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A. Alme, T. Hejkal, M. Mulhern, D. Ingvoldstad, E. Margalit; Outcome of Retinopathy of Prematurity (ROP) Patients Following Adoption of Revised Indications for Treatment . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5303.
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Retinopathy of Prematurity (ROP) is a common cause for lifelong visual impairment. The Cryotherapy for Retinopathy of Prematurity Cooperative Group (CRYO–ROP) defined the severity of ROP for which treatment should be performed (threshold disease). However, a recent seminal paper (December 2003) showed that earlier treatment in high–risk prethreshold ROP significantly reduced unfavorable outcomes. Our research has evaluated the University of Nebraska data, to determine a) if earlier laser treatment has resulted in fewer untoward events, and b) if other significant changes were observed between conventional and early treatment groups.
This retrospective chart review has focused on laser ablations performed on 125 patients from January 1, 2000, through present. Halfway through this period, the Revised Indications for Treatment of Retinopathy of Prematurity were adopted. Data collected includes date of birth, birth weight; estimated gestational age (EGA); Severity grading of ROP according to the CRYO–ROP study; date of laser ablation; time between exam one and laser ablation; outcome of laser surgery; and long–term follow–up. This data was collected for treated patients before and after December 2003 (group A, and B respectively).
581 and 464 patients were examined before and after December 2003, respectively. Group A and B included 30 and 53 patients, respectively. The average age at birth for Group A patients was 26.3 weeks, with an average birth weight of 879 grams. The average age at birth of group B patients was 25.1 weeks, and average birth weight was 709 grams. While 10% of group A patients and eyes developed stage V retinal detachment, only 5.6% of group B patients and 2.8% of eyes developed stage V retinal detachment. Further statistical analysis is pending.
This data further supports the Revised Indications criteria, with a decrease from 10% to 2.8% of eyes developing Stage V retinal detachments. The data also supports a nationwide trend of younger patients’ survival, thus increasing the likelihood of developing ROP. Decreasing Stage V retinal detachments in the setting of younger preterm infants underscores the importance of adoption of the Revised Indications for Treatment.
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