ABSTRACT
PURPOSE: To determine whether time to normalization of increased intracranial pressure (ICP) caused by intraventricular hemorrhage (IVH) is associated with retinopathy of prematurity (ROP) treatment in premature infants diagnosed with both conditions. METHODS: The medical records of all premature infants born at ≤ 35 weeks' gestation and/or birth weight of ≤ 1500 g diagnosed with both any stage of ROP and any grade of IVH, with or without secondary increased ICP (defined as ≥ 20 cm H(2)O) were retrospectively reviewed. Adjusting for birth weight and gestational age, we compared time to normalization of increased ICP in infants treated for increased ICP only with that of infants treated for both increased ICP and ROP. RESULTS: A total of 21 infants were included. ICP levels normalized at a significantly older postnatal age in infants treated for both increased ICP and ROP (100 days) than in those treated for elevated ICP alone (45 days), after we adjusted for the results for birth weight and gestational age (P = 0.049). CONCLUSIONS: Earlier control of increased ICP secondary to IVH may reduce the need for ROP treatment in premature babies initially diagnosed with both conditions.
Subject(s)
Cerebral Hemorrhage/complications , Cerebral Ventricles , Intracranial Hypertension/physiopathology , Intracranial Pressure/physiology , Retinopathy of Prematurity/complications , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/physiopathology , Cerebrospinal Fluid Shunts , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Intracranial Hypertension/diagnosis , Intracranial Hypertension/etiology , Intracranial Hypertension/surgery , Ophthalmoscopy , Retinopathy of Prematurity/diagnosis , Retinopathy of Prematurity/physiopathology , Retrospective Studies , Spinal Puncture , Time Factors , UltrasonographyABSTRACT
PURPOSE: To report the functional and anatomical outcome of intravitreal bevacizumab (IVB) treatment for macular edema due to branch retinal vein occlusion (BRVO) in a clinical setting. METHODS: The files of 45 patients treated with IVB for BRVO-induced macular edema at a tertiary medical center in 2007-2010 were reviewed. All received three loading doses (1.25 mg) and were followed every 6 weeks. Treatment was repeated for persistent or recurrent edema. If the edema did not resolve after 4-6 injections, grid laser photocoagulation was performed. RESULTS: Mean patient age was 70.7 years (SD 8.5); mean follow-up time, 18.8 months (SD 8.3); mean number of injections, 8.8 (SD 3.8). Fourteen patients (33%) received grid laser treatment before bevacizumab and 23 (51%) after. Mean logMAR visual acuity (VA) was 0.63 (SD 0.43) before treatment (Snellen, 20/140) and 0.4 (SD 0.43) (Snellen, 20/70) after (p < 0.0005). Corresponding central macular thickness (CMT) values were 382.2 microns (SD 155.6) and 320.5 microns (SD 172.8) (p= 0.028). Positive correlations were found between initial VA and initial and final CMT (p = 0.004) and between gain in VA and reduction in CMT (p = 0.03). There was no statistically significant difference in mean initial or final VA and CMT between patients who received grid laser treatment before or during the study and those who did not. CONCLUSIONS: IVB treatment improves visual function and reduces CMT in patients with BRVO-induced macular edema.
