Download A. Review of Normal Births

Update on Systemic, Ocular and Neural Complications of Premature Birth
Wendy Marsh-Tootle, OD, MS, FAA)
A. Review of Normal Births
B. POT (Pre-Term Outcome Table)
C. Acute systemic complications
1. Respiratory Distress Syndrome (RDS)
a) Bronchopulmonary Dysplasia
b) Chronic lung disease (CLD)
D. Important neurological and vision predictors
1. Grade III and IV IVH
a) hydrocephalus
2. Periventricular leukomalacia (PVL)
a) MRI and ophthalmoscopy
b) Sequelae
E. ROP definition and likelihood
F. Threshold of Viability
1. Major disabilities
2. Impairment by decades
G. Other acute problems
1. Patent Ductus Arteriosus (PDA)
2. Necrotizing Enterocolitis (NEC)
H. Eye signs with Extremely Low Birthweight
1. Strabismus
2. Congenital Optic Nerve Hypoplasia (CONH)
3. Optic Atrophy
4. Nystagmus
5. Oculomotor apraxia
a) Cortical vision impairment
6. Reduced VA
7. Myopia
I.
ROP: staging and new treatment guidelines
1. Stages
2. Plus Disease
3. Location
4. Threshold definition and CRYO-ROP
a)
b)
c)
d)
e)
Stage 3
Zone 1 or 2
5 contiguous or 8 cumulative
With Plus disease
Cryotherapy
5. New treatment guidelines for Pre-Threshold disease: results of ETROP
studies
a)
b)
c)
d)
Zone 1, any stage, plus Dz
Zone 1, stage 3
Zone 2, stage 2 or 3, plus Dz
Laser
6. Additional “soft” neurologic signs: Visual Perceptual delays
7. Quality of Life for ex-prematures at young adult age