Aggressive posterior retinopathy of prematurity (AP-ROP) is a special kind of ROP, which is characterized by ill-defined, dilated and tortuous vessels in the posterior portion of the eye and rapidly progresses to severe ROP with retinal detachment. As more and more AP-ROP cases, who usually have poor prognosis, have been found, this disease has been increasingly noted. Which premature infants are at risks? How to make earlier diagnosis? Is there any better treatment protocols? There is much research about AP-ROP and this article summarizes the risks, screening, diagnosis and treatment of this disease.
Humans ; Infant, Newborn ; Prognosis ; Retinopathy of Prematurity ; epidemiology ; etiology ; therapy

Retinopathy of prematurity (ROP) is a vasoproliferative retinopathy. Worldwide, ROP is a major cause of blindness in children. This chapter describes its risk factors, etiology, diagnosis, treatment and recent advances.
Blindness ; etiology ; Humans ; Infant, Newborn ; Infant, Premature ; Prognosis ; Retinopathy of Prematurity ; classification ; etiology ; therapy ; Risk Factors

Humans ; Infant, Newborn ; Infant, Premature ; Propranolol ; therapeutic use ; Retinopathy of Prematurity ; drug therapy

Humans ; Infant, Newborn ; Infant, Premature ; Retinopathy of Prematurity ; drug therapy ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors

Retinopathy of prematurity(ROP)is a pathological neovascularization with fibrotic changes in the fundus of premature infants.It is a major cause of preventable blindness in children in both developing and developed countries.Treatment of ROP has long been a hot research topic in ophthalmology and pediatrics.With a clearer knowledge of the pathogenesis of ROP,more basic and clinical studies have been carried out.The anti-vascular endothelial growth factor therapy and surgical treatment have become mature strategies,and a variety of therapeutic drugs including insulin-like growth factor-1,transforming growth factor-β,polyunsaturated fatty acids,and β-adrenergic receptor blockers have been developed.This article reviews the recent advances in ROP.
Child ; Humans ; Infant, Newborn ; Infant, Premature ; Neovascularization, Pathologic ; therapy ; Retinopathy of Prematurity ; drug therapy ; surgery ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors

Cryotherapy has been shown to be an effective treatment for retinopathy of prematurity (ROP) stage 3+. However, the outcome of cryotherapy is less favorable in zone 1 ROP than in zone 2 ROP. We suspected whether there may be differences in the outcomes of cryotherapy if the zone of ROP is further divided. So we reviewed the records of 85 premature infants (145 eyes) who had undergone cryotherapy for ROP. The frequencies of favorable outcome were 42.9% of 14 eyes (zone 1), 78.9% of 38 eyes (posterior zone 2), 92.9% of 70 eyes (mid zone 2), and 100.0% of 23 eyes (anterior zone 2), respectively (p < 0.001). These results suggest that the more posteriorly the ROP is located, the less favorable the outcome of cryotherapy.
Cryotherapy/*methods ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Postoperative Complications ; Retinopathy of Prematurity/pathology/*therapy ; Retrospective Studies ; Treatment Outcome

There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation (SpO2) is 90 to 93% with an intermittent review of the correlation between SpO2 and the partial pressure of arterial oxygen tension (PaO2). Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.
Bronchopulmonary Dysplasia ; Cerebral Palsy ; Humans ; Infant, Newborn ; Infant, Premature ; Oximetry ; Oxygen ; Oxygen Inhalation Therapy ; Partial Pressure ; Retinopathy of Prematurity

PURPOSE: In the present study, we aimed to evaluate the suitability of the first screening examination for retinopathy of prematurity (ROP) in a tertiary neonatal intensive care unit (NICU). METHODS: A retrospective analysis of ROP screening records of 459 infants admitted to the NICU of Seoul National University Children's Hospital between January 2006 and December 2011 was performed. The first examination was performed at 31-32 weeks of postmenstrual age (PMA) or 4-5 weeks of postnatal age (PNA), whichever was earlier. The infants were divided into subgroups according to the gestational age (GA), and the time of the first examination, time of onset of ROP, and time of laser surgery were assessed with regard to the PMA and PNA. RESULTS: Of the 459 infants, 139 infants developed ROP, with the mean PMA at onset of ROP being 34+2+/-2+3 weeks. Type I ROP developed in 57 infants, with the median PMA at laser surgery being 36+0 weeks. The median PMAs at the time of onset and the time of surgery did not significantly differ between groups divided according to GA. Infants with a GA of <26 weeks showed a higher incidence of Type I ROP compared to those with a GA of > or =26 weeks. None of the infants with a GA of <26 weeks were diagnosed with ROP at the first examination, and none of the patients in either group missed treatment. Six infants developed ROP before 31 weeks of PMA, at which time the first screening for ROP is generally performed. CONCLUSION: We suggest that the timing of the initial examination for ROP should be based on PMA or PNA, whichever is earlier, particularly in infants with GA of <26 weeks.
Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Laser Therapy ; Mass Screening* ; Retinopathy of Prematurity* ; Retrospective Studies

Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Male ; Retinal Telangiectasis ; diagnosis ; therapy ; Retinopathy of Prematurity ; diagnosis

OBJECTIVETo evaluate the use of oxygen in neonates in the past, present and future.

DATA SOURCESThe data are mainly from Pubmed with relevant published articles from the 1940s to the present with some information gathered from web searches.

STUDY SELECTIONStudies evaluating the use of oxygen in premature and term infants through history with original milestone articles included.

RESULTSThere are still many unknowns about the proper use of oxygen in preterm and term infants but many studies suggest that both liberal use (resulting in a blood oxygen saturation of greater than 94%) as well as restrictive use (resulting in a blood oxygen saturation of less than 80% - 85%) are detrimental and have long term consequences on the infant.

CONCLUSIONSDefinitive studies evaluating the appropriate concentration and duration of supplemental oxygen are ongoing and will help in the management of term and preterm infants requiring oxygen.

Animals ; Embryonic Development ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Infant, Premature ; Oxygen ; therapeutic use ; toxicity ; Practice Guidelines as Topic ; Retinopathy of Prematurity ; therapy