Document Detail


Outcome-based management of retinopathy of prematurity. Multicenter Trial of Cryotherapy for Retinopathy of prematurity Cooperative Group.
MedLine Citation:
PMID:  10530985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: A system is presented for sequentially computing the risk of progression of retinopathy of prematurity (ROP) for infants born weighing not more than 1250 gm. A personal computer program is used to monitor infants' risk of threshold ROP from first appearance of ROP, and the progression in severity is tracked with multiple logistic risk models developed from data in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity. METHODS: After entry of the infant's birth weight, gestational age, ethnicity, birth in the current hospital or elsewhere, single or multiple birth, and maturity zone of retinal vessels, risk of progression to threshold severity is calculated. New estimates of risk are computed at onset of ROP and prethreshold ROP (any zone I ROP, zone II stage 2+ or 3) according to the extent of retinal vascularization when ROP first appears, how rapidly ROP progresses, and how severe it is. When threshold ROP (8 total or 5 contiguous clock hours of stage 3+ in zone I or II) is reached,the system provides separate estimates of risk that the eye will have an unfavorable 3-month outcome if treated or not. RESULTS: Estimates of risk of progression to threshold disease among the 4099 patients in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity natural history study varied from less than 1% to more than 70%. For eyes with threshold disease, the risk of an unfavorable outcome at 3 months without treatment varied from less than 10% to more than 90%. CONCLUSION: This method of tracking identifies infants at high risk for severe ROP and poor structural outcome. It provides information about prognosis with a specificity heretofore impossible.
Authors:
R J Hardy; E A Palmer; D B Schaffer; D L Phelps; B R Davis; C J Cooper
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus     Volume:  1     ISSN:  1091-8531     ISO Abbreviation:  J AAPOS     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1999-11-02     Completed Date:  1999-11-02     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9710011     Medline TA:  J AAPOS     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  46-54     Citation Subset:  IM    
Affiliation:
University of Texas Health Science Center at Houston, School of Public Health 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Cryotherapy*
Decision Support Techniques
Differential Threshold
Disease Progression
Humans
Infant
Infant, Newborn
Prognosis
Retinopathy of Prematurity / therapy*
Software
Treatment Outcome
Grant Support
ID/Acronym/Agency:
U10 EY05874/EY/NEI NIH HHS
Comments/Corrections
Erratum In:
J AAPOS 1997 Sep;1(3):137

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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