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Carlos Abdala, Jenny Lobo Lopez, Sarah Jordan, Paul Rychwalski; Primary Rescue Therapy In The Treatment Of Threshold Retinopathy Of Prematurity. Invest. Ophthalmol. Vis. Sci. 2013;54(15):610.
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Describe the clinical characteristics and outcomes of children with Retinopathy of Prematurity (ROP) who were screened and treated in 11 Neonatal Intensive Care Units in Colombia between January 2008 - June 2012.
749 eyes were examined in 377 infants born with a gestational age (GA) of 32 weeks or less and a birth weight (BW) of 1750 g or less. One observer screened all infants at the fifth week of life or by 34 weeks post- conception.
152 of 377 patients (40%) had any type of ROP, affecting 299 eyes. 181 eyes of 97 patients required surgery (24%). 127 eyes of 69 patients required Laser Photocoagulation and 54 eyes of 28 patients required Primary Rescue Therapy (Laser and intravitreal injection of anti-VEGF). 34 eyes of 18 patients in the laser group were lost to follow-up and 4 eyes of 2 infants in the Primary Rescue Therapy group were similarly lost to follow-up. In addition, 4 eyes of 3 patients of this last group were excluded due to progression to Stage 4 ROP before treatment. In this report we analyze the results of the Primary Rescue Therapy Group. 46 eyes of 23 patients had a mean GA of 27,6 weeks. More than 50% of infants were born between 27 and 29 weeks. 100% of the patients with ROP were born < 32 weeks of gestation. The mean BW was 1008,4 g. 87% of the infants of this group weighed 1500 g or less at birth. 6/23 (26%) had a BW of between 1001 and 1500 g and 14/23 (61%) had a BW of 1000 g or less. All infants of this group had Threshold ROP. Eight eyes (17,39%) required a second rescue therapy treatment (fifteen days after the initial therapy) in order to obtain regression of ROP.
The development of ROP is related to low birth weight and gestational age. In our series, the infants had a mean BW of 1008 g with 87% of infants having a BW of 1500 g or less. 61% had a BW of 1000 g or less. In our group of patients, this was a significant risk factor in the development of threshold ROP. The combination of Laser and Anti-VEGF proved to be effective in treating Threshold ROP and halting the progression of the ROP in 93.5% of infants. Finally, 8/46 eyes (17.3%) required a second treatment in order to obtain the complete regression of the disease.
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