eLetters to:

ARTICLES: Ann Hellström, Anna-Lena Hård, Eva Engström, Aimon Niklasson, Eva Andersson, Lois Smith, and Chatarina Löfqvist Early Weight Gain Predicts Retinopathy in Preterm Infants: New, Simple, Efficient Approach to Screening Pediatrics 2009; 123: e638-e645 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

eLetters published:

Weight gain and retinopathy of prematurity (ROP)

Joao B Fortes Filho, Renato S. Procianoy   (1 April 2009)

Weight gain and retinopathy of prematurity (ROP) 1 April 2009
Joao B Fortes Filho, Professor of Ophthalmology School of Medicine, Federal University of Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Renato S. Procianoy Send letter to journal: Re: Weight gain and retinopathy of prematurity (ROP) jbfortes{at}prorop.com.br Joao B Fortes Filho, et al.	To the Editor. We read with great interest the article by Hellström et al regarding that monitoring the early weight gain since birth predicts severe retinopathy of prematurity (ROP).1 This aims to treat those babies with laser retinal photocoagulation some weeks in advance and also minimize unnecessary ophthalmological examinations in many newborns that nowadays are routinely screened for ROP. We agree that the use of weekly weight gain can predict ROP and/or severe ROP that needs treatment. We also agree that it is a simple tool very useful in developing countries, where survival rates of extremely-low -birth-weight preterm infants are improving in recent years.2 Hellström et al included 354 patients born with gestational age (GA) ≤32 weeks, with a median GA of 30 weeks, and a median birth weight (BW) of 1,310 g (range: 425-2,210 g). We recently published data from 317 patients screened for ROP in Brazil, where the median GA was 30 weeks, and median BW was 1,155 g (range: 505-1,500 g). Hellström et al reported a prevalence of stage 3 ROP of 9.9%, while our data showed 6.9% stage 3 ROP. We demonstrated that a proportional weight gain over the birth weight at six weeks of life below 51.2% was a good predictor of severe ROP.3 We stress the need for simple tools without high costs to be used in the middle-income countries. We suggest that just monitoring the weight gain is an efficient way to anticipate those at risk of severe ROP. We agree that the algorithm proposed by Hellström et al is very useful, but must be validated among other different population of preterm infants. Sincerely yours Joao Borges Fortes Filho M.D. Renato S. Procianoy M.D. Departments of Ophthalmology and Pediatrics, Newborn Section, School of Medicine, Federal University of Rio Grande do Sul and Hospital de Clinicas de Porto Alegre, Porto Alegre RS, Brazil. References 1 Hellström A, Härd A, Engström E, Niklasson A, Andersson E, Smith L, Löfqvist C. Early weight gain predicts retinopathy in preterm infants: new, simple, efficient approach to screening. Pediatric 2009;123:e638- e645. 2 Fortes Filho JB, Eckert GU, Procianoy L, Barros CK, Procianoy RS. Incidence and risk factors for retinopathy of prematurity in very low and in extremely low birth weight infants in a unit-based approach in southern Brazil. Eye 2009;23(1):25-30. 3 Filho JB, Bonomo PP, Maia M, Procianoy RS. Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies. Graefes Arch Clin Exp Ophthalmol 2008;DOI 10.1007/s00417-008-1012-3. Published online 04 December 2008. Conflict of Interest: None declared