Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment
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MDPI
Materia
Retinopathy of prematurity Treatment Predictive model
Date
2024-03-31Referencia bibliográfica
Protsyk, O.; García Serrano, J.L. Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment. J. Pers. Med. 2024, 14, 379. https://doi.org/10.3390/jpm14040379
Abstract
Aim: The temporal avascular area of the retina and the duration of mechanical ventilation
(DMV) may predict the need to treat retinopathy of prematurity (ROP). This study considers whether
the rate of retinal vascularisation and related risk factors should be included in a predictive model of
the need for ROP treatment. Methods: This single-centre, observational retrospective case–control
study was conducted on 276 preterm infants included in an ROP screening programme. All had
undergone at least three examinations of the fundus. The main outcome measures considered
were DMV (in days of treatment), the temporal avascular area (in disc diameters, DD) and the
rate of temporal retinal vascularisation (DD/week). Results: The multivariate logistic model that
best explains ROP treatment (R2 = 63.1%) has three significant risk factors: each additional day of
mechanical ventilation (OR, 1.05 [95% CI, 1.02–1.09]; p = 0.001); each additional DD of temporal
avascular area (OR, 2.2 [95% CI, 1.7–2.9]; p < 0.001) and a vascularisation rate <0.5 DD/week (OR,
19.0 [95% CI, 6.5–55.5]; p < 0.001). Two tables are presented for calculating the expected need for
ROP treatment according to these three risk factors. Conclusions: A greater DMV, a broad avascular
area of the temporal retina at the first binocular screening and slow retinal vascularisation strongly
predict the need for ROP treatment. The predictive model we describe must be validated externally
in other centres.