Učestalost i čimbenici rizika u retinopatiji nedonoščeta

master's thesis

• Title (english): Incidence and risk factors for retinopathy of prematurity
• Author: Perica Međimorec
• Mentor: Nada Sindičić Dessardo (mentor)
• Committee member: Ruža Grizelj (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Nada Sindičić Dessardo (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Retinopatija nedonoščeta (ROP) je poremećaj razvoja krvnih žila mrežnice koji zahvaća nedonoščad te je u mnogim zemljama, pa tako i u Republici Hrvatskoj, najčešći uzrok sljepoće u dječjoj dobi. Među brojnim čimbenicima rizika koji se povezuju s razvojem bolesti najvažniji su niska gestacijska dob i niska rodna masa te s njima u vezi čimbenici kao što su postotak kisika u udahnutom zraku, sepsa, slabiji prirast na tjelesnoj masi, transfuzije eritrocita i drugi. Glavni cilj rada je odrediti učestalost pojavljivanja ROP-a kod nedonoščadi gestacijske dobi ≤ 32 tjedna liječenih u razdoblju od svibnja 2018. do svibnja 2021. godine u Zavodu za neonatologiju i neonatalnu intenzivnu medicinu, Klinike za pedijatriju, KBC-a Zagreb te utvrditi rizične čimbenike koji doprinose njenom razvoju. Podaci koji su prikupljani iz povijesti bolesti i potom analizirani obuhvaćaju čimbenike vezane uz majku, uz porođaj i uz nedonošče. WINROP algoritam i CRIB II zbroj korišteni su u predviđanju retinopatije koja ugrožava vid.
Ovaj rad uključuje 77 nedonoščadi rođene u trogodišnjem razdoblju. Rezultati su pokazali da je incidencija svih oblika retinopatije nedonoščeta 37,66% a teškog oblika 9,09% . Spol, gestacijska dob, terapija kisikom, bronhopulmonalna displazija i duljina hospitalizacije identificirani su kao rizični čimbenici. WINROP algoritam je točno predvidio 55,17% nedonoščadi koja je kasnije razvila ROP. Viši CRIB II zbroj povezan je s težim oblicima bolesti. U većini slučajeva retinopatija nedonoščadi javlja se u blagom obliku koji ne zahtjeva liječenje. Kako je u malom postotku bolest teškog oblika koji može uznapredovati do ablacije mrežnice koja je povezana sa teškim oštećenjem vida važno je provoditi programe probira kako bi se liječenje započelo pravovremeno i prevenirao daljnji razvoj bolesti.

Abstract (english)

Retinopathy of prematurity is a disorder of the development of retinal blood vessels that affects premature infants and is in many countries, including the Republic of Croatia, the most common cause of blindness in childhood. Among the many risk factors associated with the development of the disease, the most important are low gestational age and low birth weight and related factors such as the percentage of oxygen in the inhaled air, sepsis, poor weight gain, erythrocyte transfusions and others. The main goal of this study is to determine the incidence of ROP in preterm infants of gestational age ≤ 32 weeks treated in the period from May 2018 to May 2021 in University Hospital Centre Zagreb, Department of pediatrics, Neonatal intensive care unit, and define the risk factors that contribute to its development. The data that were collected from medical history and then analyzed include factors related to mother, childbirth, and prematurity. The WINROP algorithm and CRIB II score were used to predict vision-threatening retinopathy. The study includes 77 preterm infants born over a three-year period. The results showed that the incidence of all forms of retinopathy of prematurity was 37.66% and of severe form 9.09%. Gender, gestational age, oxygen therapy, bronchopulmonary dysplasia, and length of hospitalization were identified as risk factors. The WINROP algorithm accurately predicted 55.17% of preterm infants who later developed ROP. Higher CRIB II score is associated with more severe forms of the disease. In most cases, retinopathy of prematurity occurs in a mild form that does not require treatment. As a small percentage of the disease is severe and can progress to retinal detachment associated with severe visual impairment, it is important to conduct screening programs to begin treatment in a timely manner and prevent further disease development.

• Keywords: nedonošenost; retinopatija nedonoščeta; kisik; WINROP; CRIB II
• Keywords (english): prematurity; retinopathy of prematurity; oxygen; WINROP; CRIB II
• Language: croatian
• URN:NBN: urn:nbn:hr:105:011197
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-11 11:32:43