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#071-075: Retinopathy of Prematurity

Hello  friends 👋

This week we are discussing the topic of retinopathy of prematurity. This is a fascinating pathology that spans the history of neonatology. We start off the week with the history of ROP, or should we say retrolental fibroplasia. This saga takes us to Massachussets in the 1940s to Melbourne, Australia and the United Kingdom. We also reviewed the pathophysiology of ROP and the multiple trials looking at oxygen saturation and ROP. We reviewed some of the most commonly used treatment modalities and some of the controversies surrounding bevacizumab. Finally, on Friday we had the privilege of chatting with Dr. Edward Wood, a vitreoretinal surgeon, expert in management of all diseases of the retina and vitreous in both adults and children. He described to us what the follow up of babies with ROP looks like and what are some of the gaps in knowledge in this areas.

We are linking to many of the articles mentioned on the show this week.

We are also sharing a presentation covering the content discussed on the podcast to help you teach the material.

Link to download the PowerPoint and notes from these episodes 👇

The articles covered on this series of episodes can be found here 👇

Fibroblastic Overgrowth of Persistent Tunica Vasculosa Lentis in Infants Born Prematurely: II. Report of Cases-Clinical Aspects.

Terry TL.Trans Am Ophthalmol Soc. 1942;40:262-84.PMID: 16693285 Free PMC article. No abstract available.


Retrolental fibroplasia; cooperative study of retrolental fibroplasia and the use of oxygen.

KINSEY VE.AMA Arch Ophthalmol. 1956 Oct;56(4):481-543.PMID: 13361620 No abstract available.


Retrolental fibroplasia; etiology and prophylaxis.

SZEWCZYK TS.Am J Ophthalmol. 1952 Mar;35(3):301-11.PMID: 14903018 No abstract available.


Supplemental Therapeutic Oxygen for Prethreshold Retinopathy Of Prematurity (STOP-ROP), a randomized, controlled trial. I: primary outcomes.

[No authors listed]Pediatrics. 2000 Feb;105(2):295-310. doi: 10.1542/peds.105.2.295.PMID: 10654946 Clinical Trial.


Final results of the Early Treatment for Retinopathy of Prematurity (ETROP) randomized trial.

Good WV; Early Treatment for Retinopathy of Prematurity Cooperative Group.Trans Am Ophthalmol Soc. 2004;102:233-48; discussion 248-50.PMID: 15747762 Free PMC article. Clinical Trial.


Target ranges of oxygen saturation in extremely preterm infants.

SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network; Carlo WA, Finer NN, Walsh MC, Rich W, Gantz MG, Laptook AR, Yoder BA, Faix RG, Das A, Poole WK, Schibler K, Newman NS, Ambalavanan N, Frantz ID 3rd, Piazza AJ, Sánchez PJ, Morris BH, Laroia N, Phelps DL, Poindexter BB, Cotten CM, Van Meurs KP, Duara S, Narendran V, Sood BG, O'Shea TM, Bell EF, Ehrenkranz RA, Watterberg KL, Higgins RD.N Engl J Med. 2010 May 27;362(21):1959-69. doi: 10.1056/NEJMoa0911781. Epub 2010 May 16.PMID: 20472937 Free PMC article. Clinical Trial.


Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity.

Mintz-Hittner HA, Kennedy KA, Chuang AZ; BEAT-ROP Cooperative Group.N Engl J Med. 2011 Feb 17;364(7):603-15. doi: 10.1056/NEJMoa1007374.PMID: 21323540 Free PMC article. Clinical Trial.


Oxygen saturation and outcomes in preterm infants.

BOOST II United Kingdom Collaborative Group; BOOST II Australia Collaborative Group; BOOST II New Zealand Collaborative Group; Stenson BJ, Tarnow-Mordi WO, Darlow BA, Simes J, Juszczak E, Askie L, Battin M, Bowler U, Broadbent R, Cairns P, Davis PG, Deshpande S, Donoghoe M, Doyle L, Fleck BW, Ghadge A, Hague W, Halliday HL, Hewson M, King A, Kirby A, Marlow N, Meyer M, Morley C, Simmer K, Tin W, Wardle SP, Brocklehurst P.N Engl J Med. 2013 May 30;368(22):2094-104. doi: 10.1056/NEJMoa1302298. Epub 2013 May 5.PMID: 23642047 Free article. Clinical Trial.


Screening Examination of Premature Infants for Retinopathy of Prematurity.



Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.

Natarajan G, Shankaran S, Nolen TL, Sridhar A, Kennedy KA, Hintz SR, Phelps DL, DeMauro SB, Carlo WA, Gantz MG, Das A, Greenberg RG, Younge NE, Bliss JM, Seabrook R, Sánchez PJ, Wyckoff MH, Bell EF, Vohr BR, Higgins RD.Pediatrics. 2019 Aug;144(2):e20183537. doi: 10.1542/peds.2018-3537. Epub 2019 Jul 23.PMID: 31337693 Free PMC article.


Neurodevelopmental Outcomes after Bevacizumab Treatment for Retinopathy of Prematurity: A Meta-analysis.

Tsai CY, Yeh PT, Tsao PN, Chung YE, Chang YS, Lai TT.Ophthalmology. 2021 Jun;128(6):877-888. doi: 10.1016/j.ophtha.2020.11.012. Epub 2020 Nov 16.PMID: 33212122 Review.


80 Years of vision: preventing blindness from retinopathy of prematurity.

Wood EH, Chang EY, Beck K, Hadfield BR, Quinn AR, Harper CA 3rd.J Perinatol. 2021 Jun;41(6):1216-1224. doi: 10.1038/s41372-021-01015-8. Epub 2021 Mar 5.PMID: 33674712 Free PMC article. Review.

Identification and Treatment of Retinopathy of Prematurity: Update 2017.

Medha Sharma, MD; Deborah K. VanderVeen, MD. Neoreviews (2017) 18 (2): e84–e90.


Interventions in Retinopathy of Prematurity

Ruwan A. Silva, MD; Darius M. Moshfeghi, MD. Neoreviews (2012) 13 (8): e476–e485.

Retinopathy of Prematurity: Recent Developments 

Brian W. Fleck, MD, FRCS, FRCOph; Neil McIntosh, DSc(Med), MRCP. Neoreviews (2009) 10 (1): e20–e30.

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