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Vol. 58. Issue 5.
Pages 471-477 (1 May 2003)
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Vol. 58. Issue 5.
Pages 471-477 (1 May 2003)
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Retinopatía del prematuro. Casuística de los años 1995–2001
Retinopathy oçf prematurity: casuistics between 1996 and 2001
Visits
7996
N. Grunauera, M. Iriondo Sanza,
Corresponding author
miriondo@hsjdbcn.org

Sección de Neonatología. Hospital Universitario Sant Joan de Déu. P. Sant Joan de Déu, 2. 08950 Esplugues de Llobregat. Barcelona. España
, A. Serra Castanerab, J. Krauel Vidala, R. Jiménez Gonzáleza
a Sección de Neonatología. Unidad Integrada de Pediatría.
b Servicio de Oftalmología. Hospital Universitario Sant Joan de Déu. Barcelona. España.
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Antecedentes

La retinopatía del prematuro (ROP) es una causa demorbilidad neurosensorial.

Objetivos

Estudiar la incidencia, factores de riesgo asociados, tratamiento y evolución de la retinopatía de la prematuridaden recién nacidos pretérmino menores de 32 semanas procedentes de nuestro hospital.

Métodos

Pacientes nacidos entre 1 de enero de 1995 y 31 de diciembre de 2001 en el Hospital Sant Joan de Déu (Barcelona) con ≤ 32 semanas de edad gestacional, que han sobrevivido hasta el mes de vida. Se les realizó fondo de ojoentre las 4 y 6 semanas de vida, continuando con el examen cada 1–2 semanas, hasta su completa vascularización. Seguimiento evolutivo de las secuelas del fondo de ojo y función visual. Estudio descriptivo con comparación bivariable entre los grupos con y sin ROP.

Resultados

De los 324 casos estudiados, 74 presentaron ROP (22,8 %), de los cuales se clasificaron de estadios 1 y 2 a 63 pacientes (21,7 %) y de estadio 3 a 11 (3,7 %). Se evidenció una correlación inversa entre la incidencia de retinopatía y el peso o la edad gestacional. El estadio umbral (3 plus) se detectó en 9 casos (16 ojos) (3,1 % de la muestra de estudio y 12,1 % de los recién nacidos afectados de retinopatía) que se trataron con fotocoagulación con láser. Las secuelas del fondo de ojo fueron leves en el 2,7 % de pacientes, moderadas en el 0,6 % y graves en el 0,6 %. La función visual (n 5 236) de los recién nacidos con ROP (n 5 74) se encontró alterada en 4 pacientes (1,7% de los explorados) de los cuales fue grave en 2 (0,8 %). En el análisis bivariante, el bajo peso al nacer, la edad gestacional, días de oxigenoterapia y ventilación mecánica, días de antibiótico, número de transfusiones de sangre mostraron diferencias significativas (p < 0,001).

Conclusiones

En este estudio la incidencia de ROP es similar a la deotros centros y se ve una fuerte asociación a distintos factores de riesgo para su aparición. No se observan estadiosgraves a partir de las 30 semanas. Los resultados de la fotocoagulación con láser son óptimos, con disminución deas secuelas en el fondo de ojo y en la función visual lasestimadas sin tratamiento.

Palabras clave:
Retinopatía de la prematuridad
Recién nacido de muy bajo peso
Agudeza visual
Ceguera
Fotocoagulación con
Background

Retinopathy of prematurity (ROP) is a cause of neurosensorial morbidity.

Objectives

To study the incidence, associated risks factors, treatment, and outcome of ROP in premature infants born atless than 32 weeks in our hospital.

Methods

We performed a descriptive study of patients born between the January 1, 1995, and December 31, 2001, in SantJoan de Déu Hospital in Barcelona (Spain) at≤32 weeks of gestation who survived until their first month of life. Anocular evaluation was performed between weeks 4 and 6 of life and was repeated every 1–2 weeks until retinal vascularization was complete. Ocular sequelae and visualfunction were evaluated. Bivariate comparison of groupswith and without ROP was performed.

Results

Of the 324 patients evaluated, 74 presented ROP (22.8 %), of which 63 patients (21.7 %) were classified as stage 1 or 2 and 11 (3.7 %) as stage 3. An inverse correlation between the incidence of retinopathy and weight and gestational age was found. Threshold disease (3 plus) was detected in 9 patients (16 eyes; 3.1 % of the study sample and 12.1 % of the neonates with retinopathy).All of these neonates were treated with laser therapy. Ocular sequelae were mild in 2.7 % of the patients, moderate in 0.6 % and severe in 0.6 %. The visual function (n 5 236) of infants with ROP (n 5 74) was altered in 4 patients (1.7 %). Of these, alterations were severe in 2 patients (0.8 %). Bivariate analysis revealed significant differences (p < 0.001) in low birth weight, gestational age, days of oxygen therapy, days of mechanical ventilation, days of antibiotic therapy, and number of blood transfusions.

Conclusions

In this study the incidence of ROP was similar to that in other centers. Development of ROP was strongly associated with its various risk factors. Severe stages were not seen above 30 weeks of gestational age. The results of laser therapy were optimal, with fewer alterations in ocular examination and visual function than those estimated in patients without treatment.

Key words:
Retinopathy of prematurity
Very low birth weight
Visual acuity
Blindness
Laser photocoagulation
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