Early Treatment for Retinopathy of Prematurity: Manual of Procedures;Rept. for Jan 98-Oct 00

摘要

In the United States an estimated 1,300 infants annually develop Retinopathy of Prematurity (ROP) that is severe enough to require medical treatment, with many more cases occurring in other countries throughout the world. The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) Study funded by the National Eye Institute demonstrated that ablation of ischemic retina in cases of severe ROP significantly reduces the rate of unfavorable structural (anatomic) and visual outcome; however, later results based on visual acuity have not been as impressive. Advances in the prevention of cicatricial ROP brought about by the CRYO-ROP Study have been counterbalanced by increased survival rates of very low birth weight infants. Thus, while the risk of visual impairment in the individual child with ROP has decreased, the absolute number of infants suffering visual impairment from ROP has remained relatively constant. Clinicians who care for children with ROP are understandably inclined to treat the disease at an earlier point, to try to avoid cicatricial changes caused by ROP and effect a better visual outcome. A study that clarifies whether earlier treatment is effective and safe is clearly needed to guide clinical care.