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Regression pattern in retinopathy of prematurity
1Department of Ophthalmology, University of Maryland, School of Medicine, Baltimore.
Insights
Retinopathy of prematurity (ROP) in premature infants typically regressed by term age. However, severe ROP cases showed delayed resolution and occasional long-term retinal complications.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Understanding ROP regression patterns is crucial for optimizing clinical management and predicting outcomes.
Purpose of the Study:
- To characterize the natural regression patterns of retinopathy of prematurity (ROP) in a cohort of very low birth weight infants.
- To identify factors influencing the duration and completeness of ROP regression.
- To assess the incidence of permanent sequelae resulting from ROP.
Main Methods:
- Retrospective analysis of 266 infants with birth weights ≤1500 g over a 22-month period.
- Detailed examination of ROP regression patterns, including timing and extent of vascularization.
- Documentation of any permanent retinal or vascular abnormalities post-regression.
Main Results:
- ROP regression was observed in most infants (255/266), with spontaneous resolution occurring around term age (40 weeks postconceptional age) for peripheral ROP.
- Posterior or stage 3 ROP exhibited a protracted resolution course, with vascularization extending to zone 3 by 42-45 weeks postconceptional age.
- Permanent sequelae, primarily incomplete temporal retinal vascularization, occurred in 10% of infants with ROP, resulting in an overall retinal morbidity rate of 6.8%.
Conclusions:
- Most cases of retinopathy of prematurity demonstrate a favorable regression pattern, particularly when limited to the peripheral retina.
- Severe ROP requires prolonged monitoring due to delayed vascularization and a higher risk of lasting retinal complications.
- ROP-related retinal morbidity is infrequent, but vigilance for sequelae like incomplete peripheral vascularization is warranted.
Abstract:
We characterized the regression pattern of retinopathy of prematurity (ROP) for 266 infants examined over a 22-month period. Infants were included in the evaluation with a birth weight of less than or equal to 1500 g. Regression of retinopathy was observed in all but 11 infants, who were treated for threshold ROP. ROP limited to the peripheral retina resolved around term (40 weeks postconceptional age). Posterior ROP and/or stage 3 ROP underwent a protracted course of resolution, often not reaching zone 3 until 42 to 45 weeks after conception. Permanent retinal/vascular sequelae of ROP were observed in 10% of infants with ROP. The most common abnormality was failure to completely vascularize the temporal retinal periphery. Overall, retinal morbidity from ROP was an infrequent occurrence (18 of 266 premature infants--6.8%).