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Early treatment can prevent severe vision loss in premature infants

A new study by specialists at the Johns Hopkins Children's Center and 25 other institutions nationwide for the first time gives eye doctors a precise way to identify premature babies at the highest risk of abnormal blood vessel growth in the retina and subsequent blindness. The computerized risk assessment tool they used should lead to treatment of retinopathy of prematurity (ROP) at its earliest stages, stopping or limiting both loss of vision and structural damage to the eye.

"Before this study, we did not have a precise clinical model to follow to help predict which infants will ultimately develop vision loss from ROP, so we often had to defer treatment until the disease reached the treatment 'threshold,' at which point there was still a 25 percent chance of retinal detachment," says Michael Repka, M.D., a pediatric ophthalmologist at the Children's Center, and a member of the study team. "Unfortunately, delaying therapy to that point leaves some infants with vision loss."

Using both old and new criteria, researchers were able to identify which premature infants enrolled in the study were at highest risk for blindness. Results of their study, published in the December issue of the Archives of Ophthalmology, show that early treatment significantly reduced the likelihood of poor vision from 19.5 to 14.5 percent at about one year of age. Early treatment also reduced the likelihood of structural damage to the eye from 15.6 to 9.1 percent.

According to Repka, ROP presents ophthalmologists with difficult treatment decisions because the disease can be highly unpredictable. In many infants, he says, it can spontaneously improve and spare the child's vision, while in others, it can suddenly progress and result in blindness.

For the study, the researchers identified 499 out of 828 infants diagnosed at birth with ROP as being at higher than usual risk for vision loss, based on the computerized guide that assessed birth weight, ethnicity,
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Contact: Jessica Collins
jcolli31@jhmi.edu
410-516-4570
Johns Hopkins Medical Institutions
8-Dec-2003


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