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P. J. Rychwalski, C. Abdala Caballero, I. Anaya Espinosa, M. Montoya Baena; Retinopathy of Prematurity (ROP) in the Developing World: A Three-Year Longitudinal Study of the Charactersistics and Outcomes of Infants With ROP in Colombia. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3105.
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Describe the clinical characteristics and outcomes of children with Retinopathy of Prematurity (ROP) who were screened and treated in 5 Neonatal Intensive Care Units in Colombia between July 2003 - July 2006.
468 eyes were examined in 234 infants born with a gestational age (GA) of 32 weeks or less and a birth weight (BW) of 1500 g or less. One observer screened all infants at the fifth week of life or by 34 weeks post-conception.
145 of 234 (62%) patients had ROP, affecting 286 eyes. ROP was bilateral in 141 patients (97%) and unilateral in 4 patients (3%). The mean GA of the neonates with ROP was 29.56 weeks. More than 50% of the cases were in infants born between 27 and 29 weeks. 91% of the patients with ROP were born before 32 weeks of gestation compared with only 9% of preterm that were born after week 32 (P=0.005). Stages of ROP follow in Table 1. The mean BW of our study group was 1146.07 g. 132/145 (91%) of the infants with ROP weighed 1500 g or less at birth. 79/145 (54.5%) had a BW of between 1000 and 1500 g and 53/145 (36.5%) had a BW of 1000 g or less. When comparing the BW between neonates with and without ROP, we found that preterm infants had a 22.46% less risk of developing ROP if their BW was greater than 1500 g. (p=0.00, Chi-square=29.13)
The development of ROP is related to low birth weight and gestational age. Dangerously, however, not all babies followed this trend:It is standard in the United States to screen only those infants weighing <1500 g at birth. Some institutions will routinely screen only those infants born with a birth weight of <1250 g. In our study, 54.5% of the infants that developed ROP weighed between 1000 and 1500 g. Similarly, 13/145 (9%) of patients with ROP were born after 32 weeks gestation. Thus, we advocate that each institution carefully monitor their trends and rates of ROP in order to develop screening criteria that will capture the greatest number of infants with ROP.
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