Discordant ROP (Retinopathy of prematurity) development in twins less than 32 weeks of gestational age
Keywords:
Prematurity, Discordant Retinopathy of prematurity, Morbidities, TwinAbstract
Background and aim: Retinopathy of prematurity (ROP), is a vasoprolipherative disorder of the immature retina and a major cause of preventable blindness in childhood. Although the development of ROP is multifactorial, the main reasons are lower gestational age and birth weight. However, in twins their gestational ages were the same, ROP development can be discordant. This study aims to evaluate the etiologic factors of discordant ROP development in twins.
Methods: We reviewed the last 5 years' records and found the twins whose discordant ROP development. This discordance was; 1. Different stages of ROP, 2. One sibling treated the other is not, 3. One sibling has aggressive posterior ROP the other is not, 4. one sibling has more influenced area as zones the other is not. We documented some data of these twins, as birth order, birth weight, resuscitation at birth, morbidities, the number of hemotransfusion, age of regaining birth weight, relative weight gain at 28 weeks.
Results: A total of 26 cases of 13 twins were evaluated. The mean gestational age and birth weight of the whole study group were 27.7 ± 2, and 1053 ± 364 grams, respectively. We found that more transfused preterm baby in twins is more likely to show severe ROP. Additionally, sepsis and the duration of mechanical ventilation may be risk factors for more severe ROP in twins.
Conclusions: We can reduce discordant retinopathy in less than 32-weeks premature twins by using methods such as cord milking and by improving non-invasive ventilation modalities.
References
Olitsky SE, Nelson LB. Pediatric Clinical Ophthalmology. In: Coats DK, Reddy A, editors. Retinopathy of Prematurity. Hongkong: Monson Publishing; 2012. p. 33-42.
Bingöl Kızıltunç P, İdil A, Atilla H, et al. Results of screening in schools for visually impaired children. Turk J Ophthalmol 2017;47:216-20.
Gilbert C. Retinopathy of prematurity: A global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev 2008;84:77-82.
Tseng H-C, Sung F-C, Mou C-H, et al. Population-based retrospective cohort study on risk of retinopathy of prematurity in twins. PLoS ONE 2020;15 (3): e0230346. https://doi.org/10.1371/journal.pone.0230346
Rudanko SL, Fellman V, Laatikainen L. Visual impairment in children born prematurely from 1972 through 1989. Ophthalmology. 2003;110(8):1639-45. doi: 10.1016/S0161-6420(03)00498-6 pmid: 12917186
Bas AY, Koc E, Dilmen U, ROP Neonatal Study Group. Incidence and severity of retinopathy of prematurity in Turkey. Br J Ophthalmol 2015. Published Online First13 Apr 2015. doi: 10.1136/bjophthalmol-2014-306286
Sun Y, Hellström A, Smith Lois E.H. Retinopathy of prematurity. Fanaroff and Martin’s Neonatal Perinatal Medicine- Diseases of the Fetus and Newborn, 10th ed. Martin RJ, Fanaroff AA, Walsh MC (eds): Saunders Elsevier, 2015;1767-74.
Blondel B, Kogan MD, Alexander GR, et al. The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: An international study. Am J Public Health 2002;92:1323-30.
Blumenfeld LC, Siatkowski RM, Johnson RA, et al. Retinopathy of prematurity in multiple-gestation pregnancies. Am J Ophthalmol 1998; 125: 197-203.
Friling R, Rosen SD, Monos T, et al. Retinopathy of prematurity in multiple-gestation, very low birth weight infants. J Pediatr Ophthalmol Strabismus 1997; 34: 96-100.
Riazi-Esfahani M, Alizadeh Y, Karkhaneh R, et al. Retinopathy of prematurity: single versus multiple-birth pregnancies. J Ophthalmic Vis Res 2008; 3: 47-51.
Fellows RR, McGregor ML, Bremer DL, et al. Retinopathy of prematurity in discordant twins. J Pediatr Ophthalmol Strabismus. 1995 Mar-Apr;32(2):86-8. PMID: 7629675.
Sheales MP, Sheth S, Edwards AG, Carden SM. Discordant retinopathy of prematurity in twin anemia-polycythemia sequence. J AAPOS. 2017 Apr;21(2):173-174. doi: 10.1016/j.jaapos.2016.11.026. Epub 2017 Feb 24. PMID: 28238729.
International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123(7):991-999. doi:10.1001/archopht.123.7.991
Azad R, Chandra P, Patwardhan SD, Gupta A. Profile of asymmetrical retinopathy of prematurity in twins. Indian J Ophthalmol. 2010;58(3):209-211. doi:10.4103/0301-4738.62645
Oh JY, Kim SJ, Yu YS, et al. Incidence and Risk Factors of Retinopathy of Prematurity in Premature Twins. J Korean Ophthalmol Soc. 2004;45(2):259-265.
Binenbaum G . Algorithms for the prediction of retinopathy of prematurity based on postnatal weight gain. Clin Perinatol 2013;40(2): 261-70. doi: 10.1016/j.clp.2013.02.004. PMID: 23719309; PMCID: PMC3692738.
Hellström A, Engström E, Hård AL, et al. Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth. Pediatrics. 2003 Nov;112(5):1016-20. doi: 10.1542/peds.112.5.1016. PMID: 14595040. [PubMed: 14595040]
Sanghi G, Dogra MR, Dutta S, et al. Intersibling variability of retinopathy of prematurity in twins and its risk factors. Int Ophthalmol. 2012 Apr;32(2):113-7. doi: 10.1007/s10792-012-9533-5. Epub 2012 Feb 24. PMID: 22361892.
Wang ZH, Li YY, Liu ZM. Birth weight and gestational age on retinopathy of prematurity in discordant twins in China. Int J Ophthalmol. 2014;7(4):663-667. Published 2014 Aug 18. doi:10.3980/j.issn.2222-3959.2014.04.14
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