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Busik V, Lorenz B, Mais C, Jäger M, Friedburg C, Andrassi-Darida M, Ehrhardt H, Hubert M. [10 years of screening for retinopathy of prematurity (2009-2019) : Results analysis of two German level-1 neonatal intensive care units (NICUs) with university on-site screening and a telemedical approach in the non-university NICU]. DIE OPHTHALMOLOGIE 2023; 120:920-931. [PMID: 37083751 DOI: 10.1007/s00347-023-01847-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/27/2023] [Accepted: 03/15/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is one of the most common causes of childhood blindness in Germany and worldwide and adequate screening is essential. The telemedical approach with objective documentation of retinal findings opens up the possibility of reliably diagnosing all ROP stages independent of the examiner, if a team of ophthalmologists specialized in ROP evaluates the images. OBJECTIVE A 10-year comparison of ROP screening at two level‑1 neonatal intensive care units (NICU): university and on-site vs. non-university and telemedical. MATERIAL AND METHODS Retrospective analysis of screened premature infants by gestational age (GA), birth weight (BW), sex, multiple births, time of ROP occurrence, treatment needs and time as well as examination frequency. RESULTS From 2009 to 2019, we screened 1191 infants of whom 29 had been screened before by an external clinic. The internal 1162 infants were screened on-site with 3713 retinal examinations. We diagnosed 34% with ROP and treated 5.4% (3.7% in Giessen, 7.2% in Siegen). Mean GA was 28.9 weeks (± 2.5 weeks); mean BW 1155 g (± 417.5 g). The number of ROP diagnoses increased by 227.3% in Giessen and by 111.1% in Siegen due to the increasing number of premature births in neonatal care. CONCLUSION Comparative analysis confirmed nationally and internationally increasing ROP screening and children with acute ROP. Telemedical screening was equivalent to on-site screening and safe. Both screening methods identified infants requiring treatment on time. No child with GA > 29 weeks required treatment, analogous to Swedish ROP registry results; however, in the German ROP registry some premature babies with GA ≥ 30 weeks required treatment.
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Affiliation(s)
- Valentina Busik
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen, Justus-Liebig-Universität Gießen, Friedrichstraße 18, 35390, Gießen, Deutschland
- Universitätsklinikum Gießen, Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland
| | - Birgit Lorenz
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen, Justus-Liebig-Universität Gießen, Friedrichstraße 18, 35390, Gießen, Deutschland.
- Universitätsklinikum Gießen, Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland.
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
| | - Christine Mais
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen, Justus-Liebig-Universität Gießen, Friedrichstraße 18, 35390, Gießen, Deutschland
| | - Melanie Jäger
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen, Justus-Liebig-Universität Gießen, Friedrichstraße 18, 35390, Gießen, Deutschland
- Augenarztpraxis, Bad Brückenau, Deutschland
| | - Christoph Friedburg
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen, Justus-Liebig-Universität Gießen, Friedrichstraße 18, 35390, Gießen, Deutschland
- Universitätsklinikum Gießen, Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland
| | - Monika Andrassi-Darida
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen, Justus-Liebig-Universität Gießen, Friedrichstraße 18, 35390, Gießen, Deutschland
- Universitätsklinikum Gießen, Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland
| | - Harald Ehrhardt
- Sektion Neonatologie und Pädiatrische Intensivmedizin, Klinik für Kinder und Jugendmedizin, Universitätsklinikum Ulm, Ulm, Deutschland
- Abteilung Allgemeine Pädiatrie und Neonatologie, Universitätsklinikum Gießen und Marburg GmbH, Gießen, Deutschland
| | - Mechthild Hubert
- Neonatologie und Pädiatrische Intensivmedizin, DRK-Kinderklinik Siegen, Siegen, Deutschland
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Kvopka M, Chan W, Lake SR, Durkin S, Taranath D. Fundus fluorescein angiography imaging of retinopathy of prematurity in infants: A review. Surv Ophthalmol 2023; 68:849-860. [PMID: 37211096 DOI: 10.1016/j.survophthal.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
Fluorescein angiography in retinopathy of prematurity is increasingly utilized over the past decade. The development of ultra-wide-field imaging combined with fluorescein angiography has allowed improved visualization of the peripheral retinal vasculature. Patient cooperation in the pediatric population is particularly challenging, but hand-held digital retinal photography has shown promise and can visualize the infant retina without the need for anesthesia and intravenous access. Many features of retinopathy of prematurity and its response to laser and anti-VEGF treatment can be either exclusively or better visualized on fluorescein angiography compared to indirect ophthalmoscopy or color fundus photography. Disease treatment is gradually shifting from laser photocoagulation to intravitreal anti-VEGF agents, the latter being associated with late-onset vision-threatening sequelae. The role of fluorescein angiography in retinopathy of prematurity monitoring will continue to increase with the longer follow-up required and different clinical behavior seen with anti-VEGF treatment. We highlight the utility, safety, and importance of fluorescein angiography in the diagnosis, treatment, and follow-up of retinopathy of prematurity.
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Affiliation(s)
- Michael Kvopka
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia.
| | - WengOnn Chan
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia; Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Australia; Machine Learning Division, Ophthalmic Research Laboratory, University of Adelaide, Australia
| | - Stewart R Lake
- Department of Ophthalmology, Division of Surgery, Flinders Medical Centre, Adelaide. Australia
| | - Shane Durkin
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Deepa Taranath
- Department of Ophthalmology, Division of Surgery, Flinders Medical Centre, Adelaide. Australia
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Li JQ, Kellner U, Lorenz B, Stahl A, Krohne TU. Frühgeborenenretinopathie. Klin Monbl Augenheilkd 2022; 239:346-363. [DOI: 10.1055/a-1758-3020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDie Frühgeborenenretinopathie zählt zu den häufigsten behandelbaren Erblindungsursachen bei Kindern. Es handelt sich um eine vasoproliferative Netzhauterkrankung, die nur bei Frühgeborenen
auftritt. Durch ein konsequentes augenärztliches Screening können nahezu alle Augen mit behandlungsbedürftiger ROP frühzeitig identifiziert und einer Behandlung zugeführt werden, sodass das
Risiko einer schweren Sehbehinderung oder Erblindung durch eine ROP erheblich gesenkt wird.
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Li JQ, Kellner U, Lorenz B, Stahl A, Krohne TU. Frühgeborenenretinopathie. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1488-0839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDie Frühgeborenenretinopathie zählt zu den häufigsten behandelbaren Erblindungsursachen bei Kindern. Es handelt sich um eine vasoproliferative Netzhauterkrankung, die nur bei Frühgeborenen
auftritt. Durch ein konsequentes augenärztliches Screening können nahezu alle Augen mit behandlungsbedürftiger ROP frühzeitig identifiziert und einer Behandlung zugeführt werden, sodass das
Risiko einer schweren Sehbehinderung oder Erblindung durch eine ROP erheblich gesenkt wird.
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Stellungnahme der Deutschen Ophthalmologischen Gesellschaft, der Retinologischen Gesellschaft und des Berufsverbands der Augenärzte Deutschlands zur Anti-VEGF-Therapie der Frühgeborenenretinopathie. Klin Monbl Augenheilkd 2020; 237:1129-1139. [DOI: 10.1055/a-1228-1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sheludchenko VM, Kozlovskaya NL, Smirnova TV, Krasnolutskaya EI. [Ophthalmic aspects of vascular and functional changes in malignant arterial hypertension of renal origin]. Vestn Oftalmol 2020; 136:324-332. [PMID: 32880158 DOI: 10.17116/oftalma2020136042324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Malignant arterial hypertension is a clinical syndrome characterized by severe diastolic arterial hypertension with signs of ischemic damage to target organs - kidneys, heart, brain, eyes. Malignant arterial hypertension can be one of the reasons, as well as a consequence of thrombotic microangiopathy - a special type of vascular lesions of the organ microvasculature. Ocular manifestations of arterial hypertension include hypertensive retinopathy of varying severity, choriopathy. The appearance of new diagnostic research methods allows a detailed study of eye damage in malignant arterial hypertension, whether associated or not with thrombotic microangiopathy, and to analyze the relationship of ocular and systemic manifestations of this disease to determine the nature and degree of involvement of the organ of vision in the pathological process and identify prognostic signs of disease progression and its forms.
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Affiliation(s)
| | | | - T V Smirnova
- Research Institute of Eye Diseases, Moscow, Russia
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