Factors associated with delayed vascular maturation in infants with retinopathy of prematurity not requiring treatment

Year 2016, Volume: 41 Issue: 2, 347 - 353, 30.06.2016

Ebru Esen , Selçuk Sızmaz Hacer Yapıcıoğlu Ferda Özlü Kemal Yar İlker Ünal Nihal Demircan

Abstract

Purpose: The aim of this study is to determine risk factors associated with delayed regression of retinopathy of prematurity and prolonged vascular completion in patients not requiring treatment.
Material and Methods: Patients with acute retinopathy of prematurity not requiring treatment were grouped as control and delayed vascularization groups, on condition that retinal vascularization had completed before postconceptional age of 50 weeks or not. Patients with retinopathy of prematurity requiring treatment constituted treatment group. A total of 17 possible risk factors that may affect the time course of retinal vascularization in patients with acute retinopathy of prematurity were evaluated. 
Results: Multivariate regression analysis showed that low Apgar score at fifth minute and blood transfusion were associated with an increased risk of delayed vascularization when compared with controls. Low gestational age and presence of patent ductus arteriosus were risk factors for retinopathy of prematurity that require treatment when compared with delayed vascularization group. 
Conclusion: Low Apgar score and blood transfusion might be predictive factors for prolonged retinal vascularization in patients with retinopathy of prematurity not requiring treatment. Having a higher gestational age and absence of patent ductus arteriosus, appeared as reducing the risk of progressing to serious disease requiring treatment for an infant with retinopathy of prematurity that undergo regression slowly.

Keywords

-

Tedavi gerektirmeyen prematüre retinopatili yenidoğanlarda gecikmiş retina damar matürasyonuyla ilişkili faktörler

Abstract

Amaç: Bu çalışmanın amacı tedavi gerektirmeyen prematüre retinopatisi olan hastalarda, retinopatinin gerilemesinde gecikme ve retina damar matürasyonunda uzama ile ilişkili olabilecek risk faktörlerini belirlemektir.Gereç ve Yöntem: Tedavi gerektirmeyen prematüre retinopatili hastalar, retina damarlanmasının 50. postkonsepsiyonel haftadan önce tamamlanmış olup olmamasına göre kontrol ve gecikmiş matürasyon grubu olarak ikiye ayrıldı. Tedavi gerektiren prematüre retinopatili hastalar ise tedavi grubunu oluşturdu. Prematüre retinopatisi hastalarında retinanın damarlanma sürecini etkileyebilecek 17 olası risk faktörü gruplar arsında karşılaştırıldı.Bulgular: Çoklu regresyon analizinde, 5. dakikadaki düşük Apgar skoru ve kan transfüzyonu öyküsü kontrol grubu kıyaslandığında gecikmiş matürasyon ile ilişkili bulundu. Gecikmiş matürasyonlu hastalar tedavi gerektiren prematüre retinopatili bebeklerle kıyaslandığında ise, düşük doğum haftası ve patent duktus arteriosus varlığı, tedavi gerektiren prematüre retinopatisi gelişmesi ile ilişkili bulundu.Sonuç: Tedavi gerektirmeyen prematüre retinopatisi hastalarında 5. dakikadaki Apgar skorunun düşük olması ve kan transfüzyonu öyküsü, retina damarlanmasının uzun sürede tamamlanacağının habercisi olabilir. Doğum haftasının yüksek olması ve patent duktus arteriosus bulunmaması ise prematüre retinopatisi yavaş gerileyen infantlarda tedavi gerekecek evrelere ilerleme riskinin düşük olacağı konusunda fikir verebilir.

Keywords

prematüre retinopatisi, uzamış gerileme, gecikmiş retina damar matürasyonu

References

• Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity: natural history ROP: ocular outcome at 5(1/2) years in premature infants with birth weights less than 1251 g. Arch Ophthalmol. 2002;120:595-9.
• Austeng D, Källen KB, Hellström A, Tornqvist K, Holmström GE. Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation 2010;128:1289-94. Arch Ophthalmol.
• Seiberth V, Linderkamp O. Risk factors in retinopathy of prematurity. a multivariate statistical analysis. Ophthalmologica. 2000;214:131-5.
• Hardy RJ, Palmer EA, Dobson V, Summers CG, Phelps DL, Quinn GE et al. Risk analysis of prethreshold retinopathy of prematurity. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol. 2003;121:1697-701.
• Rao KA, Purkayastha J, Hazarika M, Chaitra R, Adith KM. Analysis of prenatal and postnatal risk factors of retinopathy of prematurity in a tertiary care hospital in South India. Indian J Ophthalmol. 2013;61:640-4.
• van Sorge AJ, Termote JU, Kerkhoff FT, van Rijn LJ, Simonsz HJ, Peer PG et al. Nationwide inventory of risk factors for retinopathy of prematurity in the Netherlands. J Pediatr. 2014;164:494-8.
• Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2013;131:189-95. American
• International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123:991–9.
• 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.
• Repka MX, Palmer EA, Tung B. Involution of retinopathy of prematurity. Arch Ophthalmol. 2000;118:645-9.
• The natural ocular outcome of premature birth and retinopathy. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Status at 1 year. Arch Ophthalmol. 1994;112:903-12.
• Ni YQ, Huang X, Xue K, Yu J, Ruan L, Shan HD et al. Natural involution of acute retinopathy of prematurity not requiring treatment: factors associated with the time course of involution. Invest Ophthalmol Vis Sci. 2014;55:3165-70.
• Eliason KJ, Dane Osborn J, Amsel E, Richards SC. Incidence, progression, and duration of retinopathy of prematurity in Hispanic and white non-Hispanic infants. J AAPOS. 2007;11:447-51.
• Ju RH, Zhang JQ, Ke XY, Lu XH, Liang LF, Wang WJ. Spontaneous regression of retinopathy of prematurity: incidence and predictive factors. Int J Ophthalmol. 2013;6:475-80.
• Port AD, Chan RV, Ostmo S, Choi D, Chiang MF. Risk factors for retinopathy of prematurity: insights from outlier infants. Graefes Arch Clin Exp Ophthalmol. 2014;252:1669-77.
• Shin DH, Kong M, Kim SJ, Ham DI, Kang SW, Chang YS et al. Risk factors and rate of progression for zone I versus zone II type 1 retinopathy of prematurity. J AAPOS. 2014;18:124-8.
• Küçükevcilioğlu M, Mutlu FM, Sarıcı SU, Ceylan OM, Altınsoy HI, Kılıç S et al. Frequency, risk factors and outcomes of retinopathy of prematurity in a tertiary care hospital in Turkey. Turk J Pediatr. 2013;55:467-74.
• Giannantonio C, Papacci P, Cota F, Vento G, Tesfagabir MG, Purcaro V et al. Analysis of risk factors for progression to treatment-requiring ROP in a single neonatal intensive care unit: is the exposure time relevant? J Matern Fetal Neonatal Med. 2012;25:471-7.
• Cooke RW, Clark D, Hickey-Dwyer M, Weindling AM. The apparent role of blood transfusions in the development of retinopathy of prematurity. Eur J Pediatr. 1993;152:833-6.
• Christensen RD, Ilstrup SJ, Hartnett ME. Retinopathy of prematurity and transfusion practice. Transfusion. 2014;54:960-1.
• Dani C, Reali MF, Bertini G, Martelli E, Pezzati M, Rubaltelli FF. The role of blood transfusions and iron intake on retinopathy of prematurity. Early Hum Dev. 2001;62:57-63.
• Akkoyunlu I, Oto S, Yilmaz G, Gurakan B, Tarcan A, Anuk D et al. Risk factors in the development of mild and severe retinopathy of prematurity. J AAPOS. 2006;10:449-53.
• Tsui I, Ebani E, Rosenberg JB, Lin J, Angert RM, Mian U. Patent ductus arteriosus and indomethacin treatment as independent risk factors for plus disease in retinopathy of prematurity. J Pediatr Ophthalmol Strabismus. 2013;50:88-92.
• Bourla DH, Gonzales CR, Valijan S, Yu F, Mango CW, Schwartz SD. Association of systemic risk factors with the progression of laser-treated retinopathy of prematurity to retinal detachment. Retina. 2008;28:58-64.