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G. S. Ford, T. Federici, E. Cheeseman, Jr.; Necrotizing Enterocolitis as a Potential Risk Factor for Development of Advanced-Stage ROP. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1401.
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To evaluate necrotizing enterocolitis (NEC) as a contributing 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, 2006. Patients were identified using an institutional electronic database. 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. All neonates with birth GA <30 weeks and BW <1500 grams that were diagnosed with NEC were separately identified irrespective of ROP for further analysis.
Thirty-four subjects met inclusion criteria. Ten of those 34 (29%) required laser photocoagulation for treatment of threshold ROP. NEC was a comorbid condition in 4 (40%) of the treated neonates. Subset analyses reveal that a total of 9 patients had NEC + ROP, 7 of which were diagnosed with NEC prior to diagnosis of ROP. In this subset comprising 21% (7 of 34) of the study population, 57% (4) required laser therapy compared to 24% (6 of 25) in the ROP without NEC group. The mean time between ROP diagnosis to treatment was 2.5 weeks (range=0 to 4; median=3) in the ROP + NEC group and 2.8 weeks (range=1 to 6; median=2.5) in the ROP only group. Further analysis revealed that all 10 neonates requiring laser photocoagulation were 24 to 27 weeks GA at birth weighing between 500 and 899 grams. Eight subjects screened for ROP were recognized with these high risk traits among 27 neonates diagnosed with NEC during the time frame of the study. Of these 8, 100% were diagnosed with ROP, 50% (4) of which required treatment for threshold ROP.
ROP is a complex disease with many contributing variables that are not yet fully understood. These data suggest that NEC may play a role in the development and progression of ROP.
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