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An Update on Retinopathy of Prematurity (ROP)

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Abstract

Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease affecting the retina of premature infants. The clinical spectrum of ROP varies from spontaneous regression to bilateral retinal detachment and total blindness. Between these two extremes lies the form of ROP, which is amenable to treatment with laser photocoagulation, anti-vascular endothelial growth factor drugs or surgery. Increasing rates of preterm births coupled with better survival rates but lack of uniform quality of neonatal care and delays in diagnosis have led to increasing ROP blindness. Atypical forms of Aggressive Posterior ROP are seen in heavier birth weight babies in developing countries. Prevention of ROP by following stringent protocols for supplemental oxygen, prevention of sepsis, timely screening and laser treatment by a concerted and collaborative effort of neonatologists and ophthalmologists are required to fight the blindness from ROP.

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References

  1. Terry TL. Extreme prematurity and fibroblastic overgrowth of persistent vascular sheath behind each crystalline lens: I. Preliminary report. Am J Ophthalmol. 1942;25:203–4.

    Article  Google Scholar 

  2. Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008;84:77–82.

    Article  PubMed  Google Scholar 

  3. Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74:35–49.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379:2162–72.

    Article  PubMed  Google Scholar 

  5. Gilbert C, Fielder A, Gordillo L, et al; International NO-ROP Group. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics. 2005;115:e518–25.

  6. Lee AC. Katz J, Blencowe H, et al; CHERG SGA-preterm birth working group. National and regional estimates of term and preterm babies born small for gestational age in 138 low- income and middle-income countries in 2010. Lancet Glob Health. 2013;1:e26–36.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Charan R, Dogra MR, Gupta A, Narang A. The incidence of retinopathy of prematurity in a neonatal care unit. Indian J Ophthalmol. 1995;43:123–6.

    CAS  PubMed  Google Scholar 

  8. Gopal L, Sharma T, Ramchandran S. Retinopathy of prematurity: a study. Indian J Ophthalmol. 1995;43:59–61.

    CAS  PubMed  Google Scholar 

  9. Vinekar A, Dogra MR, Sangtam T, Narang A, Gupta A. Retinopathy of prematurity in Asian Indian babies weighing greater than 1250 grams at birth: ten year data from a tertiary care center in a developing country. Indian J Ophthalmol. 2007;55:331–6.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jalali S, Matalia J, Hussain A, Anand R. Modification of screening criteria for retinopathy of prematurity in India and other middle-income countries. Am J Ophthalmol. 2006;141:966–8.

    Article  PubMed  Google Scholar 

  11. Hungi B, Vinekar A, Datti N, et al. Retinopathy of prematurity in a rural neonatal intensive care unit in South India-a prospective study. Indian J Pediatr. 2012;79:911–5.

    Article  PubMed  Google Scholar 

  12. National Neonatology Forum, India. Evidence-based Clinical Practice Guidelines. Available at: http://www.nnfi.org/images/pdf/nnf_cpg_consolidated_filejanuary 102011.pdf. Accessed on 19 May 2017.

  13. Vinekar A, Gilbert C, Dogra M, et al. The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting. Indian J Ophthalmol. 2014;62:41–9.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sanghi G, Dogra MR, Katoch D, Gupta A. Demographic profile of infants with stage 5 retinopathy of prematurity in North India: implications for screening. Ophthalmic Epidemiol. 2011;18:72–4.

    Article  PubMed  Google Scholar 

  15. Flynn JT, Chan-Ling T. Retinopathy of prematurity: two distinct mechanisms that underlie zone 1 and zone 2 disease. Am J Ophthalmol. 2006;142:46–59.

    Article  PubMed  Google Scholar 

  16. Supplemental Therapeutic Oxygen for Prethreshold Retinopathy Of Prematurity (STOP-ROP). A randomized, controlled trial. I: primary outcomes. Pediatrics. 2000;105:295–310.

    Article  Google Scholar 

  17. Chen ML, Guo L, Smith LE, Dammann CE, Dammann O. High or low oxygen saturation and severe retinopathy of prematurity: a meta-analysis. Pediatrics. 2010;125:e1483–92.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Karna P, Muttineni J, Angell L, Karmaus W. Retinopathy of prematurity and risk factors: a prospective cohort study. BMC Pediatr. 2005;5:18.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Dutta S, Narang S, Narang A, Dogra M, Gupta A. Risk factors of threshold retinopathy of prematurity. Indian Pediatr. 2004;41:665–71.

    PubMed  Google Scholar 

  20. Fortes Filho JB, Bonomo PP, Maia M, Procianoy RS. Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies. Graefes Arch Clin Exp Ophthalmol. 2009;247:831–6.

    Article  PubMed  Google Scholar 

  21. Shah PK, Narendran V, Kalpana N. Aggressive posterior retinopathy of prematurity in large preterm babies in South India. Arch Dis Child Fetal Neonatal Ed. 2012;97:F371–5.

    Article  PubMed  Google Scholar 

  22. International Committee for the Classification of Retinopathy of Prematurity. The International classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005;123:991–9.

    Article  Google Scholar 

  23. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results. Arch Ophthalmol. 1988;106:471–9.

    Article  Google Scholar 

  24. Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121:1684–94.

    Article  Google Scholar 

  25. Sanghi G, Dogra MR, Vinekar A, Gupta A. Frequency-doubled Nd:YAG (532 nm green) versus diode laser (810 nm) in treatment of retinopathy of prematurity. Br J Ophthalmol. 2010;94:1264–5.

    Article  CAS  PubMed  Google Scholar 

  26. Dogra MR, Vinekar A, Viswanathan K, et al. Laser treatment for retinopathy of prematurity through the incubator wall. Ophthalmic Surg Lasers Imaging. 2008;39:350–2.

    Article  PubMed  Google Scholar 

  27. Sanghi G, Dogra MR, Katoch D, Gupta A. Aggressive posterior retinopathy of prematurity: risk factors for retinal detachment despite confluent laser photocoagulation. Am J Ophthalmol. 2013;155:159–64.

    Article  PubMed  Google Scholar 

  28. Stone J, Itin A, Alon T, et al. Development of retinal vasculature is mediated by hypoxia-induced vascular endothelial growth factor (VEGF) expression by neuroglia. J Neurosci. 1995;15:4738–47.

    CAS  PubMed  Google Scholar 

  29. Travassos A, Teixeira S, Ferreira P, et al. Intravitreal bevacizumab in aggressive posterior retinopathy of prematurity. Ophthalmic Surg Lasers Imaging. 2007;38:233–7.

    PubMed  Google Scholar 

  30. Mintz-Hittner HA, Kuffel RR Jr. Intravitreal injection of bevacizumab (avastin) for treatment of stage 3 retinopathy of prematurity in zone I or posterior zone II. Retina. 2008;28:831–8.

    Article  PubMed  Google Scholar 

  31. Darlow BA, Ells AL, Gilbert CE, Gole GA, Quinn GE. Are we there yet? Bevacizumab therapy for retinopathy of prematurity. Arch Dis Child Fetal Neonatal Ed. 2013;98:F170–4.

    Article  PubMed  Google Scholar 

  32. Hu J, Blair MP, Shapiro MJ, Lichtenstein SJ, Galasso JM, Kapur R. Reactivation of retinopathy of prematurity after bevacizumab injection. Arch Ophthalmol. 2012;130:1000–6.

    Article  CAS  PubMed  Google Scholar 

  33. Snyder LL, Garcia-Gonzalez JM, Shapiro MJ, Blair MP. Very late reactivation of retinopathy of prematurity after monotherapy with intravitreal bevacizumab. Ophthalmic Surg Lasers Imaging Retina. 2016;47:280–3.

    Article  PubMed  Google Scholar 

  34. Bhende P, Gopal L, Sharma T, Verma A, Biswas RK. Functional and anatomical outcomes after primary lens-sparing pars plana vitrectomy for stage 4 retinopathy of prematurity. Indian J Ophthalmol. 2009;57:267–71.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Shah PK, Narendran V, Kalpana N, Tawansy KA. Anatomic and visual outcomes of stage 4 & 5 ROP. Eye. 2009;23:176–80.

    Article  CAS  PubMed  Google Scholar 

  36. Gopal L, Sharma T, Shanmugam M, et al. Surgery for stage 5 retinopathy of prematurity: the learning curve and evolving technique. Indian J Ophthalmol. 2000;48:101–6.

    CAS  PubMed  Google Scholar 

  37. Dhawan A, Dogra MR, Vinekar A, Gupta A, Dutta S. Structural sequelae and refractive outcome following successful laser treatment for threshold ROP. J Pediatr Ophthalmol Strabismus. 2008;45:356–6.

  38. Katoch D, Sanghi G, Dogra MR, Beke N, Gupta A. Structural sequelae and refractive outcome after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes. Indian J Opthalmol. 2011;59:423–6.

    Article  Google Scholar 

  39. Sanghi G, Dogra MR, Das P, Vinekar A, Gupta A, Dutta S. Aggressive posterior retinopathy of prematurity in Asian Indian babies: spectrum of disease and outcome after laser treatment. Retina. 2009;29:1335–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Mangat Ram Dogra, Deeksha Katoch & Mohit Dogra

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  1. Mangat Ram Dogra
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  2. Deeksha Katoch
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  3. Mohit Dogra
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Contributions

MRD was involved in the conception, design of the work; critical revision, accuracy and integrity of data as well as final approval of the manuscript. DK and MD were involved in acquisition, analysis and interpretation of data, literature review for the work as well as drafting of the manuscript. MRD will act as guarantor for the paper.

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Correspondence to Mangat Ram Dogra.

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Dogra, M.R., Katoch, D. & Dogra, M. An Update on Retinopathy of Prematurity (ROP). Indian J Pediatr 84, 930–936 (2017). https://doi.org/10.1007/s12098-017-2404-3

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  • DOI: https://doi.org/10.1007/s12098-017-2404-3

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