Practice Patterns in Retinopathy of Prematurity Treatment for Disease Milder Than Recommended by Guidelines  

Oleh:

Gupta, Mrinali Patel ; Chan, R. V. Paul ; Anzures, Rachelle ; Ostmo, Susan ; Jonas, Karyn ; Chiang, Michael F.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: American Journal of Ophthalmology (keterangan: ada di ClinicalKey) vol. 163 (Mar. 2016), page 1–10.
Topik: Retinopathy of Prematurity; ROP
Fulltext: A12 v163 p1 kelik2016.pdf (1.14MB)

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Perpustakaan FK Nomor Panggil: A12.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Purpose: To characterize the frequency of and clinical indications for which experts treat retinopathy of prematurity (ROP) milder than type 1 disease, the recommended threshold for treatment from established consensus guidelines. Design: Descriptive analysis. Methods: SETTING: Multicenter. STUDY POPULATION: A database of 1444 eyes generated prospectively from all babies screened for ROP at 1 of 6 major ROP centers whose parents provided informed consent. INTERVENTION: Retrospective review of the database and charts to identify all patients treated for ROP milder than type 1. MAIN OUTCOME MEASURE: Indication(s) for treatment. Results: A total of 137 eyes of 70 infants were treated for ROP. Of these 137 eyes, 13 (9.5%) were treated despite a clinical diagnosis milder than type 1 ROP. Indications for treatment included active ROP with the fellow eye being treated for type 1 ROP (2 eyes, 15.4%); concerning structural changes (9 eyes, 69.2%), including tangential traction with temporal vessel straightening concerning for macular dragging (8 eyes, 61.5%) and thick stage 3 membranes with anteroposterior traction concerning for progression to stage 4 ROP (3 eyes, 23.1%); persistent ROP at an advanced postmenstrual age (4 eyes, 30.8%); and/or vitreous hemorrhage (3 eyes, 23.1%). Conclusions: Experts in this study occasionally recommended treatment in eyes with disease less than type 1 ROP. This study has important clinical implications and highlights the role of individual clinical judgment in situations not covered by evidence-based treatment guidelines.

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