidence interval (CI) was 0.490 [0.487,0.520], 0.612 [0.599, 0.638], and 0.719 [0.703, 0.740] DD/week, respectively, for babies with "treatment warranting," "low risk pre-threshold" and "no ROP" groups, respectively. In our estimate, more than 80% of eyes with a vessel growth rate of 0.54 DD/week or less required treatment.
Conclusion:
A rate of retinal vascular growth less than 0.54 DD/week can be used to determine treatment requirements in babies with ROP.
