Mrinali Patel Gupta1, R V Paul Chan1, Rachelle Anzures2, Susan Ostmo3, Karyn Jonas1, Michael F Chiang4. 1. Department of Ophthalmology, Weill Cornell Medical College/New York - Presbyterian Hospital, New York, New York. 2. Eye Institute, St Luke's Medical Center, Quezon City, Philippines. 3. Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon. 4. Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon. Electronic address: chiangm@ohsu.edu.
Abstract
PURPOSE: To characterize the frequency of and clinical indications for which experts treat retinopathy of prematurity (ROP) milder than type 1 disease, the recommended threshold for treatment from established consensus guidelines. DESIGN: Descriptive analysis. METHODS: setting: Multicenter. STUDY POPULATION: A database of 1444 eyes generated prospectively from all babies screened for ROP at 1 of 6 major ROP centers whose parents provided informed consent. INTERVENTION: Retrospective review of the database and charts to identify all patients treated for ROP milder than type 1. MAIN OUTCOME MEASURE: Indication(s) for treatment. RESULTS: A total of 137 eyes of 70 infants were treated for ROP. Of these 137 eyes, 13 (9.5%) were treated despite a clinical diagnosis milder than type 1 ROP. Indications for treatment included active ROP with the fellow eye being treated for type 1 ROP (2 eyes, 15.4%); concerning structural changes (9 eyes, 69.2%), including tangential traction with temporal vessel straightening concerning for macular dragging (8 eyes, 61.5%) and thick stage 3 membranes with anteroposterior traction concerning for progression to stage 4 ROP (3 eyes, 23.1%); persistent ROP at an advanced postmenstrual age (4 eyes, 30.8%); and/or vitreous hemorrhage (3 eyes, 23.1%). CONCLUSIONS: Experts in this study occasionally recommended treatment in eyes with disease less than type 1 ROP. This study has important clinical implications and highlights the role of individual clinical judgment in situations not covered by evidence-based treatment guidelines.
PURPOSE: To characterize the frequency of and clinical indications for which experts treat retinopathy of prematurity (ROP) milder than type 1 disease, the recommended threshold for treatment from established consensus guidelines. DESIGN: Descriptive analysis. METHODS: setting: Multicenter. STUDY POPULATION: A database of 1444 eyes generated prospectively from all babies screened for ROP at 1 of 6 major ROP centers whose parents provided informed consent. INTERVENTION: Retrospective review of the database and charts to identify all patients treated for ROP milder than type 1. MAIN OUTCOME MEASURE: Indication(s) for treatment. RESULTS: A total of 137 eyes of 70 infants were treated for ROP. Of these 137 eyes, 13 (9.5%) were treated despite a clinical diagnosis milder than type 1 ROP. Indications for treatment included active ROP with the fellow eye being treated for type 1 ROP (2 eyes, 15.4%); concerning structural changes (9 eyes, 69.2%), including tangential traction with temporal vessel straightening concerning for macular dragging (8 eyes, 61.5%) and thick stage 3 membranes with anteroposterior traction concerning for progression to stage 4 ROP (3 eyes, 23.1%); persistent ROP at an advanced postmenstrual age (4 eyes, 30.8%); and/or vitreous hemorrhage (3 eyes, 23.1%). CONCLUSIONS: Experts in this study occasionally recommended treatment in eyes with disease less than type 1 ROP. This study has important clinical implications and highlights the role of individual clinical judgment in situations not covered by evidence-based treatment guidelines.
Authors: William V Good; Robert J Hardy; Velma Dobson; Earl A Palmer; Dale L Phelps; Betty Tung; Maryann Redford Journal: Arch Ophthalmol Date: 2010-04-12
Authors: Michael C Ryan; Susan Ostmo; Karyn Jonas; Audina Berrocal; Kimberly Drenser; Jason Horowitz; Thomas C Lee; Charles Simmons; Maria-Ana Martinez-Castellanos; R V Paul Chan; Michael F Chiang Journal: AMIA Annu Symp Proc Date: 2014-11-14
Authors: Eugene Y J Ng; Brian P Connolly; J Arch McNamara; Carl D Regillo; James F Vander; William Tasman Journal: Ophthalmology Date: 2002-05 Impact factor: 12.079
Authors: Chace Moleta; J Peter Campbell; Jayashree Kalpathy-Cramer; R V Paul Chan; Susan Ostmo; Karyn Jonas; Michael F Chiang Journal: Am J Ophthalmol Date: 2017-01-11 Impact factor: 5.258
Authors: Dana Darwish; Ru-Ik Chee; Samir N Patel; Karyn Jonas; Susan Ostmo; J Peter Campbell; Michael F Chiang; R V Paul Chan Journal: Asia Pac J Ophthalmol (Phila) Date: 2018-05-29
Authors: Rene Y Choi; James M Brown; Jayashree Kalpathy-Cramer; R V Paul Chan; Susan Ostmo; Michael F Chiang; J Peter Campbell Journal: Ophthalmol Retina Date: 2020-05-04
Authors: S Grace Prakalapakorn; Sharon F Freedman; Amy K Hutchinson; David K Wallace; Sandra S Stinnett; J Wayne Riggins; Keith J Gallaher Journal: Ophthalmol Retina Date: 2018-01-10
Authors: J Peter Campbell; Michael F Chiang; Jimmy S Chen; Darius M Moshfeghi; Eric Nudleman; Paisan Ruambivoonsuk; Hunter Cherwek; Carol Y Cheung; Praveer Singh; Jayashree Kalpathy-Cramer; Susan Ostmo; Malvina Eydelman; R V Paul Chan; Antonio Capone Journal: Ophthalmology Date: 2022-02-12 Impact factor: 14.277
Authors: Kishan Gupta; J Peter Campbell; Stanford Taylor; James M Brown; Susan Ostmo; R V Paul Chan; Jennifer Dy; Deniz Erdogmus; Stratis Ioannidis; Jayashree Kalpathy-Cramer; Sang J Kim; Michael F Chiang Journal: JAMA Ophthalmol Date: 2019-07-03 Impact factor: 7.389
Authors: Stanford Taylor; James M Brown; Kishan Gupta; J Peter Campbell; Susan Ostmo; R V Paul Chan; Jennifer Dy; Deniz Erdogmus; Stratis Ioannidis; Sang J Kim; Jayashree Kalpathy-Cramer; Michael F Chiang Journal: JAMA Ophthalmol Date: 2019-07-03 Impact factor: 7.389
Authors: J Peter Campbell; Sang Jin Kim; James M Brown; Susan Ostmo; R V Paul Chan; Jayashree Kalpathy-Cramer; Michael F Chiang Journal: Ophthalmology Date: 2020-10-27 Impact factor: 14.277