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A. K. Venkataraman, R. Azad, S. Patwardhan, P. Chandra; Aggressive Posterior Retinopathy of Prematurity: Demography, Risk Factors and Treatment Outcome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5227.
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To study the demographic trends, risk factors and treatment outcome of aggressive posterior retinopathy of prematurity (APROP) in Asian eyes.
This is a retrospective review of 74 eyes of 40 infants diagnosed as APROP between Jan 2001 and July 2007 at a tertiary care hospital in India. Statistical tests involve the chi-square test for statistical significance and paired and unpaired t tests.
The mean gestational age and mean birth weight were 30.02 + 2.77 weeks (25-36 weeks) and 1336.07 + 359.61 grams (700-2300 grams) respectively. 10 of 40 infants (25%) had birth weight equal to or greater than 1500 grams. Major risk factors included oxygen therapy in 32 of 40 infants (80%), sepsis in 21 of 40 infants(52.5%) and blood transfusion in 18 of 40 infants(45%). 55% of eyes (41 of 74 eyes) had zone 1 disease with the remaining 45% (33 of 74 eyes) having zone 2 posterior disease. At a mean post-conceptional age of 37.875 + 5.02 weeks (32-54 weeks), all eyes underwent confluent diode laser photocoagulation of the avascular retina. At the end of a mean follow up period of 18 months (range 6-22 months), 58 of 74 eyes (78.37%) showed regression of APROP with a favourable anatomical outcome. 4 of these eyes (6.89 %) developed disc and macular drag. 16 of 74 eyes (21.62%) progressed to either stage 4b or stage 5 retinopathy of which 9 eyes (56.25%) had pre-retinal haemorrhages.
APROP is not limited to very low birth weight babies and can be encountered in heavier Asian babies. Pre-retinal haemorrhages emerged as important risk factor for progression of disease to advanced stage despite laser. Early laser photocoagulation is effective in causing regression of aggressive disease.
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