TY - JOUR
T1 - Practice Patterns in Retinopathy of Prematurity Treatment for Disease Milder Than Recommended by Guidelines
AU - Gupta, Mrinali Patel
AU - Chan, R. V.Paul
AU - Anzures, Rachelle
AU - Ostmo, Susan
AU - Jonas, Karyn
AU - Chiang, Michael F.
N1 - Funding Information:
Funding/Support: Michael F. Chiang and Susan Ostmo are supported by NIH grant EY19474 from the National Institutes of Health, Bethesda, Maryland. Michael F. Chiang, R.V. Paul Chan, Susan Ostmo, Karyn Jonas, and Mrinali Patel Gupta are supported by unrestricted departmental funding from Research to Prevent Blindness, New York, New York. R.V. Paul Chan was supported (at the time of this study) by the St Giles Foundation, New York, New York. The following author reports no funding/support for this study: Rachelle Anzures. Financial disclosures: Michael F. Chiang is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, California). R.V. Paul Chan is a paid consultant for Allergan and Alcon. Rachelle Anzures received an honorarium for participation in the UNRAVEL study by Novartis. The following authors report no financial disclosures: Mrinali Patel Gupta, Susan Ostmo, and Karyn Jonas. All authors attest that they meet the current ICMJE criteria for authorship.
Funding Information:
MICHAEL F. CHIANG AND SUSAN OSTMO ARE SUPPORTED BY NIH GRANT EY19474 FROM THE NATIONAL Institutes of Health, Bethesda, Maryland. Michael F. Chiang, R.V. Paul Chan, Susan Ostmo, Karyn Jonas, and Mrinali Patel Gupta are supported by unrestricted departmental funding from Research to Prevent Blindness, New York, New York. R.V. Paul Chan was supported (at the time of this study) by the St Giles Foundation, New York, New York. The following author reports no funding/support for this study: Rachelle Anzures. Financial disclosures: Michael F. Chiang is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, California). R.V. Paul Chan is a paid consultant for Allergan and Alcon. Rachelle Anzures received an honorarium for participation in the UNRAVEL study by Novartis. The following authors report no financial disclosures: Mrinali Patel Gupta, Susan Ostmo, and Karyn Jonas. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2016 Elsevier Inc. ALL RIGHTS RESERVED.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Purpose To characterize the frequency of and clinical indications for which experts treat retinopathy of prematurity (ROP) milder than type 1 disease, the recommended threshold for treatment from established consensus guidelines. Design Descriptive analysis. Methods setting: Multicenter. study population: A database of 1444 eyes generated prospectively from all babies screened for ROP at 1 of 6 major ROP centers whose parents provided informed consent. intervention: Retrospective review of the database and charts to identify all patients treated for ROP milder than type 1. main outcome measure: Indication(s) for treatment. Results A total of 137 eyes of 70 infants were treated for ROP. Of these 137 eyes, 13 (9.5%) were treated despite a clinical diagnosis milder than type 1 ROP. Indications for treatment included active ROP with the fellow eye being treated for type 1 ROP (2 eyes, 15.4%); concerning structural changes (9 eyes, 69.2%), including tangential traction with temporal vessel straightening concerning for macular dragging (8 eyes, 61.5%) and thick stage 3 membranes with anteroposterior traction concerning for progression to stage 4 ROP (3 eyes, 23.1%); persistent ROP at an advanced postmenstrual age (4 eyes, 30.8%); and/or vitreous hemorrhage (3 eyes, 23.1%). Conclusions Experts in this study occasionally recommended treatment in eyes with disease less than type 1 ROP. This study has important clinical implications and highlights the role of individual clinical judgment in situations not covered by evidence-based treatment guidelines.
AB - Purpose To characterize the frequency of and clinical indications for which experts treat retinopathy of prematurity (ROP) milder than type 1 disease, the recommended threshold for treatment from established consensus guidelines. Design Descriptive analysis. Methods setting: Multicenter. study population: A database of 1444 eyes generated prospectively from all babies screened for ROP at 1 of 6 major ROP centers whose parents provided informed consent. intervention: Retrospective review of the database and charts to identify all patients treated for ROP milder than type 1. main outcome measure: Indication(s) for treatment. Results A total of 137 eyes of 70 infants were treated for ROP. Of these 137 eyes, 13 (9.5%) were treated despite a clinical diagnosis milder than type 1 ROP. Indications for treatment included active ROP with the fellow eye being treated for type 1 ROP (2 eyes, 15.4%); concerning structural changes (9 eyes, 69.2%), including tangential traction with temporal vessel straightening concerning for macular dragging (8 eyes, 61.5%) and thick stage 3 membranes with anteroposterior traction concerning for progression to stage 4 ROP (3 eyes, 23.1%); persistent ROP at an advanced postmenstrual age (4 eyes, 30.8%); and/or vitreous hemorrhage (3 eyes, 23.1%). Conclusions Experts in this study occasionally recommended treatment in eyes with disease less than type 1 ROP. This study has important clinical implications and highlights the role of individual clinical judgment in situations not covered by evidence-based treatment guidelines.
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U2 - 10.1016/j.ajo.2015.12.005
DO - 10.1016/j.ajo.2015.12.005
M3 - Article
C2 - 26705094
AN - SCOPUS:84959328789
SN - 0002-9394
VL - 163
SP - 1
EP - 10
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -