Retinopathy of Prematurity in Zone I posterior (Zone Half): Neonatal Profile, Clinical characteristics, and outcomes

Tapas Padhy,Miloni Shah,Suman Sahu,Taraprasad Das,Utpal BHUSAL, Aveenash Singh, Souvik Bhunia, Sameer Nayak,Sameera Nayak,Bhavik Panchal,Komal Agarwal, Balakrushna Samantaray,Sabita Devi, Krishna Rao,Lingaraj Pradhan,Subhadra Jalali

Research Square (Research Square)(2022)

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摘要
Abstract Objective To report the demographic profile,clinical characteristics, and outcomes of retinopathy of prematurity (ROP) in Zone I posterior. Methods In a partly retrospective (ten years) and partly prospective (one year) study, we analyzed the demographic profile, clinical characteristics, treatment type, recurrences, and outcomes of babies with ROP in Zone I posterior. Results The study included 130 eyes of 67 infants with a mean gestational age and birth weight of 29.3 (± 2.2) weeks and 1217.3 (± 381.9) grams, respectively. All babies had received unblended oxygen with a poor weight gain in the majority.The ROP subtypes included aggressive,threshold, hybrid, stage 4, and atypical type in 78, 20, 11, 15, and 6 eyes, respectively. Fibrovascular proliferation when present,was prominent nasally, occasionally overriding the disc margin. Extensive arteriovenous tortuosity was more prominent than vascular dilatation. Atypical observations included bleb-like detachment(n = 6 eyes), candle wax-like preretinal deposits (n = 23 eyes), and large arteriovenous shunts (n = 9eyes). Primary treatment included intravitreal anti-VEGF in 119 eyes and laser in 11 eyes. Among those with follow-upfor more than 6 months, the recurrence was seen in 48.3% (n = 29) of eyes with anti-VEGF; with additional laser treatment, the outcome was favorable in 90.5% (n = 116) of eyes. Conclusions Zone I posterior ROP has a distinct profile with several atypical characteristics; it differsfrom ROP in other zones. Primary anti-VEGF treatment is beneficial but inadequate; most babies need additional laser or surgery.Improved neonatal care, earlier screening, and a combination of intravitreal anti-VEGF and laser are recommended.
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关键词
retinopathy,neonatal profile,prematurity,zone
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