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Predictive value of pre-plus disease in retinopathy of prematurity.

Publication ,  Journal Article
Wallace, DK; Freedman, SF; Hartnett, ME; Quinn, GE
Published in: Arch Ophthalmol
May 2011

OBJECTIVES: To investigate prospectively whether the presence of pre-plus disease predicts progression to severe retinopathy of prematurity (ROP) requiring laser treatment. METHODS: Posterior retinal video recordings were obtained during 710 indirect ophthalmoscopy examinations of 214 premature infants over a period of 5 years. Two masked experts reviewed short video recordings and determined whether there was plus disease, pre-plus disease, or neither. The primary analysis included results of one examination of the right eye at 33 to 34 weeks' postmenstrual age. The primary outcome was a comparison of the proportion of eyes subsequently requiring laser treatment between the group graded as having pre-plus disease vs the group graded as having neither plus disease nor pre-plus disease. RESULTS: Of 10 eyes with pre-plus disease at 33 to 34 weeks' postmenstrual age, 7 (70%) subsequently required laser treatment; of 154 eyes without pre-plus disease or plus disease at 33 to 34 weeks' postmenstrual age, 14 (9%) subsequently required laser treatment (risk ratio, 7.7; 95% confidence interval, 4.1-14.8; P < .001). The mean time between the examination diagnosing pre-plus disease and laser treatment was 1.6 weeks (range, 1.0-2.4 weeks). When adjusting for birth weight, gestational age, ROP location (zone), and ROP severity (stage), the presence of pre-plus disease at 33 to 34 weeks' postmenstrual age independently predicted the need for laser treatment (adjusted odds ratio, 7.6; 95% confidence interval, 1.4-42.3; P = .02). CONCLUSIONS: Pre-plus disease observed early during the course of ROP is strongly associated with the development of severe ROP requiring laser treatment. The diagnosis of pre-plus disease has prognostic value beyond that already provided by birth weight, gestational age, ROP zone, and ROP stage. Eyes with pre-plus disease should be closely observed to allow optimal timing of intervention.

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Published In

Arch Ophthalmol

DOI

EISSN

1538-3601

Publication Date

May 2011

Volume

129

Issue

5

Start / End Page

591 / 596

Location

United States

Related Subject Headings

  • Video Recording
  • Retinopathy of Prematurity
  • Retinal Vessels
  • Prospective Studies
  • Predictive Value of Tests
  • Ophthalmoscopy
  • Ophthalmology & Optometry
  • Laser Coagulation
  • Infant, Newborn
  • Infant
 

Citation

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Wallace, D. K., Freedman, S. F., Hartnett, M. E., & Quinn, G. E. (2011). Predictive value of pre-plus disease in retinopathy of prematurity. Arch Ophthalmol, 129(5), 591–596. https://doi.org/10.1001/archophthalmol.2011.63
Wallace, David K., Sharon F. Freedman, M. E. Hartnett, and Graham E. Quinn. “Predictive value of pre-plus disease in retinopathy of prematurity.Arch Ophthalmol 129, no. 5 (May 2011): 591–96. https://doi.org/10.1001/archophthalmol.2011.63.
Wallace DK, Freedman SF, Hartnett ME, Quinn GE. Predictive value of pre-plus disease in retinopathy of prematurity. Arch Ophthalmol. 2011 May;129(5):591–6.
Wallace, David K., et al. “Predictive value of pre-plus disease in retinopathy of prematurity.Arch Ophthalmol, vol. 129, no. 5, May 2011, pp. 591–96. Pubmed, doi:10.1001/archophthalmol.2011.63.
Wallace DK, Freedman SF, Hartnett ME, Quinn GE. Predictive value of pre-plus disease in retinopathy of prematurity. Arch Ophthalmol. 2011 May;129(5):591–596.

Published In

Arch Ophthalmol

DOI

EISSN

1538-3601

Publication Date

May 2011

Volume

129

Issue

5

Start / End Page

591 / 596

Location

United States

Related Subject Headings

  • Video Recording
  • Retinopathy of Prematurity
  • Retinal Vessels
  • Prospective Studies
  • Predictive Value of Tests
  • Ophthalmoscopy
  • Ophthalmology & Optometry
  • Laser Coagulation
  • Infant, Newborn
  • Infant