Ocular complications at the limits of viability

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Abstract

Aim

To evaluate the incidence of retinopathy of prematurity (ROP) and other ocular morbidities in extremely premature infants.

Methods

A retrospective analysis of the prevalence and nature of ocular abnormalities in a cohort of 22 extremely pre-term infants born <25 + 0 weeks of estimated gestational age (GA) was performed.

Results

The children were grouped according to the observed disorder: 13 out of 22 (59%) neonates with mild ophthalmologic findings (ROP ≤ stage II) [Group 1], 5 out of 22 (23%) infants with ROP stage III or more (Group 2) and 4 out of 22 (18%) neonates with severe ocular morbidity (congenital cataract, microphthalmia, partial optic nerve atrophy and corneal perforation due to an ulcer with lens protrusion), partly combined with ROP ≥ stage III (three of four). One child of 22 (5%) needed laser therapy. Out of 22 admitted infants, 20 (91%) were discharged alive.

Conclusion

The high rate of ocular morbidity besides ROP in extremely pre-term infants is noteworthy. Mechanisms influencing the postnatal development of the eye, especially their relation to the grade of prematurity and neonatological therapeutical strategies, require further investigations.

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