Premium
Natural history and outcomes of stage 3 retinopathy of prematurity persisting beyond 40 weeks of post‐menstrual age: Dilemma for treatment and follow up
Author(s) -
Koucheki Robert,
Isaac Maram,
N Tehrani Nasrin,
Mireskandari Kamiar
Publication year - 2020
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.13827
Subject(s) - medicine , retinopathy of prematurity , pediatrics , stage (stratigraphy) , natural history , univariate analysis , retrospective cohort study , multivariate analysis , surgery , gestational age , pregnancy , genetics , paleontology , biology
Importance To evaluate the natural history and outcomes of infants with stage‐3 retinopathy of prematurity (ROP) persisting beyond 40‐weeks of post‐menstrual age ( PMA). Background There are no specific screening guidelines for stage‐3 ROP persisting beyond 40 weeks of PMA. Persistent stage‐3 disease in zone II without plus disease or in zone III with or without plus disease poses a dilemma for treatment. Design Retrospective chart review. Participant Neonates with stage‐3 ROP persisting beyond 40‐weeks of PMA. Methods Demographic data and ROP parameters were collected. Univariate/multivariate analyses were utilized to assess risk factors associated with requiring treatment. Main Outcome Measures Evaluating the structural outcomes for infants with stage‐3 ROP persisting beyond 40 weeks of PMA. Results Out of 2356 screened infants, 115 infants (4.9%, 172 eyes) met inclusion criteria. In 95 infants (139 eyes, 80.8%), ROP resolved spontaneously. Twenty‐one infants (33 eyes, 19.2%) were treated with laser‐photocoagulation; 16 eyes had reached type 1 ROP and 17 eyes had non‐type 1 ROP. No eye had unfavourable structural outcome. On multiple regression, non‐type 1 ROP with ≥2 continuous clock hours of persistent stage‐3 temporally crossing the horizontal midline was a significant risk factor associated with receiving treatment (OR = 27.29, 95% CI = [1.61, 462.92], P = .0221). Conclusion and Relevance The majority of stage‐3 ROP persisting beyond 40‐weeks of PMA resolve spontaneously. In eyes that do not reach type 1 ROP, ≥2 continuous clock hours of persistent stage‐3 crossing the temporal horizontal midline and history of pre‐plus were considered important risk factors for macular drag and treatment can be considered.