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Ankit Mehta, Paul Lagonigro, David Isaacs, Emerson Que, Shree Kurup, Danny H.-Kauffmann Jokl; Neonatal Septicemia Is a Risk Factor for the Progression of Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3450.
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To search for risk factors to explain an asymmetric progression of ROP in genetically similar neonates.
The serologic data and clinical course of two sets of monozygotic twins designated A,B and C,D and one set of triplets (E,F,G) were assessed and correlated with the course of ROP and, where appropriate, statistical significance was calculated.
1. All seven of seven neonates (100%) had culture proven septicemia. 2. Five of seven (70%) had progression of ROP requiring surgery - laser for three of seven (43%), vitrectomy for two of seven (30%). 3. No correlation of APGAR scores, PEEP settings, serum potassium, white blood cell counts, and oxygen saturations to ROP progression was found. A genetic propensity to ROP progression could not be shown. 4. Progression to Stage 4 ROP (requiring vitrectomy) was noted in one twin (50%) of each of two twin sets (2 of 4) due to C. parapsillosis in twin B and S. epidermidis in twin C. Their respective siblings,A and D, progressed to threshold with plus disease requiring laser. Twin A had S. epidermidis sepicemia while twin D grew C. parapsillosis.One triplet, F, (33%) also progressed to threshold with plus disease requiring laser and grew out both E. fecalis and S. hominus. 5. The remaining two triplet siblings (67%) remained at zone 2, stage 2 despite septicemia due to Klebsiella and S.epidermidis in E and E. fecalis in G and both required no surgery.
1. Neonatal septicemia is a major risk factor for the progression of ROP. 2. The presence of septicemia demands frequent ophthalmic examinations to detect and manage progression of ROP.
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