محمد ریاضی اصفهانی

To evaluate the efficacy of intravitreal bevacizumab for the treatment of type 1 retinopathy of prematurity (ROP) in zone I.

Preterm infants with type 1 ROP in zone I (zone I ROP, any stage with plus disease or zone I ROP, stage 3 without plus disease) were enrolled in this prospective study. Intravitreal bevacizumab (0.625 mg/0.025 ml) was injected under topical anesthesia. The patients were followed-up weekly for 4 weeks and, then, biweekly till 90 weeks gestational age.

Seventy eyes of 35 patients with type 1 ROP in zone I were enrolled. At a gestational age of 90 weeks, ROP regressed with complete or near‑complete peripheral retinal vascularization, in 82.9% of eyes after a single injection and in 92.9% of eyes after up to two injections. In 5 eyes (7.1%), ROP progressed to stage 4B or 5, so that surgical management was required. There were no major complications such as endophthalmitis, cataract, or vitreous hemorrhage after injection.

Intravitreal bevacizumab injection is an effective method for the management of patients with Zone I ROP requiring treatment; however, some cases may progress to more advanced stages and require surgical management. Close monitoring for recurrence or progression is necessary. Eyes with persistent zone I ROP may progress to advanced stages when treated with intravitreal bevacizumab injection and re‑treatment may be needed.  

To determine the incidence, severity and risk factors for retinopathy of prematurity (ROP) in premature infants with late retinal examination at Farabi Hospital from 2001 to 2006.

In a cross-sectional study, hospital records of premature infants who were examined later than 9 weeks after birth were reviewed for possible risk factors of ROP including gender, singleton or multiple gestations, gestational age (GA), birth weight (BW), oxygen therapy, blood transfusion, photo-therapy, and respiratory distress syndrome (RDS), as well as the age at initial examination.

From 693 infants referred for ROP screening, 191 (27.6%) had late retinal examination at mean age of 144.8±158.4 (range 64-1460) days. Of these 191 infants, 75 (39.3%) had different stages of ROP, 58 (30.4%) had stage 4 or 5 disease and 27 (14.1%) had stage 5 ROP in both eyes which were untreatable. GA and BW were associated with development of ROP (P<0.001).

The high prevalence of premature infants with late retinal examination and high incidence of severe ROP necessitates prompt intervention to optimize referral and early screening of premature infants.

To determine the association between Norrie disease (ND) gene mutations and advanced stages of retinopathy of prematurity (ROP) in premature neonates who were referred to Farabi Eye Hospital, Tehran, Iran during 2005-2007.

Fifty infants including 28 male and 22 female subjects with ROP stage 3 or worse were enrolled in this case series. All three exons of ND gene underwent polymerase chain reaction (PCR) with three primer pairs and direct sequencing to determine any mutation.

Mean birth weight was 1187.6±227.6 (range 580-2000) gram and mean gestational age was 28.6±2.1 (range 24-34) weeks. Thirty-eight patients had stage 3 ROP with plus disease, four patients had stage 4 ROP and eight patients had stage 5 ROP. A C15078A mutation was found in the second intron of 90% of the cases.

C15078A mutation is in a non-translated region of the ND gene and has no effect on mRNA splicing; therefore the association between this ND gene mutation and advanced stages of ROP in Iranian neonates with ROP is not significant.