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Mingui Kong, Eun Sun Kim, Yun Sil Chang, Sang Jin Kim; Clinical Characteristics Of Retinopathy Of Prematurity In Infants Born Before 25 Weeks’ Gestation In A Korean Single Neonatal Intensive Care Unit. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5879.
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The retinopathy of prematurity (ROP) in extremely premature infants is not well characterized. We investigated the incidence and natural history of ROP in extremely preterm infants born before 25 weeks’ gestation in a Korean single neonatal intensive care unit.
The medical records of extremely preterm infants, who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from 2004 to 2010, were retrospectively reviewed. Infants born before 25 weeks’ gestation who completed screening examination were included. The screening examination for ROP followed the guidelines proposed by the American Academy of Ophthalmology and Pediatrics and Association for Pediatric Ophthalmology and Strabismus. The first examination was done at 29 to 31 weeks’ postmenstrual age. The criteria for the treatment of ROP agreed with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group.
Ninety four infants including 2 born at 22 weeks’, 35 at 23 weeks’, and 57 at 24 weeks’ gestation, were enrolled in the study. Mean birth weight was 651g (range:370 to 1104 g). Eighty six (91.5 %) of 94 infants showed any stage of ROP, with 32.8 weeks of mean postmenstrual age (PMA) at onset of ROP. Laser treatment was performed on 2 (100%) infants born at 22 weeks’, 21 (60.0%) at 23 weeks’, and 32 (50.7%) at 24 weeks’ gestation. Mean PMA at the time of laser treatment was 35.3 weeks (range: 30 to 42 weeks). All but one infant required laser treatment after 31 weeks’ PMA. One infant born at 24 weeks’ gestation showed aggressive posterior ROP at the first screening examination at 30 weeks’ PMA. 6 (6%) infants showed zone I ROP.
The incidence of severe ROP requiring laser treatment in extremely preterm infants born before 25 weeks’ gestation was high. Although current screening protocol detected almost every ROP before laser treatment was required, early screening examination may be necessary before 31weeks’ PMA in infants with high risk.
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