Journal List > J Korean Ophthalmol Soc > v.54(5) > 1009672

Myung, Wan, and Yeon: Influence of Patent Ductus Arteriosus and Its Treatment on Retinopathy of Prematurity

Abstract

Purpose

This study investigated the influence of patent ductus arteriosus (PDA) and its treatment on incidence and pro-gression of retinopathy of prematurity (ROP).

Methods

The authors retrospectively reviewed the medical records of 408 infants who underwent screening examinations for ROP at the Neonatal Intensive Care Unit of our hospital.

Results

The total incidence of ROP was 23.5% (96 out of 408) and the patients that needed treatment were 7.4% (30 out of 408). The mean birth weight and gestational age was 1406.1 grams and 30.67 weeks in patients without ROP, and 979.8 grams and 27.46 weeks in patients with ROP, respectively. In both total and very low birth weight (VLBW) patients, the incidence of ROP was higher in the PDA group than the non-PDA group, but the PDA group was an independent risk factor only in the VLBW group ( p = 0.033). The incidence of threshold disease was not significantly different between the PDA and control groups ( p = 0.757). There was no significant difference of incidence of ROP and threshold disease among the 3 treatment groups for PDA.

Conclusions

In VLBW patients, the presence of PDA increased the risk of ROP and its progression, thus more attention is needed for PDA patients. However, there was no significant difference in ROP incidence and progression according to dif-ferent PDA treatment methods.

References

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Figure 1.
ROP incidence of PDA group and control group in VLBW patients. This illustration shows that VLBW patients with PDA have much higher risk of ROP than patients without ROP. ROP = retinopathy of prematurity; PDA = patent ductus arteriosus; VLBW = very low birth weight.
jkos-54-728f1.tif
Table 1.
Demographic characteristics of study group and control group
All subject screened (n = 408) No ROP (n = 312) ROP with plus disease (n = 58) ROP with threshold disease (n = 30) All infant with ROP d (n = 96) P p-value
Male (%) 224 (54.9%) 171 (54.8%) 34 (58.6%) 18 (60.0%) 53 (55.2%) 0.585
Female (%) 184 (45.1%) 141 (45.2%) 24 (41.4%) 12 (40.0%) 43 (44.8%)
Mean birth weight, g 1305.8 ± 325.16 1406.1 ± 273.31 922.5 ± 227.85 848.5 ± 195.87 979.8 ± 260.80 0.000
Mean GA, weeks 30.06 ± 2.63 30.76 ± 2.44 27.36 ± 1.74 27.01 ± 1.81 27.79 ± 1.84 0.000

Values are presented as n (%) or mean ± SD. GA = gestational age.

Table 2.
ROP incidence of PDA group and control group
All patients (n = 408)
ROP incidence (%) p-value
Sex
Male 53/171 (23.7) 0.945
Female 43/141 (23.4)
Patent ductus arteriosus
Yes 31/62 (50.0) 0.000
No 65/346 (18.8)

ROP = retinopathy of prematurity; PDA = patent ductus arteriosus.

Table 3.
Logistic regression result for predicting retinopathy of prematurity
β Coefficient S.E β p OR 95% CI
Female 0.316 0.306 0.303 1.371 0.752-2.500
Gestational age* -0.290 0.077 0.000 0.749 0.643-0.871
Birth weight* -0.004 0.001 0.000 0.996 0.994-0.997
Patent ductus arteriosus 0.635 0.366 0.083 1.887 0.921-3.867

OR = odd ratio; S.E β = standard error of β coefficient.

* p < 0.05.

Table 4.
Demographic characteristics of PDA group and control group in VLBW
All subject screened (n = 279) No PDA (n = 219) PDA (n = 60) p-value
Male (%) 155 (55.6) 124 (56.6) 31 (51.7) 0.496
Female (%) 124 (44.4) 95 (43.4) 29 (48.3)
Mean birth weight (g) 1135.7 ± 238.29 1148.8 ± 230.59 1088.0 ± 261.02 0.080
Mean GA (weeks) 29.24 ± 2.33 29.28 ± 2.36 29.10 ± 2.24 0.610

Values are presented as n (%) or mean ± SD. PDA = patent ductus arteriosus; VLBW = very low birth weight; GA = gestational age.

Table 5.
ROP incidence of PDA group and control group in VLBW patients
VLBW patients (n = 279)
ROP incidence (%) p-value
Sex
Male 51/155 (32.9) 0.865
Female 42/124 (33.9)
Patent ductus arteriosus
Yes 29/60 (48.3) 0.005
No 64/219 (29.2)

ROP = retinopathy of prematurity; PDA = patent ductus arteriosus; VLBW = very low birth weight; GA = gestational age.

Table 6.
Logistic regression result for predicting retinopathy of prematurity in VLBW patients
β Coefficient S.E β p OR 95% CI
Female Gestational age* 0.419-0.471 0.325 0.118 0.198 0.000 1.520 0.624 0.804-2.875 0.496-0.786
Birth weight* -0.003 0.001 0.000 0.997 0.995-0.998
Patent ductus arteriosus* 0.814 0.381 0.033 2.257 1.070-4.761

OR = odd ratio; S.E β = standard error of β coefficient.

* p < 0.05.

Table 7.
Threshold disease incidence of PDA group and con-trol group in VLBW+ROP patients
VLBW+ROP patients (n = 93)
ROP incidence (%) p-value
Sex
Male 18/51 (35.3) 0.490
Female 12/42 (28.6)
Patent ductus arteriosus
Yes 10/29 (34.5.0) 0.757
No 20/64 (31.3)

PDA = patent ductus arteriosus; VLBW = very low birth weight; ROP = retinopathy of prematurity.

Table 8.
ROP and threshold disease incidence according to treatment modality of PDA
VLBW+PDA patients (n = 60)
ROP incidence (%) p-value
Treatment modality of PDA
Observation 11/21 (52.4) 0.441*
Medical treatment 6/17 (35.3)
Surgical treatment 12/22 (54.5)
VLBW+ROP+PDA patients (n = 29)
Threshold disease incidence (%) p-value
Treatment modality of PDA
Observation 5/11 (45.5) 0.276
Medical treatment 3/6 (50.0)
Surgical treatment 2/12 (16.7%)

ROP = retinopathy of prematurity; PDA = patent ductus arteriosus; VLBW = very low birth weight.

* Pearson chi-square test

Fisher’s exact test.

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