Objective: To present the incidence and screening results of retinopathy of prematurity (ROP) in preterm infants who were followed-up and treated in Ordu University Training and Research Hospital. Material and Methods: Medical records of 1,995 babies who underwent screening for ROP between January 2014 and June 2021 were reviewed retrospectively. Of these infants, 1,853 patients with a gestational age (GA) of ≤37 weeks who completed all screening sessions were included. Results: Any stage ROP (157 Stage I, 87 Stage II, 19 Stage III, and 43 aggressive ROP) was detected in 306 (16.51%) infants. None of the patients developed Stage IV or V disease. The mean GA (30.30±2.69 weeks) and birth weight (BW) (1,508.20±501.06 g) were significantly lower in patients with ROP at any stage. The rates of ROP were 13.20% and 65.25% in infants with a GA of >28 weeks and ≤28 weeks, respectively. This rates were also 12.05% and 53.23% in patients with a BW of >1,250 g and ≤1,250 g, respectively. Small GA and low BW were significantly associated with the presence of ROP. Severe ROP requiring treatment was detected in 1.2% of infants with a BW of >1,500 g and in 0.5% of patients with a GA of >32 weeks. The disease was spontaneously regressed in 80.39% of patients. Sixty (19.61%) patients received treatment [45 with low dose intravitreal bevacizumab (IVB) injection and 15 with diode laser photocoagulation]. Conclusion: Small GA and low BW are the main risk factors for ROP development. Severe ROP requiring treatment may occur even in heavier babies. Meticulously managed regular screening program providing early diagnosis and treatment prevents Stage IV or V ROP. Additionally, low dose IVB injection seems to be effective in the treatment of aggressive ROP.
Keywords: Retinopathy of prematurity; bevacizumab; light coagulation
Amaç: Bu çalışmanın amacı, Ordu Üniversitesi Eğitim ve Araştırma Hastanesinde takip ve tedavi edilen preterm infantlarda prematüre retinopatisi (PR) insidansını ve tarama sonuçlarını sunmaktır. Gereç ve Yöntemler: Ocak 2014-Haziran 2021 tarihleri arasında PR taraması yapılan 1.995 bebeğin tıbbi kayıtları retrospektif olarak incelendi. Bu hastalardan tüm tarama seanslarını tamamlayan, gebelik yaşı (GY) ≤37 hafta olan 1.853 hasta çalışmaya alındı. Bulgular: Toplam 306 (%16,51) infantta herhangi bir evre PR (157 Evre I, 87 Evre II, 19 Evre III ve 43 agresif PR) saptandı. Hiçbir hastada Evre IV veya V hastalık gelişmedi. Ortalama GY (30,30±2,69 hafta) ve doğum ağırlığı (DA) (1.508,20±501,06 g) herhangi bir evre PR olan hastalarda anlamlı olarak daha düşüktü. GY>28 hafta ve GY≤28 hafta olan bebeklerde, PR oranları sırasıyla %13,20 ve %65,25 idi. DA>1.250 g ve DA≤1.250 g olan hastalarda ise bu oranlar sırasıyla %12,05 ve %53,23 idi. Düşük GY ve DA, PR varlığı ile anlamlı olarak ilişkili idi. DA>1.500 g olan infantların %1,2'sinde, GY>32 hafta olan bebeklerin ise %0,5'inde tedavi gerektiren ciddi PR saptandı. Hastaların %80,39'unda hastalık kendiliğinden geriledi. Altmış (%19,61) hastaya tedavi [45'ine düşük doz intravitreal bevasizumab (IVB) enjeksiyonu ve 15'ine diyot lazer fotokoagülasyon] uygulandı. Sonuç: Küçük GY ve düşük DA, PR gelişimi için esas risk faktörleridir. Daha ağır bebeklerde dahi tedavi gerektiren şiddetli PR oluşabilir. Erken tanı ve tedaviye olanak sağlayan, titizlikle yürütülen düzenli tarama programı Evre IV veya V PR'yi engeller. Ayrıca agresif PR tedavisinde düşük doz IVB enjeksiyonunun etkili olduğu görülmektedir.
Anahtar Kelimeler: Prematüre retinopatisi; bevasizumab; ışık koagülasyonu
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