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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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Low dose fentanyl infusion versus 24% oral sucrose for pain management during laser treatment for retinopathy of prematurity—an open label randomized clinical trial
摘要： To compare the efficacy of low dose fentanyl infusion and 24% oral sucrose in providing optimal pain relief during laser for retinopathy of prematurity (ROP), we enrolled fifty-eight spontaneously breathing preterm infants undergoing laser. The preterm infants were randomized to either fentanyl infusion (1 mcg/kg/hr) or 24% oral sucrose (2 ml). We evaluated and compared the proportion of time spent crying during the procedure, salivary cortisol before and after the procedure, premature infant pain profile- revised (PIPP-R) scores during the procedure, apnoea during and after the procedure, need for mechanical ventilation, and feed intolerance and urinary retention 24 h after the procedure between the two groups. We found that the proportion of time spent crying during the procedure was significantly less in the fentanyl group [62.5% (50.7–74.2) vs 73.8% (55.6–83.4); P = 0.02]. Average PIPP-R score during the procedure was significantly less in the fentanyl group [7.2 vs 9.0; (mean difference of ? 1.8; P = 0.01)]. There was no difference in other outcomes between the two groups.
关键词： Pain,Laser therapy,Fentanyl,Retinopathy of prematurity
更新于2025-09-12 10:27:22
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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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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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Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis
摘要： Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP. This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0). The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001). The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series.
关键词： Retinopathy of Prematurity,Laser Therapy,Intravitreal Injections
更新于2025-09-11 14:15:04
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Comparison of Nd:YAG laser (532 nm green) vs diode laser (810 nm) photocoagulation in the treatment of retinopathy of prematurity: an evaluation in terms of complications
摘要： Purpose To compare the anterior and posterior segment complications of diode (810 nm) laser photocoagulation (LPC) and Nd:YAG (532 nm green) LPC in the treatment of retinopathy of prematurity (ROP). Patients and methods The 84 eyes of 43 patients treated with diode LPC (group 1) and 58 eyes of 31 patients treated with Nd:YAG LPC (group 2) for ROP in our clinic were enrolled in the study. Medical records of all patients were investigated retrospectively. The patients in each group were examined in terms of birth weights, gestational weeks, stage of retinopathy, number of lasers pots, laser parameters, and anterior and posterior complications of LPC. Results The mean birth weeks of group 1 patients were postmenstrual 27.7 ± 2.5 (23–33), while the mean birth weights were 1006.0 ± 334.5 (540–1980) grams. The mean birth weeks of group 2 patients were postmenstrual 27.4 ± 2.6 (23–33), while the mean birth weights were 1073.8 ± 329.2 (480–1720) grams. The mean numbers of laser spots were 1036.0 ± 515.2 (430–2410) in group 1 per eye, while the mean numbers of laser spots were 1085.4 ± 526.0 (445–2530) in group 2 per eye (p ≥ 0.05). Additional laser application was performed in four eyes (4.8%) in group 1 and four eyes (6.9%) in group 2. Four eyes (4.8%) treated with diode LPC and one eye (1.7%) treated with Nd:YAG laser developed retinal detachment. Two eyes of a patient (3.4%) applied Nd:YAG LPC developed cataract. Conclusion Cataract may develop when Nd:YAG laser is used; however, posterior segment complications may be more likely to appear with the use of diode laser in these cases.
关键词： Nd:YAG laser photocoagulation,Cataract,Diode laser photocoagulation,Exudative retinal detachment,Retinopathy of prematurity
更新于2025-09-11 14:15:04
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New insight into the role of the complement in the most common types of retinopathy-current literature review
摘要： Pathological neovascularisation, which is a critical component of diseases such as age-related macular degeneration (AMD), diabetic retinopathy (DR) and retinopathy of prematurity (ROP), is a frequent cause of compromised vision or blindness. Researchers continuously investigate the role of the complement system in the pathogenesis of retinopathy. Studies have confirmed the role of factors H and I in the development of AMD, and factors H and B in the development of DR. Other components, such as C2, C3, and C5, have also been considered. However, findings on the involvement of the complement system in the pathogenesis of ROP are still inconclusive. This paper presents a review of the current literature data, pointing to the novel results and achievements from research into the role of complement components in the development of retinopathy. There is still a need to continue research in new directions, and to gather more detailed information about this problem which will be useful in the treatment of these diseases.
关键词： diabetic retinopathy,age-related macular degeneration,factors of the complement system,retinopathy of prematurity,single nucleotide polymorphism
更新于2025-09-10 09:29:36
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Algorithm for predicting threshold retinopathy of prematurity is insufficient and fundus examinations are still needed before 31 weeks
摘要： Aim: We evaluated the weight, insulin-like growth factor-1, neonatal, retinopathy of prematurity (WINROP) algorithm for very premature infants. Method: Infants born before 32 weeks who had undergone fundus examinations in the neonatal intensive care unit at the University Hospital of Nancy were included in this French retrospective cohort study from July 2012 to July 2016. We evaluated how well the WINROP software predicted threshold retinopathy of prematurity (ROP). Results: We studied 570 infants with a mean gestational age of 28.7 ±1.8 weeks and a mean birth weight of 1,110 ±297 grams: 28.1% had ROP and 1.2% had threshold ROP. The overall WINROP sensitivity was 57.1%, specificity was 46.0%, predictive positive value was 1.3% and predictive negative value was 98.9%. At more than 30 weeks of gestation or 1,250 grams, these figures rose to a respective specificity of 100% and 95.7% and respective predictive negative value of 100% and 100%. There were independent associations between the severity of ROP and the Apgar Score at five minutes, the duration of oxygen therapy and non-invasive ventilation. Conclusion: WINROP worked better on preterm infants born from 31 weeks onwards or weighing over 1,250g. Fundus examinations remain necessary for infants born earlier or lighter.
关键词： Fundus examination,Screening,Algorithm,Retinopathy of prematurity,Premature infants
更新于2025-09-10 09:29:36
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Photobiomodulation for the treatment of retinal diseases: a review
摘要： Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber's hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: 'photobiomodulation AND retina', 'low level light therapy AND retina', 'low level laser therapy AND retina', and 'FR/NIR therapy AND retina'. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.
关键词： low level laser therapy,age-related macular degeneration,retinopathy of prematurity,photobiomodulation,retinal degeneration,amblyopia,far-red to near-infrared,methanol toxicity,retinitis pigmentosa
更新于2025-09-10 09:29:36
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[IEEE 2018 International CET Conference on Control, Communication, and Computing (IC4) - Thiruvananthapuram, India (2018.7.5-2018.7.7)] 2018 International CET Conference on Control, Communication, and Computing (IC4) - Computer Aided Detection of Demarcation Line/Ridges in the Retinal Fundus Images of Preterm Infants
摘要： Retinopathy of Prematurity (ROP) is a curable sight threatening disease which affects the visual system of premature infants, weighing less than 1750 grams and who are born before 31 weeks of gestation. The characteristic features of the disease include abnormal blood vessel growth and scar tissue formation in the retina which may lead to permanent blindness. The risk of ROP can be reduced if the disease is diagnosed in the early stage of its development. As per the recommendations of the International Committee for ROP classification, the detection of demarcation line/ridge have great prognostic significance as its presence indicates the beginning stage of the disease. In the reported work we develop a computer aided diagnostic system for the early detection of ROP, where the presence of ridge/demarcation line is identified in the fundus images of the preterm infants. The developed system uses image enhancement techniques followed by clustering operation. An image database with 33 retinal images of preterm infants are graded with the proposed system and the results obtained matches with that of the clinical expert annotation with a good accuracy.
关键词： demarcation line,Retinopathy of prematurity,clustering
更新于2025-09-10 09:29:36