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A. Fazelat, A. Srivastava, C. Sharma, E. Baron; Risk Factors for Developing Threshold Disease in Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4849.
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To determine which risk factors, if any, contribute to the development of threshold disease in pre-mature infants at high risk for Retinopathy of Prematurity (ROP).
Demographic and clinical data were collected retrospectively from the examination log books, paper chart and computer record for all infants in the neonatal intensive care unit that were referred for ophthalmologic evaluation from January 1,2004 thru October 30, 2006. Any infant with a birth weight equal to, or less than 1500 grams and/or was born 28 weeks, or less premature was referred for examination. Each infant received a baseline dilated fundoscopic examination upon presentation. The infants were subsequently scheduled for either immediate treatment or followed at a 1,2 or 3 week interval depending on the stage and characterization disease using the International Committee on Classification of Acute ROP criteria.
Of the 174 babies referred for evaluation during the study period, 155 were included in our study. 137 (88.3%) had some stage of retinopathy at presentation. 78 (50.3%) babies were born to mothers with Hispanic surnames. A total of 22 (14.2%) babies developed threshold disease requiring laser photocoagulation. The mean birth weight, gestational age, and age at presentation for those babies who developed threshold disease was 743 grams (+/- 148), 25.3 weeks (+/-1.35) and 32.2 weeks (+/- 2.1) respectively. The mean birth weight, gestational age, and age at presentation for those babies who did not develop threshold disease was 1002 grams (+/- 294), 27.6 weeks (+/- 2.1) and 33.7 weeks (+/- 2.5) respectively. 63.6% (14 of 22) of babies who developed threshold disease were born to mothers with Hispanic surnames as compared to only 48.1%(64 of 133) in the population that did not progress to threshold disease. Multivariate regression analysis revealed that only birth weight (p-value <0.0001) and Hispanic surname (p-value =0.0315) were significantly associated with the development of threshold disease. There was no statistically significant difference with regard to gestational age, age at initial presentation, stage, zone and presence or absence of plus disease at presentation between those babies who developed threshold disease and those who did not.
We conclude that lower birth weight and Hispanic surname are significantly associated with the development of threshold disease in babies with Retinopathy of Prematurity.
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