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G. S. Ford, R. M. Davis, E. Cheeseman, D. Wee; Evaluating Necrotizing Enterocolitis as a Potential Risk Factor for Advanced-stage Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3150.
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© ARVO (1962-2015); The Authors (2016-present)
To update previously presented data (ARVO 2008) regarding the evaluation of necrotizing enterocolitis (NEC) as a potential risk factor in the development of advanced-stage retinopathy of prematurity (ROP) in neonates known to be at risk on the basis of very low birth weight (<1500 grams) and gestational age at birth <30 weeks.
A retrospective chart review was conducted on patients in the neonatal intensive care unit diagnosed with ROP between March 1, 2006 and December 31, 2007. Patients were identified using institutional screening and treatment records. Data extracted included birth gestational age (GA), birth weight (BW), stage of ROP at diagnosis, highest stage of ROP reached prior to regression, treatment with laser photocoagulation, and diagnosis of NEC.
One hundred twenty-three subjects met inclusion criteria. Twenty-eight of 123 subjects (22.8%) required laser photocoagulation for treatment of threshold ROP. NEC was a comorbid condition in 8 (28.6%) of the treated neonates. Subset analyses revealed that a total of 22 patients had NEC + ROP, all of which were diagnosed with NEC prior to diagnosis of ROP. In this subset comprising 17.9% (22 of 123) of the study population, 36.4% (8) required laser therapy compared to 19.8% (20 of 101) in the ROP without NEC group (P=0.047). Further evaluation of the highest stage of ROP reached demonstrated a significant difference within the study population of patients with NEC (n=22), mean highest ROP stage 2.45, and without NEC (n=101), mean highest ROP stage=1.87 (P=0.003).
ROP is a complex disease with many contributing variables that are not yet fully understood. These data suggest that NEC may increase the risk of more advanced disease and the risk of laser treatment for ROP. The role of NEC in the progression of ROP to advanced stages warrants further investigation.
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