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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol-treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P less than .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late-onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P less than .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg.
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PMID:Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled, double-masked trial. 354

Of 99 children in the Royal Blind School, Edinburgh (which serves Scotland and part of N E England), 15 had optic atrophy (hydrocephalus 4, intracranial haemorrhage 2, prematurity 2, fetal distress 2, birth asphyxia 2, cerebral atrophy 1, cardiac arrest during hernia operation 1, and leukaemia 1). Fourteen had congenital cataract, 12 congenital retinal aplasia (Leber's congenital amaurosis) and 11 retinopathy of prematurity. There were small numbers in many other diagnostic categories, including three with non-accidental head injury. Mental retardation, spasticity, and nystagmus were frequent other correlates in all diagnostic categories. 'Very probably hereditary' was a conservative attribution in 36, while 'probable' seemed appropriate for 12-that is, almost 48% were hereditary. Only about 11 cases might have been prevented through genetic counselling, which testifies to the frequency of autosomal recessive hereditary disease, although no parents were consanguineous.
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PMID:Blindness in schoolchildren: importance of heredity, congenital cataract, and prematurity. 365 73

A cytologically distinctive type of acute hyperoxemic injury of retinal neurons occurs in premature neonates. Ganglion cells in the central well-vascularized neonate retina are susceptible to excessive oxygen and this is expressed morphologically by karyorrhexis of their nuclei. We observed retinal neuronal necrosis in neonates who had hyperoxemia of greater than 150 torr for two hours or longer in the first week of life. Neuronal necrosis was strikingly associated with immaturity as determined by gestational age and birth weight: of 30 involved neonates, all were below 2,000 g; of 47 autopsied premature infants with birth weights under 1,500 g who survived for at least two days, 26 (55%) had acute retinal necrosis. When gestational age was used as a measure of prematurity, the highest incidence occurred in the 24- to 27-week group where 13 of 21 (62%) were involved. Hyperoxemic karyorrhectic changes, most prominent in the ganglion cells of the macula, are distinct from the classic peripheral mesenchymal vascular abnormalities of retinopathy of prematurity.
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PMID:Hyperoxemic retinal neuronal necrosis in the premature neonate. 376 56

A complete analysis of the components of refractive error was performed on ten eyes of five patients with myopia and retinopathy of prematurity (ROP). In comparison to an age-matched control group, these eyes exhibited both lenticular and axial myopia. Only the high crystalline lens powers, which ranged from 22.20 to 44.13 diopters (D) (mean value, 31.27 D), were found to be statistically significant. In two patients, only one eye had high myopia. The lens power in these eyes was approximately 11 D more powerful than the lens of the fellow eye. Further investigation into the ocular changes induced by prematurity and abnormal oxygen metabolism is needed to determine the reason for the high degree of lenticular myopia.
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PMID:Myopia associated with retinopathy of prematurity. 380 18

Retinal detachment occurring in late stages of retinopathy of prematurity may appear spontaneous when a short oxygen therapy in low birthweight infant has been failed to recognized. As it is initially a tractional detachment the understanding of underlying pathogenic mechanisms is still important to choose adequate treatment which will determine the success of the surgery. Six patients with R.D. were recognised as having late complication of R.P. on the aspect of pathological posterior retinal vasculature and typical history of prematurity and oxygen therapy. All cases were treated successfully by different procedures varying with the severity of the disease. Use of vitrectomy can be advised in some cases but, is still a dangerous procedure, especially in this peculiar condition.
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PMID:[Retinal detachment caused by late-stage retinopathy of prematurity]. 381 31

Retrolental fibroplasia, frequently referred to now as the "retinopathy of prematurity," has shown an increased incidence in recent years. This is apparently due to advances in neonatal care, which have resulted in a four- to five-fold improvement in the survival of the extremely low birthweight infants and it is these infants who are at the highest risk of developing retrolental fibroplasia. The use of large supplements of vitamin E, a known antioxidant, is discussed along with other forms of therapy.
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PMID:Current therapy of retrolental fibroplasia. Retinopathy of prematurity. 634 34

Prolonged oxygen administration in premature infants is the most predictive variable for severe retinopathy of prematurity, after degree of prematurity itself. It was noted that infants receiving prolonged oxygen supplementation are probably hypoxemic relative to their healthy counterparts. Therefore, hypoxemia during recovery from a hyperoxic-induced retinal vascular injury was tested in the kitten model of oxygen-induced retinopathy. Twelve litters were exposed to 80% inspired O2 for 65 hours on day 3, and recovered in room air, 13% or 17% oxygen. The retinas were scored at 4 weeks, and 13% oxygen recovery (PO2 = 39 +/- 18 torr) was found to worsen significantly the retinopathy compared with that in room air-recovered littermates (P less than .01). Hemorrhages occurred more frequently in the retinas from the hypoxemic-recovered kittens. Clinical trials of this hypothesis are indicated in humans.
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PMID:Effects of marginal hypoxemia on recovery from oxygen-induced retinopathy in the kitten model. 654 19

Despite an apparent increase in the incidence of retrolental fibroplasia (RLF) and renewed interest in its pathophysiology and prevention, clinicians are often ill prepared to help the family promote the optimal development of its blind or severely visually impaired child. The physician's management approach is molded by both knowledge about the effects of blindness and prematurity on subsequent development and attitudes about blindness. Both issues are reviewed, with particular focus on the developmental course of the infant or child who is blind due to RLF. Although the literature regarding developmental outcome of premature infants with RLF has failed to reach definitive conclusions, studies reveal a tendency toward an IQ distribution similar to or slightly lower than that of various control samples. Blind children with RLF may also be at increased risk for emotional problems, largely as a function of early maladaptive family interaction patterns. Implications of these and other developmental patterns are translated into general and specific interventions that neonatologists, ophthalmologists, and primary care physicians can facilitate. Such physician guidance can help assure the blind or severely visually impaired child's optimal cognitive and emotional development.
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PMID:Development of blind infants and children with retrolental fibroplasia: implications for physicians. 668 66

Besides oxygen administration and immaturity of the premature retinal vessels, there are other risk factors for retrolental fibroplasia: (1) respiratory distress syndrome; (2) multiple episodes of bradycardia apnoea; (3) exchange transfusions; (4) hyaline membrane disease; (5) anemia of prematurity; (6) hyperbilirubinemia; (7) avitaminosis E; (8) cardiovascular defects; (9) infectious diseases; (10) multiple births; (11) hypocalcemia; (12) hypothermia; (13) hemorrhagic tendency; (14) delayed coaptation of the retina, and (15) spastic diplegia.
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PMID:Risk factors for retrolental fibroplasia. 668 25

The survival rate of very-low-birthweight (VLBW) infants has greatly increased due to the introduction of intensive-care methods to neonatal nurseries. It was feared that this would also cause an increase in the amount of ocular morbidity associated with prematurity. In order to estimate this, 111 very-low-birthweight infants (birthweights less than or equal to 1500 g) were reviewed at two years of age. They comprised 63% of the total number of long-term surviving babies born at, or transferred in the neonatal period to, the Royal Women's Hospital, Melbourne, in 1977 and 1978. In 33% a significant ocular problem was detected; 19% had strabismus, 17% had a significant refractive error, 10% had cicatricial retrolental fibroplasia (RLF), and 2.7% were blind, due to optic atrophy associated with cerebral palsy. Other studies have shown that 7% of VLBW infants develop severe (Stage III) RLF, and 18% of these (1.26% of VLBW infants) will be socially or totally blind. In order to estimate the significance of VLBW infants to the ophthalmic health services, and to the organisations for the care of the visually handicapped, these figures can be extrapolated. Based on 1980 figures, it would be expected that approximately 1105 VLBW infants would survive annually, and nine would become blind from RLF, while 110 would have been affected by RLF. Thirty-three children would be blind from optic atrophy associated with cerebral palsy, 210 would have strabismus, and at least 187 would have a significant refractive error. VLBW infants will contribute significantly to the number of children requiring ocular care, and because of the high incidence of ocular abnormalities, it is recommended that routine screening of all VLBW infants be carried out at one year and two years of age.
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PMID:The significance of ocular morbidity in very-low-birthweight infants to the Australian health service. 668 74


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