Influence of Patent Ductus Arteriosus and Its Treatment on Retinopathy of Prematurity

Hun Yoon Myung; Ki Baek Wan; Sung Moon Yeon

doi:10.3341/jkos.2013.54.5.728

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

Original Article

J Korean Ophthalmol Soc 2013;54(5):728-735.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.5.728

Influence of Patent Ductus Arteriosus and Its Treatment on Retinopathy of Prematurity

Hun Yoon Myung, MD¹, Ki Baek Wan, MD, PhD², Sung Moon Yeon, MD, PhD¹

¹Department of Ophthalmology, Inha University School of Medicine¹, Incheon, Korea ²

²Department of Thoracic and Cardiovascular Surgery, Inha University School of Medicine², Incheon, Korea

Address reprint requests to Yeon Sung Moon, MD, PhD Department of Ophthalmology, Inha University Hospital #27 Inhang-ro, Jung-gu, Incheon 400-711, Korea Tel: 82-32-890-2400, Fax: 82-32-890-2417, E-mail: DrMYS@inha.ac.kr

Received 5 October 20124 December 2012 Accepted 5 February 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Patent ductus arteriosus, PDA, Retinopathy of prematurity, Risk factor, Very low birth weight

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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.

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)	0.945
Patent ductus arteriosus
Yes	31/62 (50.0)	0.000
No	65/346 (18.8)	0.000

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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