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Retinopathy of prematurity

  • Neonatal and Pediatric Intensive Care
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Abstract

This review deals with retinopathy of prematurity (ROP), a disease characterized by retinovitreal neovascularization, eventually retinal detachment and blindness. Due to the increasing number of extremely premature newborns, it is becoming more frequent. ROP of all stages occurs in 25–35% of surviving premature newborns of gestational age up to approximately 35 weeks. Stages 3 or more occur in 5–10%, blindness in 3–5% of very immature babies. The incidence is inversely related to gestational age. Classification is internationally unified (ICROP) and describes 5 stages. Its pathogenesis has not yet been clarified. More or less proven risk factors are retinovascular immaturity, hyperoxia and possibly circulatory and respiratory instability. Prophylaxis consists in avoiding hyperoxia, and probably also in keeping the extremely premature newborn stable. Ophthalmologic examinations must be performed by ophthalmologists experienced in this field or under their direct responsibility and must be standardized. Treatment of ROP can be carried out at a certain stage by coagulation therapy.

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References

  1. The Committee for the Classification of Retinopathy of Prematurity (1984) An international classification of retinopathy of prematurity. Arch Ophthalmol 102:1130–1134, Pediatrics 74:127-133

    Google Scholar 

  2. The international Committee for the Classification of Late Stages of Retinopathy of Prematurity (1987) An international classification of retinopathy of prematurity. II. The classification of retinal detachment. Arch Ophthalmol 105:906–912

    Google Scholar 

  3. Morizane H (1976) Initial sign and clinical course of the most severe form of acute proliferative retrolental fibroplasia (Type II) Acta Soc Ophthalmol Jpn 80:54–61

    Google Scholar 

  4. Soejima N, Takagi I, Takashima Y (1976) Clinical, studies on retinopathy of prematurity, severe and rapidly progressive type. Folia Ophthalmol Jpn 27:155–161

    Google Scholar 

  5. Uemura Y (1977) Current status of retrolental fibroiplasia. Report of the joint committee for the study of retrolental fibroplasia in Japan. Jpn J Ophthalmol 21:366–378

    Google Scholar 

  6. Uemura Y, Tsukahara I, Nagata M, Majima A, Matsuo N, Oshima K, Yamashita Y, Morizane H, Yamamouchi I, Okuyama K, Matsuyama E, Harada M (1975) Studies of the guide line of diagnosis and treatment of retrolental fibroplasia. Ophthalmic Practice (Tokyo) 46:553–559

    Google Scholar 

  7. Bossi E, Koerner F, Flury B, Zulauf M (1984) Retinopathy of prematurity: a risk factor analysis with univariate and multivariate statistics. Helv Paediatr Acta 39:307–317

    PubMed  Google Scholar 

  8. Kalina RE, Karr DJ (1982) Retrolental fibroplasia. Experience over two decades in one institution. Ophthalmology 89:91–95

    PubMed  Google Scholar 

  9. Keith CG, Doyle LW, Kitchen WH, Murton LJ (1989) Retinopathy of prematurity in infants of 24–30 weeks gestational age. Med J Aust 150: 293–296

    PubMed  Google Scholar 

  10. Ng YK, Fielder AR, Shaw DE, Levene MI (1988) Epidemiology of retinopathy of prematurity. Lancet II:1235–1238

    Google Scholar 

  11. Palmer EA, Flynn JT, Hardy RJ, Phelps DL, Phillips CL, Schaffer DB, Tung B (1991) Incidence and early course of retinopathy of prematurity. Ophthalmology 98:1628–1640

    PubMed  Google Scholar 

  12. Purohit DM, Ellison C, Zierler S, Miettinen OS, Nadas A (1985) Risk factors for retrolental fibroplasia: experience with 3025 premature infants. Pediatrics 76:339–344

    PubMed  Google Scholar 

  13. Reisner SH, Amir J, Shohat M, Krikler R, Nissenkorn I, Ben-Sira I (1985) Retinopathy of prematurity: incidence and treatment: Arch Dis Child 60:698–701

    PubMed  Google Scholar 

  14. Saigal S, O'Brodorovich H (1987) Long term outcome of preterm infants with respiratory disease. Clin Perinatol 14:635–650

    PubMed  Google Scholar 

  15. Yamaguchi R, Sunao U, Wakikawa E, Hirata A, Okami T, Asai M, Tanaka M, Nakata E, Kameyama J (1985) Evaluation of incidence and treatment of retinopathy of prematurity in Kurashiki Central Hospital in the past ten years. Folia Ophthalmol Jpn 36:1868–1975

    Google Scholar 

  16. Yu VYH, Lim CT, Downe LM (1990) A 12-years experience of retinopathy of prematurity in infants 28 weeks gestation or<1000 g birthwight. J Paediatr Child Health 26:205–208

    PubMed  Google Scholar 

  17. Koerner F, Bossi E (1984) Frühgeborenen-Retinopathie: Klassifikation und Untersuchungstechnik (Retinopathy of prematurity: Classification and examination techniques). In: Koerner F, Bossi E (eds). Die Retinopathie des Frühgeborenen. Fischer, Stuttgart New York, pp 41–59

    Google Scholar 

  18. Koerner F, Bossi E, Meier-Gibbons F (1990) Visual morbidity of very low birthweight infants: In: Duc G, Huch A Huch R (eds) The very low birthweight infant. Thieme, Stuttgart, pp 25–40

    Google Scholar 

  19. Gibson DL, Sheps SB, Uh SH, Schechter MT, McCormick AQ (1990) Retinopathy of prematurity-induced blindness: birth weight-specific survival and the new epidemic. Pediatrics 86:405–412

    PubMed  Google Scholar 

  20. Hittner HM, Godio LB, Speer ME, Rudolph AJ, Taylor MM, Blifeld C, Kretzer FL (1983) Retrolental fibroplasia: further clinical evidence and ultrastructural support for efficacy of vitamin E in the preterm infant. Pediatrics 71:423–432

    PubMed  Google Scholar 

  21. Johnson L, Shaffer D, Quinn C, Goldstein D, Mathis MJ, Otis C, Boggs TR (1982) Vitamin E supplementation and the retinopathy of prematurity. Ann NY Acad Sci 393:473–494

    PubMed  Google Scholar 

  22. Wolbarsht ML, Landers MB III (1980) The rationale of photocoagulation therapy for proliferative diabetic retinopathy: a review and a model. Ophthalmic Surg 11:235–245

    PubMed  Google Scholar 

  23. Stefansson E, Landers MB III, Wolbarsht ML (1983) Oxygenation and vasodilatation in relation to diabetic and other proliferative retinopathies. Ophthalmic Surg 14:209–226

    PubMed  Google Scholar 

  24. Koerner F, Bossi E, Wetzel C, Flury B (1986) Retinopathy of prematurity: the influence of gestational age and retinal maturity on the statistical behaviour of risk factors. Graefe's Arch Clin Exp Ophthalmol 224:40–45

    Google Scholar 

  25. Biglan AW, Brown DR, Reynolds JD, Milley JR (1984) Risk factors associated with retrolental fibroplasia. Ophthalmology 91:1504–1511

    PubMed  Google Scholar 

  26. Prendiville A, Schulenburg WE (1988) Clinical factors associated with retinopathy of prematurity. Arch Dis Child 63:522–527

    PubMed  Google Scholar 

  27. Maisels MJ, Marks KH, Minnich ME, Palmer EA, Messner KH, Rosenberger JL (1981) Retrolental fibroplasia-factors associated with its development. Proceedings of the Ross Conference on Retrolental Fibroplasia. Ross Laboratories Columbus, Ohio 2:540–548

    Google Scholar 

  28. Sacks LM, Schaffer DB, Anday EK, Peckham GJ, Delivoria-Papadopoulos M (1981) Retrolental fibroplasia and blood transfusions, in very low-birth-weight infants. Pediatrics 68:770–774

    PubMed  Google Scholar 

  29. Hittner HM, Godio LB, Rudolph AJ, Adams JM, Garcia-Prats JA, Friedman Z, Kautz JA, Monaco WA (1981) Retrolental fibroplasia: efficacy of vitamin E in a double-blind clinical study of preterm infants. N Engl J Med 305:1365–1371

    PubMed  Google Scholar 

  30. Phelps DL, Rosenbaum AL, Isenberg SJ, Leake RD, Dorey FJ (1987) Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled doublemasked trial. Pediatrics 79:489–500

    PubMed  Google Scholar 

  31. Glass P, Avery GB, Subramanian KNS, Keys M, Sostek AM, Friendly DS (1985) Effect of bright light in the hospital nursery on the incidence of retinopathy of prematurity. N Engl J Med 313:401–404

    PubMed  Google Scholar 

  32. Ackerman B, Sherwonit E, Williams J (1989) Reduced incidental ligh exposure: effect on the development of retinopathy of prematurity in low birth weight infants. Pediatrics 83:958–962

    PubMed  Google Scholar 

  33. Fielder AR, Robinson J, Shaw DE, Ng YK, Moseley MJ (1992) Light and retinopathy of prematurity: Does retinal location offer a clue? Pediatrics 89:648–653

    PubMed  Google Scholar 

  34. Foos RY, Kopelow SM (1973) Development of retinal vasculature in paranatal infants. Surv Ophthalmol 18:117–127

    Google Scholar 

  35. Lakatos L, Hatvani I, Oroszlan G, Karmazsin L (1982) Prevention of retrolental fibroplasia in very low birthweight infants by D-penicillamine. Eur J Pediatr 138:199–200

    Google Scholar 

  36. Schaffer DB, Palmer ES, Plotsky DF, Metz HS, Flynn JT, Tung B, Hardy RJ (1993) Prognostic factors in the natural course of retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Ophthalmology 100:230–237

    PubMed  Google Scholar 

  37. Bolt B, Benz K, Koerner F, Bossi E (1992) A mydriatic eyedrop combination without systemic effects for premature infants: a prospective double-blind study. J Pediatr Ophthalmol Strabismus 29:157–162

    PubMed  Google Scholar 

  38. Nagata M, Kobayashi Y, Fukuda H, Suekane K (1968) Photocoagulation for the treatment or retinopathy of prematurity. Jpn J Ophthalmol 22:419–427

    Google Scholar 

  39. Nagata M, Tsuruoka Y (1972) Treatment of acute retrolental fibroplasia with xenon-arc, photocoagulation. Jpn J Clin Ophthalmol 16:131–143

    Google Scholar 

  40. Majima A, Takahashi M, Hibino Y, Kamao N, Takai M (1976) Clinical observations of photocoagulation on retinopathy of prematurity. Jpn J Clin Ophthalmol 30:93–97

    Google Scholar 

  41. Koerner F (1978) Retinopathy of prematurity: natural course and management. Metab Pediatr Syst Ophthalmol 2:325–329

    Google Scholar 

  42. Cryotherapy for ROP Cooperative Group (1990) Multicenter trial of cryotherapy for retinopathy of prematurity. One-year outcome—structure and function. Arch Ophthalmol 108: 1408–1416

    Google Scholar 

  43. Cryotherapy for Retinopathy of Prematurity Cooperative Group (1993) Multicenter trial of cryotherapy for retinopathy of prematurity. 3 1/2-year outcome—structure and function. Arch Ophthalmol 111:339–344

    Google Scholar 

  44. Hoyt CS (1993) Cryotherapy for retinopathy of prematurity. 3 1/2-year outcome for both structure and function. Editorial. Arch Ophthalmol 111: 319–320

    PubMed  Google Scholar 

  45. Hunter DG, Repka MX (1993) Diode laser photocoagulation for threshold retinopathy of prematurity. Ophthalmology 100:238–244

    PubMed  Google Scholar 

  46. Iverson DA, Trese MT, Orgel IK, Williams GA (1991) Laser photocoagulation for threshold retinopathy of prematurity (letter). Arch Ophthalmol 109:1342–1343

    PubMed  Google Scholar 

  47. Landers III MB, Toth Ca, Semple HC, Morse LS (1992) Treatment of retinopathy of prematurity with argon laser photocoagulation. Arch Ophthalmol 110:44–47

    PubMed  Google Scholar 

  48. McNamara JA, Tasman W, Brown GC, Federman JL (1991) Laser photocoagulation for stage 3+ retinopathy of prematurity. Ophthalmology 98:576–580

    PubMed  Google Scholar 

  49. McNamara JA, Tasman W, Vander JF, Brown GC (1992) Diode laser photocoagulation for retinopathy of prematurity. Arch Ophthalmol 110: 1714–1716

    PubMed  Google Scholar 

  50. Preslan MW (1993) Laser therapy for retinopathy of prematurity. J Pediatr Ophthalmol Strabismus 30:80–83

    PubMed  Google Scholar 

  51. Fleming TN, Runge PE, Charles ST (1992) Diode laser photocoagulation for prethreshold, posterior retinopathy or prematurity. Am J Ophthalmol 114:589–592

    PubMed  Google Scholar 

  52. Crack AV, Burke LP, Pulido JS, Keech RV (1992) Transient punctate lenticular opacities as a complication or argon laser photoablation in an infant with retinopathy of prematurity (letter). Am J Ophthalmol 113:583–584

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Universitäts-Kinderklinik, Inselspital, CH-3010, Bern, Switzerland

    E. Bossi

  2. Department of Ophthalmology, University of Bern, Bern, Switzerland

    F. Koerner

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  1. E. Bossi
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  2. F. Koerner
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Bossi, E., Koerner, F. Retinopathy of prematurity. Intensive Care Med 21, 241–246 (1995). https://doi.org/10.1007/BF01701481

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  • DOI: https://doi.org/10.1007/BF01701481

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