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Time at treatment of severe retinopathy of prematurity in China: recommendations for guidelines in more mature infants.

Chen Y, Feng J, Gilbert C, Yin H, Liang J, Li X - PLoS ONE (2015)

Bottom Line: After controlling for GA, PMA age at treatment was highest in infants with BW ≥2000 g (mean PMA 40.3±4.4 weeks, p<0.001); after controlling for BW, higher GA was associated with higher PMA at treatment (mean PMA 41.5 weeks for gestational age >34 weeks, p<0.001).The time at treatment of Type 1 prethreshold disease was similar to that for threshold disease i.e. chronological age 5.6∓7.4 weeks, or PMA 34.1∓40.2 weeks but the lower end of the 95% confidence interval for chronological age for Type 1 prethreshold disease among infants with BW ≥2000 g was 3.7 weeks (i.e. before the recommended interval of 4∓6 weeks after birth).The Chinese guidelines regarding timing of the first examination are appropriate for infants with BW <2000 g, but more mature infants should be examined a little earlier, at 3 weeks after birth, in order to detect Type 1 prethreshold disease which has a better prognosis than threshold.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, People's Hospital, Peking University, & Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China.

ABSTRACT

Purpose: To investigate the postmenstrual (PMA) age at treatment of severe retinopathy of prematurity (i.e. Type 1 prethreshold or threshold) in infants in a tertiary referral center in China.

Principal findings: 76.6% (359/469) of infants were treated for threshold disease. 67.5% (317/469) of infants had a birth weight (BW) of 1250 g or above and almost 30% (126) had a gestational age (GA) of 32 weeks or above. There was little difference in the characteristics of infants treated for Type 1 prethreshold or threshold ROP. After controlling for GA, PMA age at treatment was highest in infants with BW ≥2000 g (mean PMA 40.3±4.4 weeks, p<0.001); after controlling for BW, higher GA was associated with higher PMA at treatment (mean PMA 41.5 weeks for gestational age >34 weeks, p<0.001). For every three weeks increase in GA there was a two-week increase in PMA at treatment (R2 = 0.20, p<0.001). The time at treatment of Type 1 prethreshold disease was similar to that for threshold disease i.e. chronological age 5.6∓7.4 weeks, or PMA 34.1∓40.2 weeks but the lower end of the 95% confidence interval for chronological age for Type 1 prethreshold disease among infants with BW ≥2000 g was 3.7 weeks (i.e. before the recommended interval of 4∓6 weeks after birth).

Significance: The Chinese guidelines regarding timing of the first examination are appropriate for infants with BW <2000 g, but more mature infants should be examined a little earlier, at 3 weeks after birth, in order to detect Type 1 prethreshold disease which has a better prognosis than threshold.

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Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by birth weight (p = 0.001) (A); Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by gestational age (p<0.001) (B).
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pone.0116669.g002: Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by birth weight (p = 0.001) (A); Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by gestational age (p<0.001) (B).

Mentions: Both BW and GA were independently associated with PMA and chronological age at treatment. After controlling for the effect of GA, PMA at treatment was highest in infants with BW ≥2000g (mean PMA 40.3 ± 4.4 weeks, p<0.001) (Table 2, Fig. 2A). After controlling for the effect of BW, higher GA was associated with higher PMA at treatment (mean PMA 41.5 weeks for GA >34 weeks) (p<0.001) (Table 2, Fig. 2B). Linear regression indicated that for every three weeks increase in GA there was only a two-week increase in PMA at treatment (R2 = 0.20, p<0.001) (Fig. 3B).


Time at treatment of severe retinopathy of prematurity in China: recommendations for guidelines in more mature infants.

Chen Y, Feng J, Gilbert C, Yin H, Liang J, Li X - PLoS ONE (2015)

Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by birth weight (p = 0.001) (A); Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by gestational age (p<0.001) (B).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321962&req=5

pone.0116669.g002: Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by birth weight (p = 0.001) (A); Box plot of postmenstrual age at the time of diagnosis of ROP needing treatment, by gestational age (p<0.001) (B).
Mentions: Both BW and GA were independently associated with PMA and chronological age at treatment. After controlling for the effect of GA, PMA at treatment was highest in infants with BW ≥2000g (mean PMA 40.3 ± 4.4 weeks, p<0.001) (Table 2, Fig. 2A). After controlling for the effect of BW, higher GA was associated with higher PMA at treatment (mean PMA 41.5 weeks for GA >34 weeks) (p<0.001) (Table 2, Fig. 2B). Linear regression indicated that for every three weeks increase in GA there was only a two-week increase in PMA at treatment (R2 = 0.20, p<0.001) (Fig. 3B).

Bottom Line: After controlling for GA, PMA age at treatment was highest in infants with BW ≥2000 g (mean PMA 40.3±4.4 weeks, p<0.001); after controlling for BW, higher GA was associated with higher PMA at treatment (mean PMA 41.5 weeks for gestational age >34 weeks, p<0.001).The time at treatment of Type 1 prethreshold disease was similar to that for threshold disease i.e. chronological age 5.6∓7.4 weeks, or PMA 34.1∓40.2 weeks but the lower end of the 95% confidence interval for chronological age for Type 1 prethreshold disease among infants with BW ≥2000 g was 3.7 weeks (i.e. before the recommended interval of 4∓6 weeks after birth).The Chinese guidelines regarding timing of the first examination are appropriate for infants with BW <2000 g, but more mature infants should be examined a little earlier, at 3 weeks after birth, in order to detect Type 1 prethreshold disease which has a better prognosis than threshold.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, People's Hospital, Peking University, & Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China.

ABSTRACT

Purpose: To investigate the postmenstrual (PMA) age at treatment of severe retinopathy of prematurity (i.e. Type 1 prethreshold or threshold) in infants in a tertiary referral center in China.

Principal findings: 76.6% (359/469) of infants were treated for threshold disease. 67.5% (317/469) of infants had a birth weight (BW) of 1250 g or above and almost 30% (126) had a gestational age (GA) of 32 weeks or above. There was little difference in the characteristics of infants treated for Type 1 prethreshold or threshold ROP. After controlling for GA, PMA age at treatment was highest in infants with BW ≥2000 g (mean PMA 40.3±4.4 weeks, p<0.001); after controlling for BW, higher GA was associated with higher PMA at treatment (mean PMA 41.5 weeks for gestational age >34 weeks, p<0.001). For every three weeks increase in GA there was a two-week increase in PMA at treatment (R2 = 0.20, p<0.001). The time at treatment of Type 1 prethreshold disease was similar to that for threshold disease i.e. chronological age 5.6∓7.4 weeks, or PMA 34.1∓40.2 weeks but the lower end of the 95% confidence interval for chronological age for Type 1 prethreshold disease among infants with BW ≥2000 g was 3.7 weeks (i.e. before the recommended interval of 4∓6 weeks after birth).

Significance: The Chinese guidelines regarding timing of the first examination are appropriate for infants with BW <2000 g, but more mature infants should be examined a little earlier, at 3 weeks after birth, in order to detect Type 1 prethreshold disease which has a better prognosis than threshold.

Show MeSH
Related in: MedlinePlus