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Asymmetry of Retinopathy of Prematurity Border in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity Study
摘要： Purpose: To measure the location of the retinopathy of prematurity (ROP) border in a sample of premature infants who developed ROP and determine location for predicting subsequent development of referral-warranted ROP (RW-ROP, defined as Stage 3 ROP, zone I ROP, or plus disease) or treated ROP. Design: Secondary analysis of data from an observational cohort study, The Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study. Subjects: Infants with birth weight (BW) less than 1251g with at least one exam and image session at ≤34 weeks postmenstrual age (PMA) with ROP not meeting RW-ROP, and at least one subsequent exam at ≥36 weeks PMA. Methods: The 5-image set from the first imaging session for each eligible eye was mosaicked, and measurements of the ROP border in each mosaicked image were made using Image J. Measurements were compared among 3 groups of eyes with ROP: (1) never developed RW-ROP or received treatment, (2) developed RW-ROP but did not receive treatment, and (3) received treatment; using analysis of variance and linear trend tests that accounted for the inter-eye correlation. Main outcome measures: RW-ROP, treated ROP Results: 317 eyes from 217 infants with mean BW 755g, mean GA 25 weeks, and mean PMA 33 weeks at first exam met study criteria. Of 211 (66.6%) eyes with sufficient quality images for grading, 147 (69.7%) did not develop RW-ROP or receive treatment, 36 (17.1%) developed RW-ROP not requiring treatment, and 28 (13.3%) received treatment for ROP. Among all eyes, the disc-to-ROP border distance followed a consistent pattern, with nasal < inferior < superior < temporal. Eyes that developed RW-ROP or underwent treatment had significantly shorter nasal and temporal disc-to-ROP border distances and smaller areas of retina within the ROP border. In multivariate analysis adjusted by BW and GA, nasal ROP border distance was a significant predictor of developing treated ROP (OR=0.86 for every 10 pixel increase in distance, p=0.002). Conclusions: ROP is located asymmetrically around the optic disc and is closest to the optic disc nasally. Location of ROP nasally at first imaging is a significant predictor of developing treated ROP.
关键词： retinopathy of prematurity,ROP,asymmetry,telemedicine,optic disc
更新于2025-09-23 15:21:01
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SEVERE RECURRENT FIBROVASCULAR PROLIFERATION AFTER COMBINED INTRAVITREAL BEVACIZUMAB INJECTION AND LASER PHOTOCOAGULATION FOR AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY
摘要： To describe the clinical features of severe recurrent fibrovascular proliferation after combined intravitreal bevacizumab injections and laser photocoagulation for aggressive posterior retinopathy of prematurity. This retrospective, nonrandomized case series reviewed the medical and ophthalmic records in the referral hospital and our hospital. Four patients (seven eyes) with aggressive posterior retinopathy of prematurity. The patients were referred for vitrectomy with/without lensectomy for recurrent fibrovascular proliferation with a tractional retinal detachment after combined intravitreal bevacizumab injections and laser photocoagulation. Three patients were born at 22 weeks or 23 weeks’ gestational age and one patient at 29 weeks’ gestational age. Preoperatively, fluorescein angiography images showed all eyes had tractional retinal detachment from regrowth of fibrovascular proliferation 3 months to 5 months after the intravitreal bevacizumab injection and abnormal retinal vasculature; four eyes had a broad ischemic retina. Postoperatively, four eyes had retinal attachment and three eyes a total retinal detachment. Neovascular glaucoma developed in five of the seven eyes during the clinical course. Severe fibrovascular proliferation may recur due to widespread retinal ischemia with capillary dropout and abnormal vasculature after failed combined intravitreal bevacizumab and laser photocoagulation therapy as the initial treatment for aggressive posterior retinopathy of prematurity. Careful follow-up is important especially after anti–vascular endothelial growth factor treatment, with recognition that severe reactivation is possible.
关键词： intravitreal bevacizumab injection,vitrectomy,retinopathy of prematurity,fluorescein angiography,stage 5 ROP,vascular endothelial growth factor,stage 4 ROP,fibrovascular proliferation,laser photocoagulation,ROP surgery
更新于2025-09-12 10:27:22
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Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomised controlled trial
摘要： Despite increasing worldwide use of anti-vascular endothelial growth factor agents for treatment of retinopathy of prematurity (ROP), there are few data on their ocular efficacy, the appropriate drug and dose, the need for retreatment, and the possibility of long-term systemic effects. We evaluated the efficacy and safety of intravitreal ranibizumab compared with laser therapy in treatment of ROP.
关键词： ranibizumab,anti-VEGF,ROP,laser therapy,retinopathy of prematurity
更新于2025-09-12 10:27:22
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Rescue with intravitreal bevacizumab in aggressive posterior retinopathy of prematurity poorly responsive to laser treatment
摘要： Successful management of a case of aggressive posterior retinopathy of prematurity (APROP) poorly responsive to laser therapy with intravitreal bevacizumab (IVB) is discussed. IVB is useful as rescue therapy in such cases, if given within the correct window period post laser therapy.
关键词： Aggressive posterior retinopathy of prematurity (APROP),laser in retinopathy of prematurity (ROP),anti-vascular endothelial growth factor (anti-VEGF)
更新于2025-09-11 14:15:04
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Evaluation of a deep learning image assessment system for detecting severe retinopathy of prematurity
摘要： background Prior work has demonstrated the near-perfect accuracy of a deep learning retinal image analysis system for diagnosing plus disease in retinopathy of prematurity (ROP). Here we assess the screening potential of this scoring system by determining its ability to detect all components of ROP diagnosis. Methods Clinical examination and fundus photography were performed at seven participating centres. A deep learning system was trained to detect plus disease, generating a quantitative assessment of retinal vascular abnormality (the i-ROP plus score) on a 1–9 scale. Overall ROP disease category was established using a consensus reference standard diagnosis combining clinical and image-based diagnosis. Experts then ranked ordered a second data set of 100 posterior images according to overall ROP severity. results 4861 examinations from 870 infants were analysed. 155 examinations (3%) had a reference standard diagnosis of type 1 ROP. The i-ROP deep learning (DL) vascular severity score had an area under the receiver operating curve of 0.960 for detecting type 1 ROP. Establishing a threshold i-ROP DL score of 3 conferred 94% sensitivity, 79% specificity, 13% positive predictive value and 99.7% negative predictive value for type 1 ROP. There was strong correlation between expert rank ordering of overall ROP severity and the i-ROP DL vascular severity score (Spearman correlation coefficient=0.93; p<0.0001). Conclusion The i-ROP DL system accurately identifies diagnostic categories and overall disease severity in an automated fashion, after being trained only on posterior pole vascular morphology. These data provide proof of concept that a deep learning screening platform could improve objectivity of ROP diagnosis and accessibility of screening.
关键词： retinopathy of prematurity,ROP,deep learning,screening,artificial intelligence
更新于2025-09-10 09:29:36
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Screening Examination of Premature Infants for Retinopathy of Prematurity
摘要： This policy statement revises a previous statement on screening of preterm infants for retinopathy of prematurity (ROP) that was published in 2013. ROP is a pathologic process that occurs in immature retinal tissue and can progress to a tractional retinal detachment, which may then result in visual loss or blindness. For more than 3 decades, treatment of severe ROP that markedly decreases the incidence of this poor visual outcome has been available. However, severe, treatment-requiring ROP must be diagnosed in a timely fashion to be treated effectively. The sequential nature of ROP requires that infants who are at-risk and preterm be examined at proper times and intervals to detect the changes of ROP before they become destructive. This statement presents the attributes of an effective program to detect and treat ROP, including the timing of initial and follow-up examinations.
关键词： retinopathy of prematurity,ROP,preterm infants,screening,blindness
更新于2025-09-09 09:28:46