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V. Robredo, E. Ariza, C. Serna, N. Matti, E. Fulda, F. Graue; Early Detection and Laser Treatment for Retinopathy of Prematurity (ROP) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5306.
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Determine incidence of prematures and ROP. Detect and treat early stages of ROP.
A prospective, descriptive and longitudinal study was performed in the "Instituto de Oftalmologia Fundacion Conde de Valenciana" from august 2004 to april 2005. All infants with a gestational age of 32 weeks or less or birth weight less than 1500 g were included and examined by an ophthalmologist at 1–2 weeks intervals from 4th to 6th postnatal weeks under local anesthesia. Patients with another ocular pathology were excluded. For staging ROP the International Classification was used. The criteria for laser treatment was prethreshold staging and threshold and was performed within 48 hours after the diagnosis. Gestational age, birth weight and postnatal weeks data were recorded.
13839 infants were born, of whom 1571 (11.35%) were preterm. 60 patients (120 eyes) were evaluated during the study with the previous criteria. The maternal average age was 28.6 years (14–39).The mean gestational age at birth was 30 weeks (range 27–34) and the mean birth weight 1107gr (range 630–1508). The most frequent perinatal pathology observed was toxemia (69%) others were vaginitis and premature rupture of the amnios resulting in 41 cesareas (60.3%). We observed that 34% of our cases with ROP were born at the 30 weeks of gestation (WG), 18.2% at 28 WG and 12.9% at 29 WG. 25.8% of our patients had an initial weight between 1100 and 1200gr. Of the 60 patients with high risk of developing ROP, 16.05% where staged prethreshold or above, 43.3% had stage 1 or 2 of ROP and 16.7% did not have ROP. 18 patients were treated with laser and 42 were observed. Stage I in zone 3 was the most frequent finding (53.6%).
We observed an incidence with 81.5% regression. We did not observe any statistical difference between male or female, but all our patients that were treated with laser were females. In our data there were no patients under 29 WG that develop ROP, on the other hand, there were patients that developed ROP in any range of initial weight. Laser treatment in patients with pretheshold or above was done in 1 or more sessions, having a 94.5% efficacy on regression, just one case in our study required surgery.
Treatment with laser photocoagulation in stages pretheshold or plus disease is effective controlling ROP. The gestational age has a close relationship and is directly proportional to the stage of ROP. The weigth gain does not play a protection role for developing ROP. Close followups should be done in multiple pregnancies because the prematures can develop diferent ROP stages.
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