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Padhi TR, Bhunia S, Shah M, Sahu S, Das T, Bhusal U, Singh A, Samantaray B, Patro K, Devi S, Routray D, Mohamed A, Pradhan L, Jalali S. OUTCOME OF EYES TREATED FOR RETINOPATHY OF PREMATURITY IN POSTERIOR ZONE I: An Eastern India Study. Retina 2024; 44:1073-1082. [PMID: 38346099 DOI: 10.1097/iae.0000000000004067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
PURPOSE To analyze the outcomes of eyes treated for retinopathy of prematurity in posterior Zone I. METHODS In a part retrospective (9 years) and part prospective (1 year) interventional study, we analyzed eyes treated for retinopathy of prematurity in posterior Zone I with a minimum follow-up for 6 months. RESULTS This study included 109 eyes of 56 infants; mean gestational age and birth weights were 29.3 (±2.1) weeks and 1112.5 (±381.9) g, respectively. The treatment included intravitreal anti-vascular endothelial growth factor as the initial treatment modality in 101 eyes (92.6%), either alone (27 eyes) or combined with laser or vitreous surgery (73 eyes). Laser was the initial treatment modality in eight eyes, either alone (n = 3) or in combination with surgery (n = 5). With anti-vascular endothelial growth factor alone, 30.68% (n = 27) eyes responded favorably, and the remaining 69.32% (n = 59) eyes needed retreatment (laser in the majority). At the final follow-up, 89.9% (out of 109) of eyes did well anatomically. Good outcome was significantly linked to no detachment at presentation ( P < 0.0001) and the presence of well-defined central vascular trunks ( P = 0.001). CONCLUSION Treating the eyes before retinal detachment with bevacizumab followed by laser (and surgery, if needed) results in a favorable outcome in babies with posterior Zone I retinopathy of prematurity.
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Affiliation(s)
- Tapas R Padhi
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Souvik Bhunia
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Miloni Shah
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Suman Sahu
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Taraprasad Das
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kallam Anji Reddy Campus), Hyderabad, India
| | - Utpal Bhusal
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Aveenash Singh
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | | | - Krishna Patro
- Department of Ophthalmology, SCB Medical College, Cuttack, India
| | - Sabita Devi
- Department of Ophthalmology, MKCG Medical College, Berhampur, India
| | - Dipanweeta Routray
- Department of Community Medicine, Dharanidhar Medical College Hospital, Keonjhar, India; and
| | - Ashik Mohamed
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | | | - Subhadra Jalali
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kallam Anji Reddy Campus), Hyderabad, India
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Padhi TR, Shah M, Sahoo S, Das T, Bhusal U, Singh A, Bhunia S, Nayak S, Nayak S, Panchal B, Agrawal K, Samantaray B, Devi S, Rao K, Pradhan L, Mohamed A, Jalali S. Characteristics of posterior zone I retinopathy of prematurity. Eye (Lond) 2023; 37:3776-3780. [PMID: 37253857 PMCID: PMC10697929 DOI: 10.1038/s41433-023-02603-y] [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: 09/24/2022] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To report the demographic profile and clinical characteristics of retinopathy of prematurity (ROP) in posterior Zone I. METHODS In a partly retrospective (ten years) and partly prospective (one year) study, we analysed the demographic profile and clinical characteristics of babies with ROP in posterior Zone I. RESULTS The study included 130 eyes of 67 infants with a mean gestational age and birth weight of 29.3 (±2.2) weeks and 1217.3 (±381.9) grams, respectively. All babies had received unblended oxygen. In 47 of 51 (91.1%) babies, the weekly weight gain was <100 g (details were not available in 16 babies). The ROP subtypes included aggressive, threshold, hybrid, stage 4, and atypical types in 78 (60%), 20 (15.4%), 11 (8.5%), 15 (11.5%), and 6 (4.6%) eyes, respectively. Fibrovascular proliferation, when present, was prominent nasally, occasionally overriding the disc margin. Extensive arteriovenous tortuosity was more prominent than vascular dilatation. Atypical observations included bleb-like detachment (6 eyes; 4.6%) and candle wax-like preretinal deposits (23 eyes; 17.7%). CONCLUSIONS Retinopathy of Prematurity in posterior Zone I in this cohort was strongly associated with 100% unblended oxygen supplementation, poor weight gain, and multiple systemic co-morbidities. ROP in posterior zone 1 has a distinct profile with several atypical characteristics different from ROP in other zones.
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Affiliation(s)
- Tapas R Padhi
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India.
- Miriam Hyman Children's Eye Care Centre (MHCECC), Bhubaneswar, India.
| | - Miloni Shah
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Suman Sahoo
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Taraprasad Das
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kallam Anji Reddy Campus), Hyderabad, India
| | - Utpal Bhusal
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Abinash Singh
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Souvik Bhunia
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Sameer Nayak
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, India
| | - Sameera Nayak
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kode Venkatadri Chowdary Campus), Vijayawada, India
| | - Bhavik Panchal
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (GMRV Campus), Visakhapatnam, India
| | - Komal Agrawal
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kallam Anji Reddy Campus), Hyderabad, India
| | | | - Sabita Devi
- Department of Ophthalmology, MKCG Medical College, Berhampur, India
| | - Krishna Rao
- Department of Ophthalmology, SCB Medical College, Cuttack, India
| | | | - Ashik Mohamed
- Miriam Hyman Children's Eye Care Centre (MHCECC), Bhubaneswar, India
| | - Subhadra Jalali
- Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kallam Anji Reddy Campus), Hyderabad, India
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Bhat V, Patil SH. Role of deferred retinal laser following intravitreal injection of bevacizumab in treatment of severe retinopathy of prematurity. Oman J Ophthalmol 2023; 16:233-236. [PMID: 37602171 PMCID: PMC10433051 DOI: 10.4103/ojo.ojo_120_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/13/2023] [Indexed: 08/22/2023] Open
Abstract
PURPOSE The purpose is to determine the advantages and role of supplemental deferred retinal laser treatment following intravitreal bevacizumab (IVB) monotherapy in cases of severe retinopathy of prematurity (ROP) requiring treatment. MATERIALS AND METHODS This is a retrospective study involving preterm infants diagnosed with treatment requiring ROP, treated initially with bevacizumab monotherapy who subsequently received deferred laser treatment during the study period from April 2019 to March 2021. Deferred laser treatment was done when recurrence of ROP or plus disease was noted or nonprogression of retinal vasculature was noted on two consecutive examinations over 2 weeks. The main outcomes measured were the ability of the treatment to prevent ROP progression or recurrence and anatomic outcome at the last follow-up visit. RESULTS Twenty-three eyes of 14 neonates were treated with a deferred laser treatment following the initial intravitreal injection of Bevacizumab. The mean postmenstrual age at which IVB was given was 34+6 ± 1+3 weeks. The mean duration between IVB and retinal laser was 5+3 ± 3+4 weeks. The mean weight at the time of injection was 1317.8 ± 231.8 g. The mean weight of the infants at the time of the laser was 2050 ± 813.9 g. None of the eyes developed recurrence or adverse anatomical outcomes following laser till the last available follow-up. CONCLUSIONS In our small number of subjects, blinding complications of ROP were prevented by using a deferred laser treatment protocol following initial bevacizumab therapy in treatment requiring ROP. It is better suited in cases where compliance for long-term follow-up after bevacizumab therapy cannot be ensured.
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Affiliation(s)
- Vishalakshi Bhat
- Associate Professor, Department of Ophthalmology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
| | - Shankargouda H. Patil
- Professor, Department of Ophthalmology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
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Hoyek S, Peacker BL, Acaba-Berrocal LA, Al-Khersan H, Zhao Y, Hartnett ME, Berrocal AM, Patel NA. The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity: A Systematic Review and Meta-analysis. JAMA Ophthalmol 2022; 140:1110-1120. [PMID: 36201195 PMCID: PMC9539737 DOI: 10.1001/jamaophthalmol.2022.3988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/11/2022] [Indexed: 12/15/2022]
Abstract
Importance Literature and anecdotal evidence suggest a relationship between male sex and retinopathy of prematurity (ROP). It is not known whether a difference, if present, is sex-related pathophysiologic predisposition or sex difference in meeting ROP screening criteria. Objective To evaluate the association of sex with the development of treatment-warranted ROP. Data Sources PubMed, Embase, and Web of Science databases were searched from 2000 to 2022. The search strategy used keywords including retinopathy of prematurity or ROP or retrolental fibroplasia and treatment or anti-VEGF or bevacizumab or ranibizumab or aflibercept or conbercept or laser or cryotherapy and gender or sex or male or female and medical subject headings terms. Study Selection All studies reporting on treatment with anti-vascular endothelial growth factor, laser photocoagulation, and/or cryotherapy for ROP were identified. Studies reporting sex distribution in the treatment group were included in the meta-analysis. Exclusion criteria included case reports, case series of fewer than 10 treated patients, systematic reviews, conference abstracts, letters to the editor, animal studies, and non-English records. Data Extraction and Synthesis Two reviewers independently screened and extracted the data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The proportions of treated male and female infants were combined using random-effects meta-analysis. Main Outcomes and Measures Numbers and percentages of male and female infants treated for ROP. Results Of 11 368 identified studies, 316 met inclusion criteria, yielding a total of 31 026 treated patients. A higher percentage of male infants were treated for ROP (55% [95% CI, 0.54%-0.55%]), with low heterogeneity between studies (I2 = 34%; P < .001). Thirty-eight studies reported sex distribution in the screened population (170 053 patients; 92 612 [53%] male vs 77 441 [47%] female). There was no significant difference in the odds of receiving treatment between screened male and female infants (pooled odds ratio, 1.04 [95% CI, 0.91-1.18]; P = .67). Conclusions and Relevance More male infants are treated for ROP than female infants. This could be due to a known relative pathophysiological fragility of preterm male infants in addition to a difference in ROP screening rates, with more male infants meeting the criteria than female infants. These findings have implications for future studies and may prompt more careful clinical monitoring of male neonates.
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Affiliation(s)
- Sandra Hoyek
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Bryan L. Peacker
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Luis A. Acaba-Berrocal
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago
| | - Hasenin Al-Khersan
- Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
| | - Yan Zhao
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | | | - Audina M. Berrocal
- Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
| | - Nimesh A. Patel
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
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Bayramoglu SE, Sayin N. Quantitative vascular outgrowth and anatomic and refractive outcomes of eyes treated with bevacizumab in posterior zone Ⅰ. Eur J Ophthalmol 2022; 33:11206721221132869. [PMID: 36278775 DOI: 10.1177/11206721221132869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
PURPOSE To report the anatomic and refractive outcomes and retinal vascular outgrowth in eyes with posterior zone Ⅰ retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB). METHODS Thirty-eight eyes of 21 infants treated with IVB for type 1 and aggressive-ROP, and whose posterior border of retinal vascularization was shorter than the optic disc-to-fovea distance were defined as posterior zone Ⅰ and included in the study. RESULTS Nine eyes of five infants whose follow-up time was lower than four months were accepted as insufficient for clinical outcomes. Additional treatment(s) had been performed up to 60 weeks postmenstrual age (PMA) in 10 of 29 eyes whose follow-up were higher than four months. Macula was attached at the final examination in all eyes with > 4 months follow-up. Anatomical outcome of two eyes of one infant was accepted as unfavorable whose routine follow-up was interrupted after successful initial treatment and who was presented with straightening of the temporal vascular arcade and residual fibrovascular tractional bands on the temporal periphery. The mean progression of temporal retinal vascularization was 3.6 ± 2.0 horizontal disc diameters (DD) within 7.3 weeks and 5.1 ± 2.5 horizontal DD within 69.1 weeks in the short-term (n=15) and long-term evaluated eyes (n=21), respectively. The mean spherical equivalent was -4.1 diopters at a mean age of 21 months (n=28). CONCLUSIONS A favorable outcome had been achieved in almost all bevacizumab-treated eyes, but additional treatments were required. Significant progression of retinal vascularization was detected even in the eyes with short follow-up.
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Affiliation(s)
- Sadik Etka Bayramoglu
- Tertiary ROP Clinic, Health Science University Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Nihat Sayin
- Tertiary ROP Clinic, Health Science University Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
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Dudani AI, Dudani AA, Dudani K, Dudani AA. Combination therapy of intravitreal ranibizumab and laser photocoagulation for aggressive posterior retinopathy of prematurity. Indian J Ophthalmol 2022; 70:703-704. [PMID: 35086283 PMCID: PMC9023961 DOI: 10.4103/ijo.ijo_2225_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ajay I Dudani
- Mumbai Retina Centre, 101 Kirti Manor, Santacruz West Mumbai, Maharashtra, India
| | - Anadya A Dudani
- K J Somaiya Medical College and Hospital, Everad Nagar, Sion, Mumbai, Maharashtra, India
| | - Krish Dudani
- K J Somaiya Medical College and Hospital, Everad Nagar, Sion, Mumbai, Maharashtra, India
| | - Anupam A Dudani
- Hinduja Hospital and Research Centre, Khar, Mumbai, Maharashtra, India
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Re: Chiang et al.: International Classification of Retinopathy of Prematurity, Third Edition (Ophthalmology. 2021;128:e51-e68). Ophthalmology 2021; 129:e36. [PMID: 34844764 DOI: 10.1016/j.ophtha.2021.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022] Open
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