Düşük Doğum Ağırlığı ve Gebelik Yaşının Prematüre Retinopatisi Üzerindeki Etkisi

Yıl 2025, Cilt: 22 Sayı: 1, 26 - 31, 26.03.2025

Çağrı Mutaf , Ali Hakim Reyhan , İrfan Uzun , Funda Yüksekyayla , Ali Şimşek

https://doi.org/10.35440/hutfd.1585350

Öz

Amaç: Çalışmanın amacı, prematüre bebeklerde prematüre retinopatisi (ROP) insidansı ve tedavisini araştırmak, özellikle gestasyonel yaş ve doğum ağırlığı ile ilişkisini incelemektir.
Materyal ve Metod: Bu retrospektif çalışma, 2021 ve 2023 yılları arasında ROP için taranan, gestas-yon yaşı 34 hafta veya daha az ve/veya doğum ağırlığı 1700 gram veya daha az olan 1101 bebeği analiz etmiştir.
Bulgular: Elli beş bebek ROP tedavisi gerektirmiştir. ROP insidansı, daha düşük doğum ağırlığı ve daha erken gestasyonel yaş gruplarında daha yüksekti. 1000 gram veya daha az ağırlığındaki bebeklerin %56,1'i ROP geliştirirken, 1001-1250 gram kategorisinde %43 ve 1251-1700 gram kategorisinde %28,1 ROP geliştirmiştir. Gestasyonel yaşa göre, 27 haftadan küçük bebeklerin %53,2'si, 27-34 hafta arası bebeklerin %26,8'i ve 34 haftadan büyük bebeklerin %12,7'si ROP geliştirmiştir.
Sonuç: Prematüre bebekler, özellikle çok düşük doğum ağırlığı ve erken gestasyonel yaşa sahip olan-lar, ROP için yüksek risk altındadır ve kapsamlı tarama ve zamanında müdahale gereklidir.

Anahtar Kelimeler

Prematüre retinopatisi, Doğum ağırlığı, Gebelik yaşı, Lazer fotokoagülasyon

The Impact of Low Birth Weight and Gestational Age on Premature Retinopathy Outcomes

Öz

Background: The study aimed to investigate the incidence and treatment of retinopathy of prematu-rity (ROP) in premature infants, focusing on its relationship with gestational age and birth weight.
Materials and Methods: This retrospective study analyzed 1101 infants with a gestational age of 34 weeks or less and/or a birth weight of 1700 grams or less, screened for ROP between 2021 and 2023.
Results: Fifty-five infants required ROP treatment. ROP incidence was higher in lower birth weight and earlier gestational age groups. Among infants weighing 1000 grams or less, 56.1% developed ROP, compared to 43% in the 1001-1250 gram category and 28.1% in the 1251-1700 gram category. For gestational age, 53.2% of infants less than 27 weeks, 26.8% of 27-34 weeks, and 12.7% of over 34 weeks developed ROP.
Conclusions: Premature infants, especially those with very low birth weight and early gestational age, are at high risk for ROP, necessitating comprehensive screening and timely intervention.

Anahtar Kelimeler

Retinopathy of prematurity, Birth weight, Gestational age, Laserphotocoagulation.

Kaynakça

• 1. Zhang L et al. Retinopathy of Prematurity—Targeting Hypoxic and Redox SignalingPathways. Antioxidants (Basel). 2024;13(2):148. doi: 10.3390/antiox13020148.
• 2. Dogra MR, Katoch D, Dogra M. An update on retinopathy of prematurity (ROP). Indian J Pediatr. 2017;84(12):930-6.
• 3. Terry TL. Extreme prematurity and fibroblastic overgrowth of persistent vascular sheath behind each crystalline lens: I, pre-liminary report. Am J Ophthalmol. 2018;25:203-4.
• 4. Prasad M, Ingolfsland EC,Christiansen SP.Modifiable risk factors and Preventative Strategies for Severe Retinopathy of Prematu-rity.Life(Basel).2023;13(5):1075.doi:10.3390/life13051075
• 5. Vinekar A, Dogra M, Azad RV, Gilbert C, Gopal L, Trese M. The changing scenario of retinopathy of prematurity in middle and low income countries: Unique solutions for unique problems. Indian J Ophthalmol. 2019;67(6):717-9.
• 6. Bas AY, Koc E, Dilmen U; ROP Neonatal Study Group. Incidence and severity of retinopathy of prematurity in Turkey. Br J Opht-halmol. 2015;99(10):1311-14.
• 7. Dammann O,Stansfield BK. Neonatal Sepsis as a Cause of Reti-nopathy of Prematurity: An Etiological Explanation. Prog Retin Eye Res. 2023;98:101230. doi: 10.1016/j.preteyeres.2023.101230.
• 8. Koç E, Baş AY, Özdek Ş, Ovalı F, Başmak H; TOD ROP Komisyonu, TRÇ Grubu. Türkiye Prematüre Retinopatisi Rehberi. Türk Neo-natoloji Derneği. 2016;4-5.
• 9. Chen J, Smith LE. Retinopathy of prematurity. Angiogenesis. 2007; 10: 133-40.
• 10. Kim SJ et al. Retinopathy of Prematurity: A Review of Risk Factors and their Clinical Significance. Surv Ophthalmol. 2018 Apr 19;63(5):618–637 doi: 10.1016/j.survophthal.2018.04.002.
• 11. Hellström A, Carlsson B, Niklasson A, Segnestam K, Boguszewski M, de Lacerda L, et al. IGF-I is critical for normal vascularization of the human retina. J Clin Endocrinol Metab. 2002;87(7):3413-6.
• 12. Berrocal A et al. Retinopathy of Prematurity: Advances in the Screening and Treatment of Retinopathy of Prematurity Using a Single Center Approach. Am J Ophthalmol. 2021;233:189–215. doi: 10.1016/j.ajo.2021.07.016.
• 13. Hardy R, Good W, Dobson V, Palmer E, Tung B, Phelps D; Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prema-turity: Results of the early treatment for retinopathy of prema-turity randomized trial. Arch Ophthalmol. 2003;121:1684-94.
• 14. Shah PK, Narendran V, Kalpana N, Gilbert C. Severe retinopathy of prematurity in big babies in India: history repeating itself?. Indian J Pediatr. 2009;76:801-4.
• 15. Chen Y, Li X. Characteristics of severe retinopathy of prematu-rity patients in China: a repeat of the first epidemic? Br J Opht-halmol. 2006;90(3):268-71.
• 16. Yurdakök M. Prematüre retinopatisi. Cocuk Sagligi ve Hastalikla-ri Dergisi. 2019;62.
• 17. Fierson WM. Section on Ophthalmology, American Academy of Pediatrics, American Academy of Ophthalmology, American As-sociation for Pediatric Ophthalmology and Strabismus. Scree-ning examination of premature infants for retinopathy of pre-maturity. Pediatrics. 2006;117(2):572-6.
• 18. Holmström G, Hellström A, Jakobsson P, Lundgren P, Tornqvist K, Wallin A. Evaluation of new guidelines for ROP screening in Sweden using SWEDROP–a national quality register. Acta Opht-halmol. 2015;93(3):265-8.
• 19. Gilbert C, Fielder A, Gordillo L, Quinn G, Semiglia R, Visintin P, et al; International NO-ROP Group. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics. 2005;115(5):518-25.
• 20. Koç E, Baş AY, Özdek Ş, Ovalı F, Başmak H. Türk Neonatoloji Derneği ve Türk Oftalmoloji Derneği prematüre retinopatisi uz-laşı rehberi. Turk Pediatri Ars. 2018;53(Suppl 1):s151-60.
• 21. Mutlu FM, Altinsoy HI, Mumcuoglu T, Kerimoglu H, Kiliç S, Kul M, et al. Screening for retinopathy of prematurity in a tertiary care newborn unit in Turkey: frequency, outcomes, and risk factor analysis. J Pediatr Ophthalmol Strabismus. 2008;45(5):291-8.
• 22. Sarikabadayi YU, Aydemir O, Ozen ZT, Aydemir C, Tok L, Oguz SS, et al. Screening for retinopathy of prematurity in a large terti-ary neonatal intensive care unit in Turkey: frequency and risk factors. Ophthalmic Epidemiol. 2011;18(6):269-74.
• 23. Özbek E, Genel F, Atlıhan F, Güngör İ, Malatyalı R, Menteş J ve ark. Yenidoğan yoğun bakım ünitemizde prematüre retinopatisi insidansı, risk faktörleri ve izlem sonuçları. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi. 2011;1(1):7-12.
• 24. Good WV, Hardy RJ, Dobson V, Palmer EA, Phelps DL, Quintos M, et al. Early Treatment for Retinopathy of Prematurity Coo-perative Group. The incidence and course of retinopathy of prematurity: findings from the early treatment for retinopathy of prematurity study. Pediatrics. 2005;116(1):15-23.
• 25. Sancak S, Topçuoğlu S, Çelik G, Günay M, Karatekin G. Evalua-tion of the incidence and risk factors of retinopathy of prema-turity. Zeynep Kamil Medical Journal. 2019;50(1):63-8.