· 2 Dear Colleagues: On behalf of the organizing committee, we cordially invite you to attend the World ROP Congress III, an international conference on retinopathy of prematurity

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Table of Contents / 目录

Welcome Message 会议欢迎辞��2

Committee 会议组委会��3

Congress Information 会议信息��4

Information for Speakers and Presenters 讲者须知��6

Information for Poster Presenters 壁报交流须知��7

Official & Social Programs 重要活动及社会活动��7

Congress Major Corporate Partners / 大会主要合作伙伴��8

Scientific Program 会议日程��9

Abstracts 论文摘要��29

Abstracts for Plenary Lecture��35

Abstracts for Oral Presentation��36

Abstracts for Poster Presentation��50

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Dear Colleagues:

On behalf of the organizing committee, we cordially invite you to attend the World ROP Congress III, an international conference on retinopathy of prematurity to be held in October14-16, 2012, in Shanghai, China.

The purpose of this 3rd international ROP congress is to provide a forum for ophthalmologists, neonatologists and neonatal nurses to share knowledge and experiences about ROP. The World ROP Congress III will feature a comprehensive overview of all aspects of ROP ranging from current concepts to etiology, screening, research and management practices. Everyone will have an opportunity to participate via free papers and poster presentations.

The conference will be hosted in Shanghai China. Shanghai is a big modern city mixed with traditional Chinese culture and offers a diverse range of tourism opportunities in and around the city.

We look forward to welcoming you to this grand event.

Welcome Message / 会议欢迎辞

Prof. Xiaoxin LiVice Chair ExecutiveOrganizing CommitteeWorld ROP Congress

Prof. Rajvardhan Azad Chair ExecutiveOrganizing CommitteeWorld ROP Congress

Prof. Peiquan ZhaoSecretary GeneralOrganizing CommitteeWorld ROP Congress

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Committees

Honorary ChairClare Gilbert, UK Michael Trese, USA

Executive ChairRajvardhan Azad, India

Executive Vice ChairXiaoxin Li, China

Organizing SecretariesPeiquan Zhao, China (Secretary General) Li Huang, China (Secretary Deputy)

Program Committee MembersAlistair Fielder, UK Anna Ells, Canada Ashok Deorari, India Brian Darlow, New Zealand

Dharmapuri Vidyasagar, USA E Song, China Fang Lu, China Gerd Holmstrom, Sweden

Graham Quinn, USA Guoming Zhang, China Helen Mintz-Hittner, USA Hideyuki Hayashi, Japan

Hiroyuki Kondo, Japan Mangat Dogra, India Marilyn Miller, USA Michael Shapiro, USA

Padmaja K. Rani, India Parijat Chandra, India Peiquan Zhao, China Rasa Bagdoniene, Lithuania

Rasa Sirtautiene, Lithuania Rita Sitorus, Indonesia RV Paul Chan, USA Shunji Kusaka, Japan

Tailoi Chan-Ling, Australia V Narendran, India Wei-chi Wu, China Xin Huang, China

Yi Chen, China Yusheng Wang, China

Scientific CommitteeGraham Quinn, USA (Chair) Anna Ells, Canada Ashok Deorari, India Brian Darlow, New Zealand

Clare Gilbert, UK Glen Gole, Australia Helen Mintz-Hittner, USA Mangat Dogra, India

Padmaja K. Rani, India Peiquan Zhao, China Rajvardhan Azad, India V Narendran, India

Xiaoxin Li, China Parijat Chandra, India(Coordinator)

Committees / 会议组委会

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Congress Information / 会议信息

Congress Venue / 会议地点InterContinental Shanghai Puxi

500 Heng Feng Road, Shanghai 200070, China

Tel: +86 21 5253 9999

上海浦西洲际酒店

上海市恒丰路 500 号 , 邮编 200070

电话 : (021)52539999

Registration & Badge Pickup / 现场报到及胸卡领取Venue: Lobby, InterContinental Shanghai Puxi

报到地点：上海浦西洲际酒店大堂

DATE / 日期 TIME / 时间

Sunday, 14 October 2012 / 2012 年 10 月 14 日星期日 08:30-20:00

Monday, 15 October 2012 / 2012 年 10 月 15 日星期一 08:30-17:30

Tuesday, 16 October 2012 / 2012 年 10 月 16 日星期二 08:30-16:30

Certificate of Attendance / 参会证书The Certificate of Attendance will be given to delegates after registration.

会议注册时将把参会证书发给各个参会代表

Coffee Break / 茶歇Coffee Breaks will be held in the Foyer of the Grand Ballroom, 3/F, InterContinental Shanghai Puxi.

会议茶歇处位于上海浦西洲际酒店三层豪华大宴会厅前厅

Official Language / 会议语言The official language of ROP2012 is English.

大会的官方语言为英语。

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Congress Information

Climate / 天气October is a warm month in general, with changing weather. The average daytime and nighttime temperatures are

23℃ and 16℃ , respectively.

十月上海的天气比较温暖 , 气候变化较大。白天平均气温在 23 度左右 , 晚间平均气温在 16 度左右。

Currency / 货币The currency in China is the Chinese Yuan (RMB). Credit cards are widely accepted in all major hotels and

shopping malls.

The exchange rate is approximately US$1.00 to 6.30RMB.

中国的流通货币为人民币。基本上大的酒店和购物中心都接受信用卡付费。汇率大约为 1 美金 =6.3 人民币。

Time Zone / 时差The local time in Shanghai is 8 hours ahead of the Greenwich Mean time (GMT + 8).

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Information for Speakers and Presenters / 讲者须知

Speakers are requested to submit their presentation file to the staff at the Grand Ballroom at least 2 hours before

the presentation session.

请讲者在发言前至少提前两个小时把本人的发言文件提交给会场工作人员

Presentation Format / 发言形式Only presentations using a personal computer are acceptable. OHP slides and videos cannot be used for

presentations. Sound data cannot be used. Please use the mouse provided at the speaker’s podium to operate

your own presentation. (The personal computer on which data is stored is not situated at the podium.)

会议只接受使用电脑的幻灯文件。大会不接受 OHP slides and videos。不能使用声音文件。请使用讲台上的鼠标来

操作你的发言文件。（存储发言文件的电脑没有放置在讲台上。）

Data Format / 幻灯文件格式The compatible data formats for presentations at the Congress are as follows. Please ensure that your

presentation will function on the specifications given below.

会议对发言幻灯文件的要求如下 , 请保证您的发言文件按照如下要求存储。

Windows: PowerPoint 2000, 2003 and 2007

If your PowerPoint presentation includes movies and moving images, please bring along your own equipment and

adapter.

如果您的 powerpoint 文件里面有电影和动画 , 请携带本人的电脑和转换器

* For presentations that include movie or moving images, please note that these can only be played back using the

following software:

* 如果幻灯文件中有电影或者动画 , 请注意这些文件能使用如下软件播放：

Windows: Windows Media Player

If your presentation includes links to other data (static images, moving images, graphs, etc.), please save the

linked data and download all data to the computer at the meeting room to ensure that the presentation functions

correctly.

如果您的发言文件包括打开其他文件的链接（如静止的图片 , 动画 , 图表等等）, 请将所有相关的链接文件上传到会

场电脑并查看以保证文件能够运行。

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Congress Information

Information for Poster Presenters / 壁报交流须知

Venue: Grand Ballroom 2, 3/F / 3 层豪华大宴会厅 2

Exhibition Time / 展示时间 :SET-UP TIME / 张贴时间： Monday, 15 October 2012 / 2012 年 10 月 15 日星期一 08:30-09:30

DISPLAY TIME / 展示时间： Monday, 15 October 2012 / 2012 年 10 月 15 日星期一 09:30-17:30

Tuesday, 16 October 2012 / 2012 年 10 月 16 日星期二 08:30-16:00

DISCUSSTION TIME / 讨论时间： Monday, 15 October 2012 / 2012 年 10 月 15 日星期一 16:00-17:00

TEAR-DOWN TIME / 回收时间： Tuesday, 16 October 2012 / 2012 年 10 月 16 日星期二 16:00 onwards/ 以后

Please ensure that to dismantle and take with you all exhibition items. Any items left behind after the scheduled

dismantling time will be disposed off by the secretariat.

请注意在撤除本人壁报时取走所有相关物品。在壁报回收时间之后的所有遗留物品将被秘书处丢弃。

Exhibit Requirements / 壁报展示要求 :1. Exhibition number will be prepared by the secretariat and affixed to your exhibition panel.

大会秘书处将准备壁报号标识并粘贴在展板上

2. The main panel should be no larger than 150 cm high by 90 cm wide.(In particular, make sure that the panel is

no wider than 90 cm.)

壁报尺寸不的超过 150cm 高 , 90 厘米宽。（请特别注意不得超过 90 里面宽）

3. Please use double-sided tape to affix your presentation panel firmly. Tapes are also available at the secretariat

office.

请使用双面胶粘帖您的壁报。大会秘书处将提供双面胶。

Official & Social Programs / 重要活动及社会活动

Inauguration 开幕式Date & Time: 14 October 2012, Sunday / 2012 年 10 月 14 日星期日 • 5:00-5:35 PM

Venue: Grand Ballroom 1, 3/F / 3 层豪华大宴会厅

Congress Dinner 大会晚宴Date & Time: 15 October 2012, Monday / 2012 年 10 月 15 日星期一 • 6:30-8:30 PM

Venue: Crystal Room 2+3, B1/F / 地下一层水晶厅 2+3

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Congress Major Corporate Partners / 大会主要合作伙伴

The Organizing Committee of World ROP Congress III appreciates the following corporate partners for their generous support and proactive participation:本次大会衷心感谢以下主要合作伙伴的鼎力支持：

Platinum Sponsors / 白金合作伙伴

Gold Sponsors / 金牌合作伙伴

Silver Sponsors / 银牌合作伙伴

卡尔·蔡司公司

参天制药(中国)有限公司

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Program 2012 年 10 月 14-16 日 October 14-16, 2012

October 14, 2012

Sunday

Program / 大会日程

Crystal Room 1, B1/F 地下一层水晶厅 116:00-17:00 Council Meeting / 组委会会议

Grand Ballroom 1, 3/F 三层豪华大宴会厅 117:00-17:35 Inauguration / 开幕式

17:00-17:05 Welcome address欢迎辞Kanxing Zhao

17:05-17:10 Welcome address欢迎辞Xiaoxin Li

17:10-17:15 Introduction of ROP congress: from Lithuania to Shanghai早产儿视网膜病变大会介绍：从立陶宛到上海Rajvardhan Azad

17:15-17:20 Development of retinal detachment in ROP eyes treated with anti VEGF抗血管内皮生长因子治疗后早产儿视网膜病变眼的视网膜脱离的发生Michael Trese

17:20-17:25 Perspectives on ROP: public health problem, programs and policy早产儿视网膜病变展望：公共卫生问题，流程和政策Clare Gilbert

17:25-17:30 Speech of guest speakers: retinopathy of prematurity – history, natural course and treat-ment特邀发言：早产儿视网膜病变 - 历史，自然病程和治疗Kenji Oshima

17:30-17:35 Thanks address 感谢辞Peiquan Zhao

17:35-18:50 Plenary Session: Recent advances in ROP / ROP 新进展

Chair: Michael Trese Co-chair: Rajvardhan Azad Moderator: Xiaoxin Li

17:35-17:50 PL-01 The interaction of ophthalmology, neonatology/pediatrics, and nursing眼科、新生儿科 / 儿科和护理之间的合作Dharmapuri Vidyasagar

October 14, 2012 Sunday / 2012 年 10 月 14 日

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17:50-18:05 PL-02 ROP awareness program: organizational concepts, workshop modules, impact on tar-get population 早产儿视网膜病变认知项目：组织概念，机构模式，对目标人群的影响Rajvardhan Azad

18:05-18:20 PL-03 Integrating technology with ROP: benefits and losses早产儿视网膜病变整合技术：利益与弊端Michael Trese

18:20-18:35 PL-04 Pathogenesis – new concepts发病机理 - 新概念Tailoi Chan-Ling

18:35-18:50 PL-05 Prospective on ROP in China中国早产儿视网膜病变展望Xiaoxin Li

Program / 大会日程October 14, 2012 Sunday / 2012 年 10 月 14 日

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October 15, 2012

Monday


Grand Ballroom 1, 3/F 三层豪华大宴会厅 108:30-10:00 Session I: Epidemiology / 流行病学

Chair: Clare Gilbert Co-chair: Graham Quinn Moderator: Tinh Nguyen Xuan

08:30-08:40 OR-01 ROP as cause of blindness worldwide and babies at risk早产儿视网膜病变全球致盲疾病及高危婴儿Clare Gilbert

08:40-08:50 OR-02 Epidemiology of ROP in China中国早产儿视网膜病变流行病学Chao Chen

08:50-09:00 OR-03 Epidemiology of ROP in Latin America拉丁美洲早产儿视网膜病变流行病学Juan Carlos Silva

09:00-09:10 OR-04 Epidemiology of ROP in Vietnam越南早产儿视网膜病变流行病学Tinh Nguyen Xuan

09:10-09:20 OR-05 ROP experiences from Khartoum, Sudan苏丹喀土穆早产儿视网膜病变防治经验Ahmed Fahmi

09:20-09:30 OR-06 Replication of ROP diagnosis and treatment patterns in some developing regions早产儿视网膜病变诊治模型在某些发展中地区的复制Rasa Bagdoniene

09:30-09:40 OR-07 Screening for retinopathy of prematurity: the first report from upper EgyptROP 筛查：来自上埃及的首次报告Mahmoud Nassar

09:40-09:50 OR-08 Comparative study of the profiles of premature babies in urban & semi-urban neonatal intensive care units (NICUs) in Karnataka, India印度卡纳塔卡的城市和亚城市 NICU 早产儿特点比较研究Krishna. R Murthy

09:50-10:00 Panel discussion讨论

10:00-10:30 Tea Break / 茶歇

October 15, 2012 Monday / 2012 年 10 月 15 日

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10:30-12:30 Session 2: Risk factors, prevention of ROP / 早产儿视网膜病变的高危因素，预防

Chair: Shunji Kusaka Co-chair: Hayashi HideyukiI Moderator: Tailoi ChinLing

10:30-10:42 OR-09 Update on the role of oxygen in ROP氧气在早产儿视网膜病变中扮演的新角色 Chao Chen

10:42-10:54 OR-10 Risk factor algorithms to predict serious ROP (WINROP, PINTROP) 危险因素运算法对重度早产儿视网膜病变的预测（WINROP, PINTROP）Gil Binenbaum

10:54-11:06 OR-11 Impact of neonatal care – where quickest improvements can be made 新生儿监护的影响——可以最快改进的地方Brian Darlow

11:06-11:18 OR-12 The role of nurses in preventing ROP and supporting programmes护理在预防早产儿视网膜病变中的角色以及支持治疗Ana Quiroga

11:18-11:30 OR-13 Introduction of ROP prevention in Shenzhen from 2003 to 20122003 至 2012 深圳早产儿视网膜病变防治介绍Guoming Zhang

11:30-11:40 OR-14 Rate of absolute weight gain at 5 weeks after birth as a predictor for severe retinopathy of prematurity in very low birth weight infants生后 5 周净体重增长率作为极低出生体重儿发生重度早产儿视网膜病变的预测指标Timothy Hoi Min Fung

11:40-11:50 OR-15 BOOST-II UK – preliminary ophthalmic resultsBOOST-II UK——初步眼部结果Alistair Fielder

11:50-12:00 OR-16 WINROP - a useful adjunct to predict sight threatening ROP in an extremely preterm cohortWINROP——一项有效预防极度早产儿发生视力受损早产儿视网膜病变的辅助治疗Chatarina Löfqvist


October 15, 2012 Monday / 2012 年 10 月 15 日

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October 15, 2012

Monday

Program / 大会日程October 15, 2012 Monday / 2012 年 10 月 15 日

Crystal Room, B1/F 地下一层水晶厅12:30-1:30 Lunch / 午餐

Grand Ballroom 1, 3/F 三层豪华大宴会厅 113:30-15:30 Session 3: Screening and imagingChair: Alistair Fielder Co-chair: Anna Ells Moderator: Parijat Chandra

13:30-13:42 OR-17 ROP screening guidelines-South American perspective早产儿视网膜病变筛查指南——南美洲观点Ximena Katz

13:42-13:54 OR-18 ROP screening guidelines-Indian perspective早产儿视网膜病变筛查指南——印度观点Narendran Venkatapathy

13:54-14:06 OR-19 ROP screening guidelines-Chinese perspective早产儿视网膜病变筛查指南——中国观点Ping Fei

14:06-14:18 OR-20 ROP screening guidelines-European perspective早产儿视网膜病变筛查指南——欧洲观点Alistair Fielder

14:18-14:30 OR-21 Digital imaging and quantifying ROP (Retcam)早产儿视网膜病变数字图像和质量（Retcam）Clare Wilson

14:30-14:42 OR-22 Teleophthalmology in case detection in ROP – American experience远程眼科技术发现早产儿视网膜病变——美国经验Graham Quinn

14:42-14:54 OR-23 Teleophthalmology in case detection in ROP – Indian experience 远程眼科技术发现早产儿视网膜病变——印度经验Anand Vinekar

14:54-15:06 OR-24 Differentiation of ROP with other intraocular proliferating diseases 早产儿视网膜病变与其他眼内增殖性疾病的鉴别Hayashi Hideyuki


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15:30-16:00 Tea break / 茶歇

16:00-17:00 Session 4: Poster session / 壁报交流

Chair: Michael TreseJudges: Michael Shapiro, Hiroyuki Kondo, Mangat Dogra

Crystal Room, B1/F 地下一层水晶厅18:30-20:00 Dinner / 晚宴

Program / 大会日程October 15, 2012 Monday / 2012 年 10 月 15 日

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October 16, 2012

Tuesday

Program / 大会日程October 16, 2012 Tuesday / 2012 年 10 月 16 日

Grand Ballroom 1, 3/F 三层豪华大宴会厅 108:30-10:10 Session 5: New concepts and techniques in ROP / 早产儿视网膜病变的新概念和新技术

Chair: Michael Shapiro Co-chair: Peiquan Zhao Moderator: Graham Quinn

08:30-08:40 OR-25 Genetic variations in advanced retinopathy of prematurity 晚期早产儿视网膜病变中的遗传变异Hiroyuki Kondo

08:40-08:50 OR-26 Drug delivery for ROP: challenges and potential strategies早产儿视网膜病变的药物传递：挑战与潜在的策略RV Paul Chan

08:50-09:00 OR-27 Characteristics of macular retina on OCT in premature and full term neonates早产儿和足月新生儿 OCT 上黄斑视网膜的特征Fang Lu

09:00-09:10 OR-28 Long term evaluation of functional and structural macular changes assessed by OCT in regressed and lasered ROP利用 OCT 对退化和激光过的早产儿视网膜病变的黄斑功能和结构变化的长期评估Rajvardhan Azad

09:10-09:20 OR-29 OCT in the premature infant早产儿的 OCT 检查Ramiro Maldonado

09:20-09:30 OR-30 Fluorescein angiography in APROP急进性后部型早产儿视网膜病变的荧光素血管造影Parijat Chandra

09:30-09:40 OR-31 Fluorescein angiography in ROP – does it help our understanding?早产儿视网膜病变的荧光血管造影 - 它有助于我们了解吗？Domenico Lepore

09:40-09:50 OR-32 Higher visual dysfunction in preterm children早产儿视觉功能障碍发生率更高Gordon Dutton / Clare Gilbert

09:50-10:00 OR-33 Spectral-domain optical coherence tomography in diagnostics of cicatricial retinopathy of prematurity谱域 OCT 对瘢痕化早产儿视网膜病变的诊断D. Ryabtsev


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15:30-16:00 Tea Break / 茶歇

10:30-12:45 Session 6: ROP management / 早产儿视网膜病变的管理

Chair: Rajvardhan Azad Co-chair: Helen Mintz - Hittner Moderator: Mangat Dogra

10:30-10:40 OR-34 Laser treatment for ROP早产儿视网膜病变的激光治疗Anna Ells

10:40-10:50 OR-35 Anti-VEGF in ROP: current status早产儿视网膜病变的抗 VEGF 治疗：现状Helen Mintz - Hittner

10:50-11:00 OR-36 Anti-VEGF in ROP: systemic safety 早产儿视网膜病变的抗 VEGF 治疗：系统安全性Brian Darlow

11:00-11:10 OR-37 Anti-VEGF and ROP: where do we need to go?早产儿视网膜病变和抗 VEGF 治疗：我们的前景在何处？David Wallace

11:10-11:20 OR-38 Recent experience with Avastin for ROPAvastin 治疗早产儿视网膜病变近期的经验Michael Shapiro

11:20-11:30 OR-39 Serum concentrations of Bevacizumab (Avastin) & VEGF in infants with ROP早产儿视网膜病变婴儿贝伐单抗（Avastin）和 VEGF 的血清浓度Shunji Kusaka

11:30-11:40 OR-40 Staged lensectomy and posterior vitrectomy for stage 5 ROP5 期早产儿视网膜病变的分期晶切和后玻璃体切割术Peiquan Zhao

11:40-11:50 OR-41 Surgery in ROP – define limits and techniques早产儿视网膜病变手术治疗 - 定义局限性和技术Rajvardhan Azad

11:50-12:00 OR-42 A hybrid form of retinopathy of prematurity一种混合型早产儿视网膜病变Mangat Dogra

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October 16, 2012

Tuesday


12:00-12:08 OR-43 Late onset vitreoretinal complications of regressed retinopathy of prematurity退化性早产儿视网膜病变中的晚发性玻璃体视网膜并发症Ludmila Kogoleva

12:08-12:16 OR-44 Aggressive posterior retinopathy of prematurity in infants ≥ 1500 gm birth weight出生体重≥ 1500 克婴儿中的急进性后部型早产儿视网膜病变Gaurav Sanghi

12:16-12:24 OR-45 Outcome of single vs multiple session laser photocoagulation of flat neovascularization in Zone 1 AP-ROP: a prospective, randomized study对1区急进性后部型早产儿视网膜病变新生血管的单或多次激光光凝的结果：一项前瞻性，随机对照研究Anand Vinekar

12:24-12:32 OR-46 Comparison of systemic morbidity associated with ablative laser for ROP using sedative versus non-sedative laser激光时是否使用镇静剂对发生激光相关全身性疾病的发病率比较Natalia Matti


Crystal Room, B1/F 地下一层水晶厅12:45-1:30 Lunch / 午餐

Grand Ballroom 1, 3/F 三层豪华大宴会厅 113:30-15:10 Session 7: Beyond ROP clinical care and discussion of cases / 早产儿视网膜病变临床护理以外部分及病例讨论

Chair: Rita Sitorus Co-chair: RV Paul Chan Moderator: Wei-chi Wu

13:30-13:40 OR-47 Assessment of neonatal care and ROP programmes in Mexico墨西哥的新生儿护理评估和早产儿视网膜病变计划Consuelo Zepeda

13:40-13:50 OR-48 When, where and how to start ROP program when none exists从零起步，何时，何地以及如何开始启动早产儿视网膜病变计划？Rita Sitorus

13:50-14:00 OR-49 Lessons from regional and national ROP workshops区域和国家早产儿视网膜病变工作站的经验教训Graham Quinn / Andrea Zin

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14:00-14:10 OR-50 Engaging parents with ROP babies让早产儿视网膜病变婴儿的父母参与进来Luz Gordillo

14:10-14:20 OR-51 Vision training, low vision services and rehabilitation视觉训练，低视力帮助和康复Yan Wei


14:30-15:10 Case discussions / 病例讨论

Chair : Anna EllsMembers:Yi Chen, Mangat Dogra, Dr Tinh, Consuelo Zepedo, RV Paul Chan5 cases 8 mins each with panel to discuss / 5 个病例，每个 8 分钟，小组讨论14:30-14:38 Yi Chen14:38-14:46 Mangat Dogra14:46-14:54 Tinh Nguyen Xuan14:54-15:02 Consuelo Zepedo15:02-15:10 RV Paul Chan

15:30-16:30 Session 8: ROP programs / 早产儿视网膜病变计划

Chair: Brian Darlow Co-chair: Gerd Holmstrorm Moderator: Juan Carlos Silva

15:30-15:40 OR-52 Planning efficient and effective programs规划高效率和有效的方案Yi Chen

15:40-15:50 OR-53 The ITCROPS (Indian Twin cities ROP screening) program ITCROPS （印度双城早产儿视网膜病变筛查）计划Padmaja Kumari

15:50-16:00 OR-54 Management information systems for ROP早产儿视网膜病变管理信息系统Gerd Holmstrom

16:00-16:10 OR-55 The importance of policy in ROP: The Latin American experience对早产儿视网膜病变的政策的重要性：拉丁美洲的经验Juan Carlos Silva


16:30 Closing ceremony / 闭幕式


Abstracts论文摘要

第三届世界早产儿视网膜病变大会

Word ROP Congress III

中国·上海

Shanghai, China

30

Word ROP Congress III, 2012·第三届世界早产儿视网膜病变大会

Abstracts List / 论文摘要目录

Abstracts for Plenary LecturePL-01 The interaction of ophthalmology, neonatology/

pediatrics, and nursing ............ Dharmapuri Vidyasagar(35)PL-02 ROP Awareness program: Organizational

concepts, workshop modules, impact on target population ...........................................Rajvardhan Azad(35)

PL-03 Integrating technology with ROP: benefits and losses ..................................................Michael T. Trese(35)

PL-04 Pathogenesis – new concepts ............................................................. Tailoi Chan-Ling(35)PL-05 Prospective on ROP in China ................Xiaoxin Li(35)

Abstracts for Oral PresentationOR-01 ROP as cause of blindness worldwide and babies

at risk .........................................................Clare Gilbert(36)OR-02 The incidence of retinopathy of prematurity: a

prospective multicenter study in China ............................................................. Chao Chen, etc.(36)OR-03 Epidemiology of ROP in Latin America ........................................................... Juan Carlos Silva(36)OR-04 Epidemiology of ROP in Vietnam ..........................................................Tinh Nguyen Xuan(37)OR-05 ROP experiences from Khartoum, Sudan .................................................................Ahmed Fahmi(37)OR-06 Replication of ROP diagnosis and treatment

patterns in some developing regions ...................................................Rasa Bagdoniene, etc.(37)OR-07 Screening for Retinopathy of Prematurity: The

first report from Upper Egypt .............Mahmoud Nassar(37)OR-08 Comparative study of the profiles of premature

babies in Urban & Semi-urban Neonatal Intensive Care Units(NICUs) in Karnataka, India

...................................................Krishna. R Murthy, etc.(37)OR-09 Update on the role of oxygen in ROP .....................................................................Chao Chen(38)OR-10 Risk factor algorithms to predict serious ROP

(WINROP, PINTROP) .............................Gil Binenbaum(38)OR-11 Impact of neonatal care – where quickest

improvements can be made ..............Brian Darlow MD.(38)OR-12 The role of nurses in preventing ROP and

supporting programmes.............................Ana Quiroga(38)OR-13 Introduction of ROP prevention in Shenzhen

............................................................. Guoming Zhang(39)

OR-14 Rate of absolute weight gain at 5 weeks after birth as a predictor for severe retinopathy of prematurity in very low birth weight infants

............................................ Timothy Hoi Min Fung, etc.(39)OR-15 BOOST-II UK – Preliminary Ophthalmic Results

..................................................... Alistair R Fielder, etc.(39)OR-16 WINROP - a useful adjunct to predict sight

threatening ROP in an extremely preterm cohort .................................................. Chatarina Löfqvist, etc.(39)

OR-17 ROP screening guidelines-South American perspective ................................................Ximena Katz(40)

OR-18 ROP screening guidelines-Indian perspective ............................................... Narendran Venkatapathy(40)

OR-19 ROP screening guidelines in China .................................................................. Ping Fei, etc.(40)OR-20 ROP screening guidelines-European perspective

.............................................................Alistair R Fielder(41)OR-21 Digital imaging and quantifying ROP (Retcam)

...................................................................Clare Wilson(41)OR-22 Teleophthalmology in case detection in ROP –

American Experience .............................Graham Quinn(41)OR-23 Teleophthalmology in case detection in ROP –

Indian Experience ...................................Anand Vinekar(42)OR-24 Differentiation of ROP with other intraocular

proliferating diseases..................Hideyuki Hayashi, etc.(42)OR-25 Genetic variations in advanced retinopathy of

prematurity.............................................Hiroyuki Kondo(42)OR-26 Drug Delivery for ROP: Challenges and Potential

Strategies ............................................... RV Paul Chan(42)OR-27 Dynamics of retina development in neonates

.................................................................. Fang Lu, etc.(42)OR-28 Long Term evaluation of functional and structural

macular changes assessed by OCT in regressed and lasered ROP .......................................Rajvardhan Azad(43)

OR-29 OCT in the premature infant .................................................Ramiro Maldonado, etc.(43)OR-30 Fluorescein angiography in APROP .............................................................. Parijat Chandra(43)OR-31 Fluorescein angiography in ROP – Does it help

our understanding?............................Domenico Lepore(43)OR-32 Higher visual dysfunction in preterm children

...................................................................Clare Gilbert(43)OR-33 Spectral-Domain Optical Coherence Tomography

31

Abstracts List

in Diagnostics of Cicatricial Retinopathy of Prematurity ..........................................................D.I. Ryabtsev, etc.(43)

OR-34 Laser Treatment for ROP ......................Anna Ells(44)OR-35 Anti-VEGF in ROP: current status(Basic

Concepts of Intravitreal Monotherapy) ............Hittner M(44)OR-36 Anti-VEGF in ROP: systemic safety ...................................................................Brian Darlow(44)OR-37 Anti-VEGF and ROP: where do we need to go?

................................................................ David Wallace(44)OR-38 Recent experience with Avastin for ROP ............................................................. Michael Shapiro(45)OR-39 Serum concentrations of Bevacizumab (Avastin)

& VEGF in infants with ROP .................... ShunjiKusaka(45)OR-40 Staged lensectomy and posterior vitrectomy in

stage V ROP ............................................Peiquan Zhao(45)OR-41 Surgery in ROP – define limits and techniques

............................................................Rajvardhan Azad(45)OR-42 A hybrid form of retinopathy of prematurity

................................................................ Mangat Dogra(45)OR-43 Late onset vitreoretinal complications of

regressed retinopathy of prematurity ......................................................... Kogoleva L.V., etc.(45)OR-44 Aggressive posterior retinopathy of prematurity in

infants ≥ 1500 gm birth weight ....... Gaurav Sanghi, etc.(46)OR-45 Comparing the outcome of single vs

multiple session laser photocoagulation of flat neovascularization in Zone 1 Aggressive Posterior Retinopathy of Prematurity: A Prospective, Randomized Study ..............................................Anand Vinekar, etc.(46)

OR-46 Comparison of Systemic Morbidity Associated with Ablative Laser for ROP Using Sedative Versus Non-Sedative Laser ........................... Natalia Matti, etc.(46)

OR-47 Assessment of neonatal care and ROP programmes in Mexico

.............................. Luz Consuelo Zepeda Romero, etc.(47)OR-48 When, where and how to start ROP program

when none exists .........................................Rita Sitorus(48)OR-49 Lessons from regional and national ROP

workshops ....................Andrea Zin and Graham Quinn(48)OR-50 Engaging parents with ROP babies ....................................................................Luz Gordillo(48)OR-51 Vision training, low vision services and

rehabilitation ............................................. Yan Wei, etc.(48)OR-52 Planning efficient and effective programs ...........................................................................Yi Chen(48)OR-53 The ITCROPS (Indian Twin cities ROP

Screening) Program ............................Padmaja Kumari(48)

OR-54 Management information systems for ROP .............................................................Gerd Holmström(49)OR-55 The importance of policy in ROP: The Latin

American experience ......................... Juan Carlos Silva(49)

Abstracts for Poster PresentationPO-01 The early change of oxygen-induced retinopathy

and the effect of 17-beta-estradiol on it ....................................................HongBing Zhangi, etc.(50)PO-02 retinopathy of prematurity in multiple infants.................................................................. ping wangi, etc.(50)PO-03 Clinical analysis of retinopathy of prematurity in

cases with multiple gestational births ............................................................. Tang Songi, etc.(50)PO-04 The effects of preterm birth on an animal model

of oxygen-induced retinopathy in mice ........................................................... Zhaojie Chui, etc.(51)PO-05 Proliferation and Activation of Retinal Microglia

Promote Vascular Repair in the Mouse Model of Oxygen-induced Retinopathy

..................................................Xiaoshuang Jiangi, etc.(51)PO-06 Aggressive posterior retinopathy of prematurity in

triplets: a report of 2 cases .................................................................Yu Dongi, etc.(52)PO-07 Pleiotropic effects of Dll1-RGD in mice oxygen-

induced retinopathy ............................ Guorui Doui, etc.(52)PO-08 Telemedicine detection of type 1 ROP in a distant

neonatal intensive care unit ....................Daniel Weaver(52)PO-09 Efficacy of Combine Laser-Ranibizumab Therapy

for Retinopathy of Prematurity With Umbral/Pre-Umbral and “Plus Disease”

.................................. Luis Porfirio Orozco-Gomezi, etc.(53)PO-10 Variations in the Morphology of ROP in Extreme

Prematurity ..................................Ed Schulenburgi, etc.(53)PO-11 Treatment of active stages of retinopathy of

premature babies with the use of modern technologies .........................................Alexandr Tereshchenkoi, etc.(54)PO-12 “ROP-MORPHOMETRY” for retinopathy of

prematurity quantification .........................................Alexandr Tereshchenkoi, etc.(54)PO-13 Stages of providing comprehensive eye care

premature children with retinopathy of prematurity .........................................Alexandr Tereshchenkoi, etc.(54)PO-14 A Study of Characteristics on Retinal

Vascularization of Preterm Infant ........................................................Xianqiong Luoi, etc.(55)PO-15 Study on the pathogenesis of prematurity

32


retinopathy ............................................. Yijie choui, etc.(55)PO-16 Longitudinal Association between

Thrombocytopenia and Retinopathy of Prematurity .......................................................Gil Binenbaumi, etc.(56)PO-17 Aggressive posterior retinopathy of Prematurity:

Risk factors for retinal detachment despite confluent laser photocoagulation. .................Gaurav Sanghii, etc.(56)

PO-18 Addressing the surgical pathology of stage 4 ROP- RETCAM based evaluation and timely surgical intervention ....................................... Salil Gadkarii, etc.(56)

PO-19 Polymorphism of Structural Changes of Retina and Vitreous at 4 Degree of Cicatricial Retinopathy of Prematurity ................................. Dmitry Ryabtsevi, etc.(57)

PO-20 Retinal laser coagulation for retinopathy of prematurity under topical anesthesia.......Xunda Jii, etc.(57)

PO-21 Efficacy and safety of Intravitreal Bevacizumab injection without Laser for Retinopathy of Prematurity as Primary Therapy: 6 year follow-up results with anatomical, functional, OCT and neurodevelomental analysis........................................Dr. Alay Bankerir, etc.(57)

PO-22 Aggressive posterior retinopathy of prematurity: Myopia at 1 year corrected age following successful laser treatment............................ Deeksha Katochi, etc.(58)

PO-23 Experience of Confluent Laser Photocoagulation in the Aggressive Posterior Retinopathy of Prematurity ............................................Natalia Pasechnikovai, etc.(58)

PO-24 Efficacy and Safety of Bevacizumab (Avastin) as a Therapeutical Tool in Severe Retinopathy of Prematurity – the Romanian Experience

................................................. Simona-Delia Talui, etc.(58)PO-25 Retinal development of preterm rat....................................................................... Rong lii, etc.(59)PO-26 Systemic and Ocular Adverse Events After

Intravitreal Bevacizumab in the Treatment of ROP: A Five-Year Follow-up

............................Maria Ana Martinez-Castellanosi, etc.(59)PO-27 Fluorescein angiographic findings in

spontaneously-regressing stage 1 or 2 retinopathy of prematurity..........Maria Ana Martinez-Castellanosi, etc.(60)

PO-28 Fluorescein Angiography macular abnormalities assessed by Optical Coherence Tomography in Retinopathy of Prematurity

............................Maria Ana Martinez-Castellanosi, etc.(60)PO-29 Retinal Vascular Changes Following Intravitreal

Anti-VEGF Therapy for Treatment Requiring Retinopathy of Prematurity

............................Maria Ana Martinez-Castellanosi, etc.(60)

PO-30 Influence of Foveal Photoreceptor Sub-Elements on Visual Acuity in Premature Infants With and Without Retinopathy of Prematurity ............ Anand Vinekari, etc.(61)

PO-31 Did untreated, transient, subclinical foveal edema influence vision in premature infants? 1-year follow-up study with age and weight matched controls

.......................................................Anand Vinekari, etc.(61)PO-32 “Imaging the Image” – Enhancing Image

Characteristics of Retinal Images of Retinopathy of Prematurity Using An Indigenous Patent Pending Software (RetiView) .......................Anand Vinekari, etc.(62)

PO-33 Comparing Cost-Utility Analysis Between “KIDROP” -A Tele-ROP Model With Alternate Strategies for Retinopathy of Prematurity Screening in Remote Areas in India .................Anand Vinekar1i, etc.(62)

PO-34 Intravitreal bevacizumab for retinopathy of prematurity resistant to photocoagulation

................................................ Tomoko Tsukaharai, etc.(62)PO-35 How Early Do We Need to Initiate Retinopathy of

Prematurity Screening to Improve Enrollment? Results of a Prospective Study from Rural India

.......................................................Anand Vinekari, etc.(63)PO-36 Integrating live-video consultation with remote

reporting of ROP images on the tablet : The KIDROP experience .....................................Anand Vinekari, etc.(63)

PO-37 The ability of the neonatal management of severe ROP among the ELBW babies

..................................................... Natalya Fominai, etc.(64)PO-38 Plasma levels of Vascular Endothelial Growth

Factor after intravitreal bevacizumab injection for infants ................................................ Yuji Oshimai, etc.(64)

PO-39 Effect of Topical Bromfenac in Retinopathy of Prematurity ...........................................Sarita Berii, etc.(64)

PO-40 A New Scoring System for Risk Factors of Rop - a Pilot Study

....................................................Rajbir Singh Berii, etc.(65)PO-41 Six years experience with use of bevacizumab in

ROP .............................................Susana Teixeirai, etc.(65)PO-42 Vascular findings eyes after intravitreal

bevacizumab for ROP ................. Susana Teixeirai, etc.(66)PO-43 First results of treatment of active retinopathy in

Kazakhstan ...............................Alfiya Gabaidulinai, etc.(66)PO-44 Comparing 500 laser treatments from a rural vs

urban cohort from Southern India: Four year KIDROP experience .....................................Anand Vinekari, etc.(66)

PO-45 Development of vision in babies undergoing successful vitreoretinal surgery for advanced ROP

33

.......................................................... Salil Gadkarii, etc.(67)PO-46 On the impact of tunica vasculosa lentis to ROP

treatment ....................................Rasa Sirtautienei, etc.(67)PO-47 Smart phone: An innovative tool for telemedicine

approach in ROP diagnosis ....... Sucheta Kulkarnii, etc.(68)PO-48 Role of Socioeconomic factors in incidence ROP

................................................... Sucheta Kulkarnii, etc.(68)PO-49 Retinal vasculitis and Aggressive posterior ROP

occurring in a preterm infant: A case report ................................................... Sucheta Kulkarnii, etc.(68)PO-50 Macular formation at children with ROP according

with optical coherence tomography ..................................................Ludmila Katarginai, etc.(68)PO-51 Subgroup Analysis by Gender and Race of

Clinical Risk Index for Babies Illness Severity Subscore as a Predictor of Severe Retinopathy of Prematurity ..................................................................Michael Yang(69)

PO-52 Asymmetric revascularisation pattern after intravitreal bevazicumab for acute posterior ROP

.......................................................... Birgit Lorenzi, etc.(69)PO-53 Retinopathy of Prematurity screening results in

the Government and Private Neonatal Units in Rural India: Data from 16 remotely managed KIDROP outreach centers using the Retcam and Tele-ROP .......................................................Anand Vinekari, etc.(70)

PO-54 Course of Refractive status and ocular growth in preterm babies - A 1 year Follow Up

..................................Muralidharan Ponnurangami, etc.(70)PO-55 Diagnostics and treatment of aggressive posterior

retinopathy of prematurity ............Assel Sharipovai, etc.(71)PO-56 Quantitative characteristics of the hemodynamic

parameters in active phase of retinopathy of prematurity .....................................................Assel Sharipovai, etc.(71)

PO-57 Transscleral photocoagulation in retinopathy of prematurity........................... Martin Flores-Aguilari, etc.(71)

PO-58 Refractive status and presence of strabismus in preterm babies with ROP ...........Milena Vujanovici, etc.(72)

PO-59 Ocular morbidity in preterm children without retinopathy of prematurity

......................................Gordana Stankovic-Babici, etc.(72)PO-60 Clinical Utility of an Indigenous, Patent Pending

Software Algorithm for Automatic Detection of Stages of Retinopathy of Prematurity ........ Anand Vinekari, etc.(72)

PO-61 Retinopathy of prematurity screening trials .................................................... T.K. Botabekovai, etc.(73)PO-62 Role of oral dextrose in pain management

during laser treatment of ROP babies under topical

anaesthesia ...................................Subina Narangi, etc.(73)PO-63 ROP treatment-RetCam documented study ............................................................... Ana Orosi, etc.(74)PO-64 Refractive Status of Eyes Treated for Retinopathy

of Prematurity (ROP) with Bevacizumab alone versus Laser at 4 years follow-up. ................ Alay Bankeri, etc.(74)

PO-65 Gujarat ROP Telemedicine Network for Diagnosis of Retinopathy of Prematurity ............ Alay Bankeri, etc.(75)

PO-66 Retinopathy of Prematurity in East China .....................................................................Yu Xui, etc.(75)PO-67 Look What Else We Found! Clinical entities

serendipitously detected on Retcam imaging during routine ROP screening ..................Anand Vinekari, etc.(75)

PO-68 The introduction of retinopathy of prematurity prevention in Shenzhen from 2003 to 2012

.....................................................Guoming Zhangi, etc.(76)PO-69 Fractal analysis of Images of AP ROP ............................................................ Maja Kostići, etc.(76)PO-70 A correlation of birth weight to refractive outcomes

in treated pre threshold Retinopathy of Prematurity children. ..................................... Alokesh Gangulyi, etc.(77)

PO-71 ROP in Babies with Birth Weight less than 1000gm...............................Abhijit Chattopadhyayi, etc.(77)

PO-72 Macular OCT findings in ROP patients treated with both laser and bevacizumab

.........................................Cristina Moreira-Santosi, etc.(77)PO-73 Clinical Features of Smoldering ROP Occurring

Spontaneously and Subsequent to Anti-VEGF Therapy .................................................... Khaled Tawansyi, etc.(78)

PO-74 Vascular Regression Patterns After Intra-Vitreal Bevacizumab for Zones I and Posterior Zone II Stage 3 Plus ROP .............................................Eugene Ngi, etc.(78)

PO-75 Vascular Activity Score as a Marker of Disease Burden and Prognosis in Neonatal ROP

......................................................... Enrique Arizai, etc.(79)PO-76 Treatment of Ap-Rop by Intravitreal Injection of

Bevacizumab – 1 Years Follow up Result .................................................Nguyen Xuan Tinhi, etc.(79)PO-77 Five Years Follow up of Intravitreal Bevacizumab

Therapy in the Treatment of Retinopathy of Prematurity. Anatomical, Functional, and Neurodevelopmental Analysis ...............Maria AnaMartinez-Castellanosi, etc.(80)

PO-78 Blindness Prevalence Rate in Patients Treated For Retinopathy of Prematurity Using off Label Bevacizumab as Monotherapy in The Blindness Prevention Program in Two Secondary Healthcare Hospitals in Mexico, Three Years Follow Up

Abstracts List

34


............................Maria Ana Martinez-Castellanosi, etc.(80)PO-79 Comparison of Optical Coherence Tomography

Macular Findings in 5 Year-Old Patients with a History of Pre-Threshold or Threshold Retinopathy of Prematurity Treated with Intravitreal Bevacizumab as Monotherapy.......Maria Ana Martinez-Castellanosi, etc.(81)

PO-80 Proliferative retinopathy of prematurity is associated with low serum levels of adiponectin ..................................................Chatarina Lofqvisti, etc.(81)

PO-81 Reduced number of ROP screening examinations with the use of WINROP in infants with a GA>28 weeks at birth........................... Carola Pfeiffer Mosessoni, etc.(82)

PO-82 Description of a clinical phase II trial with IGF-I/IGFBP-3 supplementation ..............Ann Hellströmi, etc.(82)

PO-83 Evaluation of effect and influence factors of vitreous surgery for advanced retinopathy of prematurity................................................Jiakai Lii, etc.(82)

PO-84 Stage 5 Retinopathy of Prematurity – Demographic and Clinical Profiles of Patients at a Tertiary Eye Care Centre in India

............................................Padmaja Kumari Ranii, etc.(83)PO-85 Repetitive laser treatment for retinopathy of

prematurity............................................... Ping Feii, etc.(83)PO-86 Silicone oil in the surgery of retinopathy of

prematury ....................................................Yu Xui, etc.(84)PO-87 Results of ROP Screening in 400 Consecutive, at

Risk Pre Term Babies .............Raj Kumar Sharmai, etc.(84)

PO-88 Prevention of blindness from retinopathy of prematurity in Mexico: cross sectional study of the quality of neonatal care and programs for control

............................. Luz Consuelo Zepeda-Romeroi, etc.(84)PO-89 Avastin and laser treatment for ROP ..................................................................YI Cheni, etc.(85)PO-90 An Updated Study Of The Use Of Bevacizumab

In The Treatment Of Patients With Pre-Threshold Retinopathy Of Prematurity In Taiwan

............................................................Wei-Chi Wui, etc.(85)PO-91 Current practices of sedation, respiratory support

and outcomes in patients requiring laser retinopexy for ROP .........................................................Mian UKi, etc.(86)

PO-92 The usage of RetCam II in the diagnosis of infantile eye diseases .............................Qi Zhangi, etc.(86)

PO-93 Mortality and Major Morbidity among Very Low Birth Weight (VLBW) Infants: Important Clinical Context for ROP Screening ............. Agnieshka Baumritteri, etc.(86)

PO-94 Telemedicine Approaches to Evaluating Acute-phase ROP - e-ROP .......................... Graham E. Quinn(87)

PO-95 Incidence of ROP at Government Wenlock Hospital in Mangalore .......................manjunath kamath(87)

PO-96 Applying screening criteria for retinopathy of prematurity in preterm infants ..........................Hui Yang(87)

PO-97 Risk Factors and Late Stage of ROP. Giant Babies in Indonesian Cases .............. Dian E Yuliai, etc.(88)

35

PL-01The interaction of ophthalmology, neonatology/pediatrics, and nursingDharmapuri Vidyasagar

PL-02ROP Awareness program: Organizational concepts, workshop modules, impact on target populationRajvardhan Azad

PL-03Integrating technology with ROP: benefits and lossesMichael T� Trese, MD

Retinopathy of prematurity continues to be a challenging problem worldwide, but fortunately medical technology can allow more rapid interpretation of the clinical circumstance and incorporation of earlier treatments, which undoubtedly lead to a better clinical result� The combination of telemedi-cine screening of digitally captured retinal images can allow a single screener to manage many different locations remote-ly� This is particularly advantageous in rural communities

or very large industrialized communities where travel is dif-ficult and treatment needs to be centralized� The further use of laser technologies and perhaps, if proven to be safe and efficacious, pharmacologic therapies may lead to an increase in the number of children treated early to either prevent or prepare retinal detachment for efficacious surgical interven-tion� The benefits of integrating this technology seem to far outweigh the losses� Perhaps the greatest loss would be the children who do not achieve or receive the benefit of newer technology and rapid intervention� It is indeed possible to create such a safety net to try and avoid children falling through to retinal detachment from retinopathy of prematu-rity and either legal or complete blindness�

PL-04Pathogenesis – new conceptsTailoi Chan-LingThe University of Sydney

PL-05Prospective on ROP in ChinaXiaoxin LiPeking University People’s Hospital

Abstracts for Plenary Lecture

36


OR-01ROP as cause of blindness worldwide and babies at riskClare Gilbert

OR-02The incidence of retinopathy of prematurity: a prospective multicenter study in ChinaChao Chen,MD; Yequn Zhou,MD; Wenjing Shi,MDDept.of Neonatology, Children`s Hospital of Fudan Univer-sity, Shanghai, China

Objective: A population of infants are at high risk of reti-nopathy of prematurity (ROP) due to the increased survival of low birth infants in China�However,the screening system of ROP was just established for a few years, the situation of ROP prevalence is uncertain�The aim of present study is to investigate the ROP situation in China,and to evaluate the incidence of ROP by a prospective multicenter study �Methods: Twelve hospitals across the country were se-lected in the multicenter network� All infants with birth weight<2000g ,or gestational age<34weeks,or other infants with long-term oxygen history,born in or transferred to one of the participating centers from 1 June 2010 through 1 Januel 2012 were enrolled in this study� Ophthalmologic ex-minations were started at 4 weeks after delivery until resolu-tion or retinal maturation�The examination were performed by skilled ophthalmologists using indirect ophthalmoscope or Retcam�Before examinations,pupils were dilated with Mydrin eye drop�ROP was graded according to international Classification of ROP�Non-ROP infants were examed every 2 weeks,infants with mild ROP were examed every 1-2 weeks ,infants with prethreshold ROP or more need operation im-mediately ,Babies without ROP were examed until they were at least 42 postconceptional weeks old �Examination of ba-bies with ROP continued until their fundus findings became stablished�Each unit collected clinical datas and final exami-nation result�Results: 2025 preterm infants fulfilled the screening criteria�we found that 304 out of 2025 infants had some degree of ROP(15�01%)� 2025 preterm infants have been registered in database, 58�73% of these infants with GA<28w,37�09% of infants with GA 28 w to 30 weeks,16�01% of infants with GA 30 w to 32 weeks and8�94% of infants with GA 32 w to 34 weeks had ROP� 48�33% of infants birth weight <1000 g, 41�06% of infants birth weight 1000 g ~ < 1250 g,21�07% of infants birth weight 1250 g ~ < 1500 g and 8�64% of infants

birth weight1500 g ~ < 2000 g had ROP� 63�49% of infants had stage1ROP，26�64% of infants had stage 2 ROP，9�87% of infants had stage 3 ROP , 29 infants received laser therapy�Conclusions: The incidence of ROP is15�01%，9�87% in-fants with ROP need operational therapy�The ROP screening can reduce the damage due to ROP�Key words Retinopathy of prematurity; incidence; Risk fa-tors; Multicenter study

OR-03Epidemiology of ROP in Latin AmericaJuan Carlos SilvaPan American Health Organization, World Health Organiza-tion

In Latin America the high proportion of childhood blindness as a result of ROP was reported in the 90s� There are many middle income countries where first birth rates and rates of premature births are higher combined with a low quality neonatal care� There are several predisposing factors such as lack of awareness, insufficient skilled personnel, and finan-cial constraints; in many countries screening and treatment are not in place� In different studies in Latin America the prevalence of any stage of ROP varies from 2% to 25% but the different inclusion criteria limits comparative analysis, and the lack of longitudinal information prevent determine trends� A study in 7 neonatal care units in Rio, newborns =< 2000gm <37 weeks were examined in a 34 months period, 3�6% were treated� In that city there are different levels of quality of neonatal care and the risk of ROP differ from one NICU to another so the screening criteria would be different, this picture may apply to several countries in Latin America� The study recommends to use a wider screening criteria of =<1500 =< 35 weeks until quality of neonatal care is optimal in all neonatal units� In several services assessments in Latin America it was found a wide variation in the implementa-tion of the screening programs, transportation problems, screening criteria not established in several countries, lack availability of laser/cryo, deficient infrastructure and human resources and of poor follow-up and low vision services; however there are progress in services delivery in many countries and increasing interest of NGOs, governments and scientific national societies� For the future the epidemiologic assessments in Latin America should include multi-centric studies to analyses prevalence, improve scientific quality of studies, uses the same inclusion criteria and gather and ana-lyze services data to monitor prog�

Abstracts for Oral Presentation

37


OR-04Epidemiology of ROP in VietnamTinh Nguyen Xuan

OR-05ROP experiences from Khartoum, SudanAhmed Fahmi

OR-06Replication of ROP diagnosis and treatment patterns in some developing regionsRasa Bagdoniene[2], Rasa Sirtautiene[1]

1 dept. of ophthalmology Vilnius University Hospital San-tariskiu Clinics2 Eye care and treatment centre REGA, Vilnius, Lithuania

Purpose� To provide an up to date review of the state of ROP treatment in South Caucasus and Central Asia regions�Methods� We can clearly see an emerging trend in increase of ROP numbers in developing regions of the former Soviet Union countries, concentrating in two main geographical ar-eas – South Caucasus and Central Asia� In modern contexts, all definitions of Central Asia include the five republics of the former Soviet Union: Kazakhstan (pop� 16�0 million), Kyrgyzstan (5�5 million), Tajikistan (7�3 million), Turkmeni-stan (5�1 million), and Uzbekistan (27�6 million), for a total population of 61�5 million as of 2009, and the South Cau-casus region includes three republics: Armenia (3�2 million, 2008), Georgia (4�6 million, 2006) and Azerbaijan (9�2 mil-lion, 2011), for a total population of 17�0 million inhabitants� During last years we have organized several workshops in Georgia and Kazakhstan covering ROP problem space, with emphasis on screening importance and development of prac-tical screening skills�Results� We have extensive experience in ROP treatment, having started in Lithuania in 1994 and pioneered the treat-ment methodology in former Soviet Union� Advances in ROP treatment vary greatly by region – while in western world ROP is being treated for more than quarter of a cen-tury, for 17 years in Lithuania, for a year in Armenia, the first lasercoagulation procedures in Kazakhstan and Georgia were performed by us only in 2011, and there still are no threshold ROP treatments being performed in other countries of the region�Conclusions� With 78�5 million of people living in South Caucasus and Central Asia, we need to have a strong and effective ROP screening and treatment program in place� Everything is important in this quest, starting from educa-tion and spreading of awareness, transfer of information and

skills, adaptation of training materials to local region specif-ics, allowing for joint work of western and local medical professionals in the field�

OR-07Screening for Retinopathy of Prematurity: The first report from Upper EgyptMahmoud NassarOphthalmology Dept., Faculty of Medicine, Minia University

Objective The amplitude of retinopathy of prematurity (ROP) as a potential visual problem in Egypt is not docu-mented� We aim to detect the incidence of ROP in a tertiary referral neonatal ICU in Upper Egypt and to describe the ob-stacles faced during implementing the screening protocol for the first time�Methods Consecutive infants were enrolled at birth and screened for ROP� We used the UK ROP guideline (May 2008) for infant selection, follow up and treatment� Repeat examinations were performed until vascularisation was com-plete�Results 52 infants; 24 males and 28 females� Mean gesta-tional age was 31�3 weeks (+ 2�8 SD) and mean birth weight was 1234�6 grams (+ 221�1 SD)� Incidence of ROP was 36�5% (stages 1, 2, 3 & 4a were 9�6%, 9�6%, 15�4% & 1�9% respectively) no stages 4b or 5 were found in this series� 6 in-fants (11�5%) died during screening none of them had ROP, 25 infants (48�1%) were discharged from screening with reti-nal vascularisation reaching zone III, 5 infants (9�6%) were treated with indirect Diode with or without additional Cryo-therapy and 16 infants (30�8%) were lost to follow up� In this series gestational age rather than birth weight was found significantly correlated and predictive (p < 0�05) with ROP stages�Conclusion ROP in a single site in Upper Egypt appears to have comparable incidence to other areas worldwide� The main screening obstacle was missing cases and in the absence of a national ROP screening protocol we were not able to detect the suitability of the UK ROP guideline to our locality�

OR-08Comparative study of the profiles of premature babies in Urban & Semi-urban Neonatal Intensive Care Units(NICUs) in Karnataka, India.Krishna� R Murthy,[2],[3], Dhwani Shah,[2], Praveen� R Mur-thy,[2], Madhav Nandhan, Niranjan H�S, Naveen Benakappa1 Vittala International Institute of Ophthalmology2 Prabha Eye Clinic and Research Centre3 Indira Gandhi Institute of Child Health

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Purpose: To compare the profile of Retinopathy of prematurity(ROP) in premature babies in urban and semiur-ban NICUs�Methods: Our study was a retrospective study� Babies admit-ted in the NICUs of 2 urban and 7 semi-urban centres who were < 36 weeks of gestational age were subjected to fun-dus photography with a Retcam shuttle camera� Photos and NICU details were uploaded on a secure website with the help of indigenously developed software� Photographs were read by a single observer� Infants were followed till retinal vascularization was complete or the disease was stable by serial photographic screening� Babies developing threshold ROP were lasered�Results: 500 babies were screened (243 - urban group and 257 - semi-group)� Incidence of ROP was 16�5% (40) and 14�8% (38) respectively� Mean gestational age was 30�90 weeks and 31�53 weeks respectively� Mean birth-weight was 1344 grams and 1375 grams respectively� 29 babies were la-sered, 15 and 14 from each group respectively� There was no statistically significant difference between any of the param-eters compared� Level of significance fixed at 0�05Conclusions: The magnitude of the burden of ROP is com-parable between urban and semiurban NICUs stressing the need for effective screening strategies in semiurban and rural areas as well�

OR-09Update on the role of oxygen in ROPChao Chen

OR-10Risk factor algorithms to predict serious ROP (WINROP, PINTROP)Gil BinenbaumThe Childrens Hospital of Philadelphia

OR-11Impact of neonatal care – where quickest improvements can be madeBrian Darlow MD�Department of Paediatrics, University of Otago, Christ-church, New Zealand.

Much retinopathy of prematurity (ROP) is preventable by overall better care� Improving outcomes for preterm babies and reducing the incidence of ROP depends on a partner-ship between neonatologists, nurses, ophthalmologists and parents� Improvements are possible in many areas that are

both cheap and cost effective� All change begins by collect-ing data in a standard way and documenting the problem: for ROP prevention this means all babies at risk of ROP are identified and examined appropriately� The major morbidi-ties of preterm infants are linked by common elements in the pathogenesis� Evidence-based protocols concerning key as-pects of care will keep the baby more physiologically stable and decrease the incidence of all morbidities� Obstetricians and midwives delivering preterm births must be encouraged to use antenatal steroids� Labour ward stabilization has a key impact; plastic occlusive wraps prevent hypothermia and de-laying cord clamping by 30-60 seconds reduces morbidities� International recommendations are now to avoid using 100% oxygen initially but to commence resuscitation with air or blended air and oxygen� Thereafter, in the NICU appropriate oxygenation depends on the use of blenders, oxygen satura-tion monitoring and agreed saturation targets; preterm babies almost never require 100% oxygen� Preterm babies do feel pain and become unstable; painful episodes can often be pre-vented including by the use of oral sucrose or glucose, and pain scores allow appropriate treatment� Avoidance of infec-tion is crucial and begins with appropriate hand hygiene by all staff at all times� Consider appointing a senior nurse to an infection control role� Antibiotics should be narrow spectrum and discontinued if cultures are negative� Optimising growth requires early and continued feeding with mother’s own breast milk and careful monitoring� Nurse to patient ratios might be improved in critical care areas and ongoing training provided for nurses and nurse assistants� When parents are involved in their baby’s care from early on they are more likely to attend important follow-up appointments after dis-charge�

OR-12The role of nurses in preventing ROP and supporting programmesAna QuirogaAustral University

Prevention of ROP depends not only on providing enough staffing and equipment to monitor all babies receiving supplemental oxygen and other risk factors like infection and nutrition but also on having trained ophthalmologists and equipment for a good diagnosis and treatment� It is then the nurse who plays a key role at this point by both increas-ing awareness among health professionals, parents and the people in general and delivering safe and high quality care according to evidence based interventions; all of which aligns to global efforts to reduce this preventable cause of blindness�The rates of severe ROP in preterm babies are higher in the Latin American region compared with high income coun-tries, in many cases due to the range of service providers

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with units having excellent facilities, human resources and results and others with low nursing /patient’s ratio and lack of monitoring equipment� This emerging problem in the re-gion has a combination of the first and the second epidemic (survival of younger babies without safe environments of care)�Argentine National Program of Infant Blindness Prevention due to Retinopathy of Preterm” has improved ROP in the country with different strategies and nurses were involved

OR-13Introduction of ROP prevention in ShenzhenGuoming ZhangShenzhen Eys Hospital

OR-14Rate of absolute weight gain at 5 weeks after birth as a predictor for severe retinopathy of prematurity in very low birth weight infantsTimothy Hoi Min Fung, Vignesh Raja, CK PatelOxford Eye Hospital

Objectives: This study aimed to determine whether in an Oxfordshire based population, absolute rate of weight gain is an independent risk factor for the development of severe reti-nopathy of prematurity (ROP) and whether absolute rate of weight gain can be used to predict the development of severe ROP among preterm infants�Methods: A study which included 108 infants with birth weight (BW) ≤ 1500g and gestational age (GA) ≤ 32 weeks was conducted� The main outcome was development of se-vere ROP� In all infants, body weight measurements were recorded weekly and absolute rate of weight gains (g/day) were calculated�Results: Absolute rate of weight gain at week 5 was sig-nificantly lower in infants with severe ROP (P = < 0�001)� When placed into a logistic regression model, absolute rate of weight gain at week 5 was shown to be an independent risk factor for the development of severe ROP (P = 0�031)� Receiver operating curve (ROC) analysis for absolute rate of weight gain at week 5 revealed a sensitivity of 82% and a specificity of 74% for the best discriminative cut-off of 10�8g/day�Conclusions: Poor rate of absolute weight gain at week 5 postnatal age is an independent risk factor for the develop-ment of severe ROP� However it cannot be used as a screen-ing tool alone to predict the development of severe ROP due to its low sensitivity and specificity�

OR-15BOOST-II UK – Preliminary Ophthalmic ResultsAlistair R Fielder,1 on behalf of the BOOST-II UK Collab-orative Group 2

1 Department of Optometry & Visual Science, City Univer-sity UK, London;2 National Perinatal Epidemiology Unit, University of Ox-ford, UK

Background The optimal oxygen saturation (SpO2) for pre-term infants is unknown� BOOST-II UK is part of a global research collaboration directed to studying the safe lower oxygen saturation limit and its impact on ROP�Objective To compare incidence and severity of retinopathy of prematurity (ROP) in infants randomised to target oxygen saturation of SpO2 85-89% vs 91-95% in the BOOST-II UK randomised controlled trial�Methods Collect acute phase ROP data from the BOOST-II UK study, comparing target SpO2 85-89% vs 91-95% in infantsResults - preliminary973 infants were randomised: 486 to the lower target SpO2 (85-89%) and 487 to the higher target SpO2 (91-95%)� 165 infants died before 31 weeks postmenstrual age and ophthalmic data missing in 20� The median gestational age in each group was 26+1 weeks� ROP developed in 242 (62�9%) in the higher SpO2 group and 262 (65�0%) in the lower SpO2 group (stages 1, 2, 3, APROP, 4, 5 in the lower group: 14�6%, 27�3%, 20�6%, 0�5%, 0, & 0; in the higher group: 15�6%, 26�8%, 21�1%, 1�0% 0�5%, 0)� ROP treatment was performed in 149 (29�5%) of whom 65 (16�5%) and 84 (20�7%) were in the lower and higher SpO2 groups respectively�Conclusion More babies randomised to receive a higher tar-geted SpO2 required treatment for ROP� The possible signifi-cance of this finding will be discussed�

OR-16WINROP - a useful adjunct to predict sight threatening ROP in an extremely preterm cohortChatarina Löfqvist[1], Pia Lundgren[2], Magnus Domellöf[3], Gerd Holmström[1], Elisabeth Stoltz[3], Ann Hellström[1]

1 Department of Ophthalmology, Institute of Neuroscience and physiology, University of Gothenburg, Gothenburg, Swe-den2 Department of Clinical Sciences, Ophthalmology, Umeå Univeristy, Umeå, Sweden3 Department of Clinical Sciences, Pediatrics, Umeå Univ-eristy, Umeå, Sweden4 Department of Ophthalmology, Uppsala University, Up-psala, Sweden

Objective: Approximatly 4 % of infants screened for reti-nopathy of prematurity (ROP) selected by conventional risk

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criteria require treatment� Finding tools to better predict se-vere ROP is important� WINROP (www�winrop�com), an al-gorithm using postnatal weight measurements, was assessed as a ROP prediction tool in a nationwide study population in Sweden�Study population & Methods: Our current WINROP study was performed retrospectively on 506 infants born before 27 weeks of gestation during 2004-2007, originally derived from the EXPRESS study� Weight measurements were en-tered into WINROP, which signals an alarm when the infant has an abnormal weight gain rate� Infants are classified into (1) low risk (unlikely to develop sight threatening (type 1) ROP) and (2) high risk (at risk for developing type 1 ROP)� WINROP use requires that the infant has a gestational age < 32 weeks at birth, weekly weight measurements, and a physi-ological weight gain� One hundred were excluded; 18 due to hydrocephalus and eighty-two due missing weights before postmenstrual age 32 weeks �Results: Analyses included 406 infants with a median ges-tational age of 25�6 weeks (range: 23�0- 26�9 weeks) and a median weight of 780 g (range: 348 g - 1315 g)� A high risk alarm occurred in 319 infants with a median time; from birth to alarm of 3 weeks (range:1-10 weeks) and from alarm to treatment of 12 weeks (range: 8-28 weeks)� The sensitivity of WINROP was 95�7%, the specificity 23�7% and the negative predictive value 97�7%� Three of the infants that received treatment did not receive a high risk alarm� For one of these three infants the criteria of ROP type 1 was not fulfilled� For one infant the diagnosis of ROP type 1 was uncertain, and for one infant only one eye was treated�Conclusion: WINROP is a useful adjunct for ROP screen-ing that identifies high risk infants early optimizing care and potentially reducing the overall number of diagnostic ROP examinations even in an extremely preterm cohort�

OR-17ROP screening guidelines-South American perspectiveXimena Katz

Latin America was the first region of the world to be hit by an ROP epidemic after the developed world had already seen its rates of childhood blindness from ROP go down� Child-hood blindness studies also suggested a different epidemio-logical situation from developed nations� As neonatology’s development progressively ensured survival of premature babies, Latin America’s high fertility rates meant that a high number of infants were at risk� This posed a difficult problem: human as well as equipment resources were not available for either screening or treatment� Slowly, ROP pro-grams started to emerge, and eventually it became apparent that simply following guidelines from developed countries would miss a significant number of babies� Evidence showed

that infants at risk were different not only among countries in Latin-America, or different health systems within them, but even among different neonatal units in the same country� Ide-ally thus, guidelines should be adjusted to their own epide-miological context� Scarceness of trained ophthalmologists, especially in ROP, and competing priorities persist as an ex-tra difficulty for the region, so innovation in low-cost alter-native screening methods is being pursued� It is possible that a new model for selecting babies at risk, applying innovative screening methods and centralizing diagnosis by experts will be needed in the region�

OR-18ROP screening guidelines-Indian perspectiveNarendran VenkatapathyAravind Eye Care System

OR-19ROP screening guidelines in ChinaPing Fei, Qi Zhang, Peiquan Zhao,Department of Ophthalmology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, China 200092

Retinopathy of prematurity (ROP) is a disorder of the develop-ing retinal blood vessels of the preterm infant� China has pub-lished a criteria of ROP screening and instruction of oxygen inhalation in2004� The current Chinese screening guidelines suggest that premature babies or full-term babies less that 2000 grams birth weight should be screened for ROP� Larger sick babies may also be screened, if the neonatologist believes there is high risk to develop ROP even the birth weight is more than 2000g� Initial screening should be performed at four to six weeks’ chronological age or at 32 weeks’ postmenstrual age (whichever is earlier) by an ophthalmologistexperienced in the detection of ROP� Follow-up examinations and treat-ment are conducted according to stage of ROP� Stage 1 and 2 in Zone III should be followed up periodically until the ROP regresses and the peripheral retina is vascularized� Infants with type 1 prethreshold ROP and threshold ROP are referred for laser Indirect Ophthalmoscope or cryotherapy� Surgery will be performed in stage 4 and 5 ROP patients� In this presentation, we will present some data to explain why China set the screen-ing criteria to less than 2000g birth weight�

OR-20ROP screening guidelines-European perspectiveAlistair R FielderDepartment of Optometry & Visual Science, City University UK, London

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The first UK guidelines for ROP screening were drawn up in 1990� In 1995 they were revised and extended to cover treat-ment, parent information and counselling, and also the man-agement of end-stage ROP� The third iteration in 2008 was necessary because of both developments in the methodology of guideline development and also the revision of both ROP classification in 2005 and in 2003 the indications for treat-ment following the Early Treatment for ROP Randomized Trial (ETROP)� A critical component of the guideline process was to revise any component of the previous guideline which was considered to have caused confusion or had proved to be inadequate�In this presentation I will discuss fundamental principles of the UK guideline (as a model only) and discuss whether its recommendations will fit all communities and if it fails whether this is in principle or in detail� The well-documented development of aggressive posterior ROP, over a very short time course, in relatively mature babies who have received high levels of oxygen, is an example which will be used to test the underlying principles of the UK model which has used as its inclusion criteria birthweight and gestational age but has never included a sickness or oxygen dosage criterion�

OR-21Digital imaging and quantifying ROP (Retcam)Clare Wilson

Digital imaging and advances in image analysis techniques offer exciting new methods of screening for disease� Retinal disease, as it is so accessible to view and photograph through the pupil, is leading the way in automated image analysis� ROP is one of the conditions that could pioneer automated retinal screening techniques, as the epidemic currently faced in middle income countries could benefit greatly from screen nurse-lead screening, as ophthalmology expertise in these areas is sparse�The implementation of nurse-lead telemedicine screening programs in middle income countries has been successful at identifying those infants most at risk of needing treatment, and therefore needing an examination by an ophthalmologist� Various research groups around the globe have been ana-lysing the vessel changes associated with plus disease, and have shown, with a handful of different image analysis tools, that an increase in retinal vessel tortuosity and/or width can predict those babies more likely to need treatment for ROP� Perhaps the combination of nurse-lead screening combined with immediate on-site automated image analysis will enable widespread dissemination of effective ROP screening, and ultimately preservation of a lifetime of vision in these tiny babies�

OR-22Teleophthalmology in case detection in ROP – American ExperienceGraham QuinnChildrens Hospital of Philadelphia, Univ of Pennsylvania

The shift from a diagnostic examination performed by oph-thalmologists expertienced in ROP to ROP screening was made feasible with the introduction of the term Referral War-ranted ROP� This term indicates the presence of ROP in zone I, stage 3 ROP, and/or the presence of plus disease� When determining the presence of these findings in the evaluation of retinal images of at risk babies, it is possible to identify those eyes that ae in need of an ROP examination by an oph-thalmologist to determine whether treatment is indicated and, if not, what follow-up is indicated�In the US and other countries with highly developed NICU systems, there have been a number of studies that evalu-ated retinal images for the presence of ROP� In general, the samples are small and, with an expected incidence of serious ROP (defined differently across studies) of around 10-15%, the studies build a good case for telemedicine in ROP, but lack convincing power�In 2010, the National Eye Institutes/National Institues of Health funded a multicenter study entitled Telemedicine Ap-proaches to Evaluating Acute-phase ROP – eROP� This study was designed to evaluate validity, reliability, feasibility, safe-ty, and cost-effectiveness of a telemedicine system to detect eyes of at-risk babies in need of a diagnostic examination by an ophthalmologist experienced in ROP� Anticipated enroll-ment is around 2000 babies <1251g birth weight in 11 clini-cal centers in the USA and 1 in Canada� After informed con-sent from the parents and at the time of the baby’s routine ROP examination by an ophthalmologist, a non-physician takes wide-field digital images of the pupil and retina� These images are uploaded to a remote server and each image set is subsequently graded by two masked non-physician readers (a subsample of images is also graded by masked ROP experts)� The images are evaluated for the presence of plus disease, any ROP in zone I, or stage 3 ROP� These gradings will be compared to the results of diagnostic examinations�The results of this ongoing study will provide important in-formation on the sensitivity, specificity, negative predictive value and positive predictive value of a systematic approach with digital imaging of at risk babies to determine those eyes that need careful diagnostic evaluation by an ophthalmolo-gist experienced in ROP� Further it will provide important information about the safety and cost-effectiveness of ths ap-proach�

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OR-23Teleophthalmology in case detection in ROP – Indian ExperienceAnand VinekarNarayana Nethralaya Postgraduate Institute of Ophthalmology

OR-24Differentiation of ROP with other intraocular proliferating diseasesHideyuki Hayashi, M�D�& Ph�D�Fukuoka, Japan

Various diseases show intraocular fibrovascular prolifera-tion and retinal detachment among infant� The terminal figure of extensive retinal detachment has been described as leukocoria or white pupil� ROP is the leading cause of intraocular proliferation in neonatal period� Differentiation from ROP from other intraocular proliferating disease is not difficult with known history of preterm birth, especially the birth earlier than 31 gestational weeks, and bilaterallity of disease� Incontinentia pigmenti suffers bilateral eyes of full term infant, and associated with specific skin lesion, and is predominantly seen among female� On ROP, avascular retina presents as circular fashion in peripheral retina while avascu-lar retina existed on flow area of obliterated retinal vessels� On PFV: PHPV small corneal diameter and short axial length on suffered eye is contributory for diagnosis� For diagnosing FEVR, careful family history taking and fundus examina-tion of parents are strongly recommended since mild periph-eral vascular abnormality are frequently seen in the eyes of healthy family� Uveal coloboma frequently associated with retinal detachment, and might be show iris coloboma or cho-roidal coloboma in fellow eye� Careful differentiation is es-sential for saving vision of patients�

OR-25Genetic variations in advanced retinopathy of prematurityHiroyuki KondoDepartment of Ophthalmology, University of Occupational and Environmental Health, Japan

Retinopathy of prematurity (ROP) is a multifactorial disease and many causative factors have been suggested including low birth weight, low gestational age, and prolonged oxy-gen supplementation� Genetic variations of genes related to systemofretinal angiogenesis have also been considered in association with development of advanced ROP, however, little is known about the exact genetic mechanisms� Among the systems,theNorrin/FZD4 signalingpathway has become

underscored because mutations in genes for this pathway are found in a small fraction of advanced ROP� This pathway is also known to be involved in familialexudative vitreoretinopa-thy, a hereditary disease that shows clinically similar features as ROP�We analyzed53 Japanese patients with advanced ROP for mutations in genes for the Norrin/FZD4 signaling (Norrin,FZD4,andTSPAN12while LRP5 is being searched)� Our results indicated that 8% variants in FZD4 were identifie-din the advanced ROP�The data suggest that the Norrin/FZD4 signalinghas an important role in development ofadvanced ROPthan thought�Here, current knowledge of genetics in ROP will be reviewed and discussion will be provided for better un-derstanding of mechanisms causing advanced ROP�

OR-26Drug Delivery for ROP: Challenges and Potential StrategiesRV Paul Chan

OR-27Dynamics of retina development in neonatesFang Lu1, Yunxia Gao1, Yanling Hu2, Xingli Wan2, Shaoyu Su2

1. Dept. of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China2. Dept. of NICU, West China Women’s and Children’s Hos-pital, Sichuan University, Chengdu, Sichuan, China

Purpose: To quantitative measure the thickness of various layers of retina in premature and full term neonates with portable spectral domain-optical coherence tomography (SD-OCT), and evaluate the morphologic development of the fovea and macular retina�Methods: This is a prospective study, 54 babies aged 31-53 weeks corrected gestational age (CGA) were randomly enrolled, with 41 cases of premature and 13 full term babies, retinopathy of prematurity and other detectable retinal diseases were exclud-ed� All neonates were divided into 4 groups according to their CGA: ＜ 32w，32~38w，38~42w，＞ 42w� Ten adults with-out ocular abnormal were examed as control group� OCT iVue (Optovue, Inc, Freemont, CA) were applied for macular retinal measurement, the thickness of various retinal layers at central foveal and parafoveal (750µm and 1500µm) were analyzed�Results: In comparison with adult fovea, the difference of contour and full retinal thickness of fovea in both premature and full term babies were statistically significant� The thick-ness of parafoveal retina increased as the fovea matured; the photoreceptor layer was thinner and inner nuclear layer persisted in smaller CGA, while the inner retinal layer was gradually replaced by photoreceptor layer at fovea as the baby growth older� Six cases (12 eyes) with macular cyst edema were detected, no relative factor was found�

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Conclusions: This is a first study of retinal development in Chi-nese baby by using portable SD-OCT� This noninvasive exami-nation provides us more accurate data of retinal development�

OR-28Long Term evaluation of functional and structural macular changes assessed by OCT in regressed and lasered ROPRajvardhan Azad

OR-29OCT in the premature infantRamiro Maldonado MD, Du Tran-Viet BS,David K� Wallace MD, MPH, Sharon Freedman MD, Cynthia Toth MD�Duke University Eye Center Durham, NC, USA

Introduction Retinopathy of prematurity is a major cause of blindness worldwide, affecting the retina during a crucial time of visual development� Optical coherence tomogra-phy (OCT) imaging of the retina plays an important role in the diagnosis of adult retinal diseases but this technique is not widely used in infants� Factors such as different optical properties of the small neonatal eye and poor subject co-operation have prevented this technique from being widely used in infants� The purpose of this study was to evaluate the feasibility, safety and efficacy of an age-customized method of performing handheld spectral domain OCT (SD-OCT) for the evaluation of the retina in premature neonates and to demonstrate subclinical findings from the images obtained�Methods 97 premature neonates, ages 31-42 weeks postmenstru-al age (PMA) were enrolled in this IRB approved study� SD-OCT was performed at the bedside using a handheld, non-contact, por-table system� SD-OCT imaging parameters were customized for the infant age�1 � Feasibility was assessed by the time to complete each session and the number of scans needed to achieve macular imaging� Safety was assessed by documenting fluctuations in vital signs (oxygen saturation, heart rate and respiratory rate) and adverse events� Efficacy was determined by a) the B-scan image quality adequate to identify retinal contour and differentiate reti-nal layers and b) the ability to image the macula�Results A total of 485 individual imaging sessions were performed� Imaging sessions lasted on average 10 minutes for both eyes with an average of 4 scans per eye� All imag-ing sessions included macular and optic nerve volumes� Vital signs did not change more than 20% from baseline values during 98% of imaging sessions, and no adverse events re-lated to imaging were observed� The B-scan images met our quality requirements in 92%, and we were able to image the macula in 98% of these subjects� SD-OCT revealed sub-clin-ical pathology not noted by indirect ophthalmoscopy such as macular edema, pre-retinal tissue and sub-retinal fluid�Conclusions Age customized handheld SD-OCT can be per-formed on non-sedated premature infants in a safe, reproduc-

ible and efficient manner� This imaging tool aids in the evalu-ation of ROP, foveal development at cellular and sub-cellular levels and in the detection of sub-clinical pathology such as macular edema of prematurity� These findings might help in understanding the pathogenesis of neonatal retinal diseases�

OR-30Fluorescein angiography in APROPParijat ChandraAIIMS, New Delhi

OR-31Fluorescein angiography in ROP – Does it help our understanding?Domenico LeporeCatholic University of the Sacred Heart

OR-32Higher visual dysfunction in preterm childrenClare Gilbert

OR-33Spectral-Domain Optical Coherence Tomography in Diagnostics of Cicatricial Retinopathy of PrematurityD�I� Ryabtsev, L�A� Katargina, L�V� KogolevaMoscow Helmholtz Research Institute of Eye Diseases

Purpose: to study structural changes of posterior segment of eyes in children with cicatricial retinopathy of prematurity (ROP) using a spectral-domain optical coherence tomogra-phy (SD-OCT)�Methods� We examined 111 children (144 eyes) with cica-tricial ROP aged from 6 months to 16 years� We evaluated morphometric parameters, the internal structure, reflectivity and location of vessels in the retina using SD-OCT�Results� There was a lack of foveal depression in 93% of children under the age of 6 months� We found the tendency to the thinning of the retina in all areas (zone 1 - 264±9,42 µm, zone 2 - 203±8,21 µm, zone 3 - 171±10,77 µm, confi-dence interval – 95%)� Local diffuse hyper-reflectivity of the retina and loss of the layered structure were present in 80% in the central areas of the retina� In GCL retinal vessels were only in 15%� In 35% – they were located in NFL, and in 50% – extraretinaly� There was a relation between the degree of displacement of retinal vessels and presence of extraretinal

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tissue, as well as a tendency to thinning of the retina in cases with extraretinal localization of the vessels (p<0,01)� The in-cidence of later complications increased with growing degree of the displacement of vessels�Conclusions� The results showed a generalized retinal changes� Location of retinal vessels can be an important criterion of the severity of the process and important test helping detect a preclinical negative trend in cicatricial ROP� High precision of SD-OCT provides the early diagnosis and monitoring of cicatricial ROP�

OR-34Laser Treatment for ROPAnna Ells

OR-35Anti-VEGF in ROP: current status(Basic Concepts of Intravitreal Monotherapy)Hittner M

WHEN: Timing of Administration (critical): must relate to Phase II of Pathogenesis of ROP: (Stage 3 with plus preferred)--in rare circumstances early Stage 4a but always avoid Stages 1-2 and 4-5�WHAT: Type of ROP: APROP (poor prognosis) versus Stage 3+ disease�WHERE: Location of ROP: very small zone I (poor progno-sis) versus medium to large zone I or small zone II�WHY: Avoid consequences and complications of laser therapy--they do occur in very small zone I, especially APROP, cases�HOW MUCH [of What]Dose considerations--we don’t know now--but should relate to amount of VEGF requiring neutralization:in retina = extent of extraretinal fibrovascular proliferation (mild = ETROP = preferred with careful screening!!) versus (severe = CRYO-ROP and beyond = reality of clinical refer-rals!!)in vitreous = ocular volume related to adjusted age of infant: (31-33 weeks at treatment = relatively small volume) (37-39 weeks of infant = relatively large volume)[Drug considerations--we don’t know now--but will relate more to possible systemic toxicity than to ocular efficacy] [Combination of Drugs in the future?]FOLLOW-UP:Must recognize recurrenceWhat to look for (return of plus disease; rate of anterior progression of retinal vascularization (almost none or very slow); and return of neovascularization at 2 sites (advancing edge or site of original extraretinal fibrovascular prolifera-tion)�How to treat (repeat anti-VEGF versus laser therapy--de-pends on presence of membranes not on absence of vascular-

ization to ora serrata)�When to stop “monitoring for recurrence” and start “routine follow-up” for refractive errors, amblyopia, strabismus, vi-sual acuity, visual field, stereoacuity, color vision, contrast sensitivity, fundus photography, fluorescein angiography, ocular coherence tomography, etc�, etc�

OR-36Anti-VEGF in ROP: systemic safetyBrian Darlow MD�Department of Paediatrics, University of Otago, Christ-church, New Zealand. [email protected]

Is intravitreal bevacizumab (or other anti-VEGF agents) safe when given to treat acute ROP in the preterm newborn? We do not know because of a lack of evidence� But a lack of evidence is NOT the same as evidence of no harm� Does intravitreal bevacizumab escape into the systemic circulation when given to preterm infants? It clearly does and the evi-dence is that it leads to much higher concentrations and for longer than other anti-VEGF agents� Sears (2008) has calcu-lated the doses used are 1,000 times the concentration needed to neutralise the highest measured concentration of VEGF in the eye, so there is a great excess� Are there crucial actions of endogenous VEGF in developing preterm infants that might be adversely affected by high systemic concentrations of bevacizumab? There are many� VEGF has roles in normal angiogenesis in other organs that are developing in parallel with the retina; in the lungs VEGF has an important role in alveolisation; in the central nervous system it is neurotropic and neuroprotective and maintains the blood brain barrier; and it is involved in bone, cardiac and kidney development� For example, newborn rats treated with a single dose of a systemic VEGF receptor inhibitor developed pulmonary hy-pertension and an abnormal lung structure (Le Cras 2002)� How should we use this information? We need to be very cautious and only use bevacizumab in restricted and careful-ly defined circumstances� The parents should be informed of the potential risks and the child enrolled in longterm follow-up including of neurodevelopmental status� And we need to await further trials that specifically assess the long-term safety before bevacizumab can be considered the preferred treatment to laser therapy�

OR-37Anti-VEGF and ROP: where do we need to go?David WallaceDuke Eye Center

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OR-38Recent experience with Avastin for ROPMichael Shapiro

OR-39Serum concentrations of Bevacizumab (Avastin) & VEGF in infants with ROPShunjiKusaka, M�D�Sakai Hospital, Kinki University Faculty of Medicine

PURPOSE: To determine the serum concentrations of beva-cizumab and vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity (ROP) who received intravitreal bevacizumab; and to determine whether the changes in the serum concentration of bevacizumab were significantly correlated with the serum concentration of VEGF after intravitreal bevacizumab�METHODS: Eleven infants (4 girls and 7 boys) with ROP were studied� They received 0�25 mg or 0�5 mg of intravitreal beva-cizumab to either 1 eye (unilateral cases) or both eyes (bilateral cases) with vascularly active ROP� Serum samples were collected before and 1 day, 1 week, and 2 weeks after the intravitreal beva-cizumab� The serum concentrations of bevacizumab and VEGF were measured by enzyme-linked immunosorbent assay, and the correlation in the serum levels between the 2 was determined�RESULTS: The serum concentration of bevacizumab be-fore and 1 day, 1week, and 2 weeks after a total of 0�5 mg of intravitreal bevacizumab was 0 ng/mL, 195± 324ng/mL, 946 ± 680 ng/mL, and 1214 ± 351 ng/mL,respectively� The serum bevacizumab level before and 1 day and 1 week after a total 1�0 mg of intravitrealbevacizumab was 0 ng/mL, 248 ± 174 ng/mL, and 548± 89 ng/mL, respectively� The serum concentration of VEGF before and 1 day, 1 week, and 2 weeks after a totalof 0�5 mg intravitreal bevacizumab was 1628 ± 929 pg/mL, 427 ± 140 pg/mL, 246 ± 110 pg/mL, and 269± 157 pg/mL, respectively� There was a significant negativecorrelation (r= -0�575, P= �0125) between the serum concentration of bevacizumab and VEGF when a total of 0�25 mg or 0�5 mg of bevacizumab was injected�CONCLUSIONS: These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP� Con-tinued extensive evaluations of infants are warranted for pos-sible effects after intravitreal bevacizumab in ROP patients�

OR-40Staged lensectomy and posterior vitrectomy in stage V ROPPeiquan ZhaoDepartment of Ophthalmology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, China 200092

Purpose: To verify the safety and feasibility of the staged lensectomy and posterior vitrectomy in stage Ⅴ ROP�Patients and methods: Eight eyes of six patients of stage Ⅴ ROP with disappeared anterior chamber were included in this analysis� Those patients had central corneal opacity which made the fundus invisible and/or had active retinopathy� Staged lensectomy and posterior vitrectomy were performed in these eight eyes�Results: Corneal opacity disappeared or reduced in all these eight eyes 3 to 9 months later after lensectomy which made the fundus visible or the active retinopathy turned to be inac-tive and further posterior vitrectomy were performed in these eyes� All these eyes were followed for at least 3 months after vitrectomy� Surgical results were analyzed� Three of eight eyes had transparent cornea during the follow up, while the remaining five eyes had central corneal opacity due to the cornea vulnerability in ROP patients and cornea endothelium decompensation� Retina was partially or subtotally attached in four eyes and remained detached in the other four eyes�Conclusions: Stage V ROP with disappeared anterior cham-ber and central corneal opacity is very difficult to manage, especially those with active retinopathy� Staged lensectomy and posterior vitrectomy is one of the choices� The earlier the lensectomy is performed, the better the prognosis is�

OR-41Surgery in ROP – define limits and techniquesRajvardhan Azad

OR-42A hybrid form of retinopathy of prematurityMangat DograAdvanced Eye centre, PGIMER

OR-43Late onset vitreoretinal complications of regressed retinopathy of prematurityKogoleva L�V�, Katargina L�A�, Belova M�V�, Ryabtsev D�I�Moscow Research Institute of Eye Diseases

Purpose: to study the clinical findings, management, and re-sults of treatment of the vitreoretinal complications (VCR) in patients with regressed ROP�Methods� 130 patients (260 eyes) with favorable results of regressed ROP in aged 6-17 years were observed�Clinical examinations were included: vitreoretinal findings at presentation by ophthalmoscopy and Ret Cam; fluorescein angiography, SD–OCT; surgery undertaken, and functional outcomes� The mean length of follow up was 42 months�

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Results� 43 eyes (20,1%) had late onset VCR� The mean age at presentation of VRC was 10,5 years� 16 eyes had signs of lattice peripheral retinal degeneration and retinal breaks; 8 eyes – peripheral vitreoretinal traction� Primary laser treat-ment was anatomically successful in all cases� Of 19 eyes with rhegmatogenous retinal detachment (RD), 8 eyes ini-tially underwent a scleral buckling procedure and 6 eyes initially underwent vitrectomy� 5 eyes with tractional RD had initial primary vitrectomy with or without scleral buckling�Primary surgery was anatomically successful in 7/8 eyes that underwent a scleral buckling procedure and 9/11 that requied vitrectomy�Conclusions� Late onset VRC are the most important fac-tor for loss visual in patients with mild ROP� A most of eyes with peripheral retinal changes that underwent prophylactic laser treatment were stabilized� In eyes with RD and signs of regressed ROP successful retreatment of the retina can be achieved using either vitrectomy or external surgery�

OR-44Aggressive posterior retinopathy of prematurity in infants ≥ 1500 gm birth weight.Gaurav Sanghi,[2], Mangat Dogra, Deeksha Katoch, Neha Kumari, Mohit Dogra, Amod Gupta1 Advanced Eye Centre,PGIMER,Chandigarh,India2 Grewal eye institute,Chandigarh,India

Purpose: To study the spectrum of aggressive posterior reti-nopathy of prematurity (APROP) in infants ≥ 1500 gm birth weight�Methods :A retrospective review of infants ≥ 1500 g birth weight and treated for APROP at a tertiary centre between January 2006 and December 2009Results: Twenty-nine eyes of 15 infants are included� The mean birth weight and gestational age were 1791�27± 281�86 g and 30�7 ± 1�03 weeks respectively� All in-fants were referred from level I or II accredited nurseries for treatment� All infants received supplemental oxygen� Systemic co-morbidities were common and included neo-natal jaundice,sepsis,respiratory distress syndrome, infu-sion of blood products and birth asphyxia� Of the 29 eyes, 10(34�48%) had zone 1 and 19(65�52 %) had posterior zone 2 disease �Twenty-five (86�21%) eyes had flat neovascular syncytium while 4(13�79 %) eyes had brush like prolifera-tion � We noticed large vascular loops in 10(34�48%) eyes� All eyes underwent confluent laser treatment at a mean post conceptional age of 35�2±1�54 weeks �Twenty-two (75�86%) eyes had a favorable outcome� Seven (24�14%) eyes had an unfavorable outcome (Stage 5 : 2 eyes, Stage 4a:2 eyes,Cataract;2 eyes, vitreous hemorrhage :One eye)�Conclusion: APROP may be encountered in premature in-fants ≥ 1500 g birth weight managed in neonatal intensive care units with limited and variable neonatal care

OR-45Comparing the outcome of single vs multiple session laser photocoagulation of flat neovascularization in Zone 1 Aggressive Posterior Retinopathy of Prematurity: A Prospective, Randomized StudyAnand Vinekar[1], Antonio Capone[2], Sherine Jr�[1], Bhujang Braganza[1], Mike Shetty[2]

1 Narayana Nethralaya Postgraduate Institute of Ophthal-mology, Bangalore, India2 Associated Retinal Consultants, William Beaumont Hospi-tal, Royal Oak, Michigan, USA

Objective: To compare single vs two-session laser photoab-lation for flat neovascularization (FNV) in cases with Zone 1 Aggressive Posterior Retinopathy of Prematurity (APROP)�Methods: Twenty-nine consecutive infants with APROP were randomized for each eye to receive one of the two methods (29 eyes in each group- A or B) proposed by the PHOTO-ROP group� Group A: underwent single session la-ser photocoagulation of the avascular retina underlying the FNV by direct laser over the fronds along with the rest of the avascular retina� Group B: laser in 2 sessions where the avascular retina underlying the FNV was lasered after 7 days when the neovascular fronds had retracted and exposed the avascular strip� Outcome following laser and complications between the two groups were analyzed�Results: The mean birth weight and gestational ages of the infants included was 1276 grams and 30�1 weeks respective-ly� The mean postmenstrual age at first laser was 34�2 weeks� The mean number of laser spots (532 nm green) per eye for primary treatment was 3126 (range 1942 – 4328) spots and the mean number of supplement laser spots (group B) was 265� All eyes (100%) in the study had a favorable outcome with a minimum follow-up of 12 months� Hemorrhages at the FNV site were noted in 41�4% vs 17�2% and residual fibrosis in 10�3% vs 0% in Group A and B respectively� No eye in Group B had hemorrhages larger than 1 disc diameter compared to 25% in Group A�Conclusion: This is the first randomized study to compare the two methods to laser FNV in zone 1 APROP originally suggested by the PHOTO-ROP group� The two-session meth-od results in fewer complications, although the final outcome is not altered� This may be preferred over the single-session treatment� Adequate and aggressive treatment of these zone 1 eyes with the described protocol results in a very high inci-dence of successful favorable outcome�

OR-46Comparison of Systemic Morbidity Associated with Ablative Laser for ROP Using Sedative Versus Non-Sedative Laser

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Natalia Matti, Enrique Ariza, Eugene Ng, Khaled TawansyChildrens Retina Institute, Pasadena CA

Objective: To determine if non-sedative anesthesia can in-fluence systemic morbidity associated with ablative laser treatment in neonates with treatment-warranted ROP�Purpose: To review one decades experience of a multi-center pediatric retina group performing laser ablation in Southern and Central California at 4 settings, including 1) hospitals that routinely intubate preemies for laser, 2) hospi-tals that routinely sedate without intubation, 3) hospitals that have adopted a non-sedative protocol using oral acetamino-phen 15 mg/kg and suckling with sucrose, and 4) outpatient clinics where only acetaminophen + sucrose is permitted�Methods: Retrospective ophthalmic and medical chart re-view of 550 non-intubated preemies treated with bilateral laser from 1/1/02 – 12/31/11 at 3 children’s hospitals, 25 community hospitals, and 5 outpatient clinics�Results: Mean gestational age was 26�3+/- 1�6 weeks, mean birth weight 785+/- 235 grams, mean age at laser 36�1+/- 2�1 weeks, and mean days on ventilator or positive airway pres-sure 47+/- 23 days� Of 136 preemies intubated for laser, 9 required CPR or cardiac support, 5 developed pneumonia, 3 died of respiratory failure, and 70 remained hospitalized for six weeks or more� Of 144 preemies sedated for laser, 6 re-quired CPR and intubation, none developed pneumonia, and 66 remained hospitalized for four weeks or more� Of 150 that received acetaminophen and suckled with sucrose, 4 needed supplemental sedation, none required CPR or intubation or developed pneumonia and 70 remained hospitalized for two weeks or more� Of 120 preemies having laser using acet-aminophen + sucrose in the office, none received sedation, none had cardiopulmonary problems and none were hospital-ized� Mean duration of procedure was 55 minutes for the in-tubated, 36 minutes for the sedated, 29 minutes for the non-sedated but hospitalized, and 19 minutes for the outpatients� Ocular outcomes were similar in all groups and included the need for a second treatment in 16 preemies (2�9%), complete regression with good structural outcome in 546 preemies (99�3%) and macular dragging or retinal detachment in 4 preemies (0�73%)� Chi squared values were significant when mortality was compared between intubated and non-intubat-ed preemies (8�6) and when cardiopulmonary events were compared between sedated and non-sedated preemies (15)�Conclusions: Ablative laser treatment for ROP using a com-bination of oral acetaminophen and suckling with sucrose can be performed reliably with good structural outcomes and possibly lower systemic morbidity and mortality and shorter post-laser hospitalizations than treatment using intubation or sedation�

OR-47Assessment of neonatal care and ROP programmes in MexicoLuz Consuelo Zepeda Romero MD MsCEH1 Prof Clare Gil-bert 2

1 MSc Community Eye Health 2010-2011, Retinopathy of Prematurity Clinic, Hospital Civil de Guadalajara, Guada-lajara, Mexico2 International Centre for Eye Health, London School of Hy-giene and Tropical Medicine, London, United Kingdom

Retinopathy of prematurity (ROP) is the main avoidable cause of childhood blindness in Latin America, including Mexico� A result of constant improvements in the health sys-tem is an <5 Mortality Rate (MR) of 15/1000 live births and an Infant MR rate of 17/1000 live births� Low <5MR as a proxy indicates a low prevalence of childhood blindness, but the IMR rate shows, that ROP is an important public health problem� There is evidence that suggests that the proportion of blindness in children due to severe ROP is high, and that adequate prevention of blindness is not available at all the NICUs� Untreated ROP is the main cause of blindness in ma-jor capital cities of the country�The Mexican Health system is complex and has many dif-ferent providers� In Mexico the “Secretaria de Salud” (SSA) regulates the health policies, practices and standards of care� It provides health services to 38�5% of the Mexican popula-tion with the “Popular Health Insurance” (PHI)�Since 2000, Mexico health system’s has improved access and financial protection� In 2004 the “PHI” was established, which offers free neonatal care� Prematurity and its compli-cations are considered catastrophic expenditure and covered by this schema� PHI reported in 2010, 70% survival for pre-term babies with ≤ 1500 g birth weight�In 2002 with obligatory observance, the OfficialNorm (NOM-034-SSA2-2002), for the prevention and control of the birth defects defines the need of ophthalmic referral for patients born ≤ 35weeks of Gestational Age, with ≥ 5 days of mechanical ventilation� In 2004, the National Council for the Prevention and Treatment of the Vision threatening diseases was constituted� The Mexican Technical Guidelines for the prevention of ROP were published in 2007�The control of childhood blindness in Mexico is a priority of VISION2020 and is included in the action plans of the Pan American Agency of Prevention of Blindness� However, ROP remains an important cause of blindness in children in Mexico, despite there being policies, guidelines and financial support for treatment in place� Review of the literature and findings of a cross sectional study that included the visit of 5 states with more births, and their units with more capac-ity will be discussed; results give insight of the situation and barriers to achieve the control of the epidemic of ROP blind-ness in Mexico�

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OR-48When, where and how to start ROP program when none existsRita Sitorus

OR-49Lessons from regional and national ROP workshopsAndrea Zin and Graham Quinn

A series of in-country workshops have been conducted in various countries throughout the world since the late 1990s with a particular concentration of workshops in Latin Amer-ica� The purpose of these meetings is use the experience and expertise of participants to plan efficient and effective programs for prevention of blindness due to ROP� There are several objectives including:Understand current status (situation analysis) of ROP detec-tion/treatment programs and neonatal care facilitiesDevelop national guidelinesDevelop regional and national short and longer term plans to improve the coverage and/or quality of programsPrepare forms for ROP and neonatal dataEngage parentsThe workshops represent a local effort by in-country or in-region leaders who determine location and attendees (usually NICU nurses, neonatologists/paediatricians, ophthalmologists, and government officials) and who develop the program along with international experts� A series of Latin America ROP workshops started in 1997 with attendees from 8 Latin Ameri-can countries convening in Ecuador and they have generally been funded by nongovernmental organizations such as CBM, ORBIS, and others� This effort has now expanded to include countries in south Asia and Eastern Europe�The four major components of these workshops are gathering epidemiologic and health systems data, ROP team building, increasing local capacity, and developing partnerships with governmental agencies and nongovernmental agencies� They also aim to increase awareness and advocacy in the medical community and the general public, especially parents of at-risk babies�Further workshops concentrate on identifying progress, identifying and addressing barriers, and working out further action plans to promote sustainability of the effort� This mul-tidisciplinary collaboration is a work in progress and will be complete only when adequate systems are in place for ROP detection and treatment for premature babies

OR-50Engaging parents with ROP babiesLuz Gordillo

OR-51Vision training, low vision services and rehabilitationYan Wei, Pei-quan Zhao, Xiao-li KangDepartment of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, People’s Republic of China;

Preterm infants with retinopathy of prematurity (ROP) have been reported to have higher risks of developing myopia, stra-bismus and visual impairment� So even if ROP lesions have regressed, the babies should also continue to receive regular ophthalmologic follow-up for early intervention of refractive errors, amblyopia, strabismus and low vision� The rehabilita-tion start with assessment of residual visual functions, which include visual acuity, contrast sensitivity, binocularity, refrac-tive errors, perimetry and oculomotor functions� The aim of assessing residual visual functions is to detect functional vision that can be improved with the use of optical devices� Following assessment, prescribing appropriate vision therapy training can lead to maximize residual functional vision� Opti-cal devices such as image relocation with prisms to a preferred retinal locus, field displacement to primary gaze position, field expansion, and manipulation of light are practiced today in addition to magnification� After restoration of optimal residual visual functions is achieved with optical devices, one can fol-low with training programs for restoration of lost vision-re-lated skills� Correction of refractive errors, occlusion therapy, enhancement of oculomotor skills, and field restitution are all additional methods now available for prescribing devices lead-ing to rehabilitation of visual functions�

OR-52Planning efficient and effective programsYi ChenPeking University People’s Hospital

Retinopathy of Prematuirty is one of the main causes of childhood blindness� With the increase of the survival rate of premature baby, the incidence of ROP increased in devel-oping country� To plan efficient and effective programs for screening and treating ROP is very important to decrease the ROP blindness� It is very important that have enough human resources, technology and equipment, economic resources and government support� Increasing the public awareness of the disorder also is very essential�

OR-53The ITCROPS (Indian Twin cities ROP Screening) ProgramPadmaja Kumari

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OR-54Management information systems for ROPGerd HolmströmDepartment neuroscience/ophthalmology, Uppsala univer-sity, Sweden

It is well-known that the population of infants at risk of de-veloping treatment-requiring ROP differs in different coun-tries� Therefore, screening ought to be adapted to the country per se and preferably should be based on population-based studies� In Sweden, several population-based studies on vari-ous aspects on ROP have been performed during the last decades� Based on these studies we have been able to modify screening criteria in our country from infants born at less than 33 weeks of gestation to less then 32 weeks� A recent national study on extremely preterm infants with a gestation-al age of less than 27 weeks, made it possible to postpone the first examination a few weeks�Based on the experience and network of screening paediat-ric ophthalmologists from the national study, a web-based national register (SWEDROP) for ROP-screening was build up and initiated in late 2006, with the purpose to further im-prove the quality of screening� Today more than 4000 infants are registered in SWEDROP, which has a national coverage of around 95 % of infants born before 32 weeks of gestation in Sweden� Data on infants born 2008 to 2009 have recently been analyzed and the results have further implications on screening in Sweden�Regardless of previous ROP screening, web-based manage-ment information systems may offer help when building up screening, for collection of data and to achieve knowledge of the local situation of ROP� Further, they provide valuable help when designing screening programs�

OR-55The importance of policy in ROP: The Latin American experienceJuan Carlos SilvaPan American Health Organization, World Health Organiza-tion

ROP interventions have become a priority in Latin America due to national and regional leadership and strong sup-port of the international organizations� Many countries are moving from NGO and personal commitment to MOH and governmental support, at the regional level the ministers of health approved a plan of action that includes ROP in 2009 at the Pan American Health Organization Directing Council� To get several countries in the region having policies and/or regulations, leading to financing structures for improving neonatal care and for examination or for laser treatment, a systematic advocacy approach was used� Evidence was gen-erated, disclosing the importance of ROP as the main cause of blindness, and several prevalence studies were done at the country level to reveal the magnitude of the problem� To re-spond to the needs, strategies and tools were elaborated and then provided to the countries� The evidence and strategies were widely disseminated through several national work-shops supported by IAPB, CBM and PAHO� These national courses and workshops were used to make coalitions around the ROP needs� National health authorities were approached at the regional and national level requesting the formula-tion and implementation of ROP policies� Several counties respond organizing national ROP committees, elaborating strategies, operational plans, guidelines and policies� Many countries are already increasing program coverage and mak-ing significant progress in neonatal and ophthalmologic care� This is the result of a coordinated effort between national and international stakeholders�

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PO-01The early change of oxygen-induced retinopathy and the effect of 17-beta-estradiol on itHongBing Zhang1,2, NaiXue Sun1, HouCheng Liang2, Xiang-Hua Xiao2, XianNing Liu2, YaNi Wang2

1 The Second Affiliated Hospital of Xian Jiao tong University2 Eye Institute of Shaanxi Province

PURPOSE: To explore the early morphological and oxida-tive stress changes of oxygen induced retinopathy (OIR) and the effect of 17β- estradiol (17β-E2) on it�METHODS: Newborn mice were kept in hyperoxia (75%±2%) from postnatal day 7 (P7) to P12, then in nor-moxia from P12 to P14, and simultaneously, daily subcutane-ous injections of either different doses of 17β-E2 in vehicle or vehicle alone were administered� Retinal flat mounts were scored for the percentage of capillary-free/total retinal area on P9� Malondialdehyde (MDA) and vascular endothelial growth factor (VEGF) concentrations, and the activity and quality of reduced nicotinamide adenine dinucleotide phos-phate (NADPH) oxidase in the retinas were determined on P9 and P13 (14) respectively�RESULTS: Vascularization was almost completed in the ret-inas of pups exposed to normoxia on P9, while capillary-free area was found in the retinas of pups exposed to hyperoxia on P9, and which was reduced in a dose-dependant man-ner in the retinas of 17β-E2 treated pups, and no notable neovascular tufts and clusters was found on the border of capillary-free and vascular zone� The concentration of MDA, and the activity and quality of NADPH oxidase, elevated sig-nificantly in the retinas of pups exposed to hyperoxia on P9, followed by on P13, were significantly decreased by 17β-E2 in a dose-dependant manner� The concentration of VEGF, significantly decreased on P9 and increased on P14 in the retinas of pups exposed to hyperoxia, was elevated on P9 and decreased on P14 in the retinas of 17β-E2 treated pups� The effect of 17β-E2 on the retinal morphology, MDA concen-tration, and the activity and quality of NADPH oxidase was significantly reversed by ICI182780�CONCLUSIONS: Notable morphological and oxidative stress alterations take place in OIR early phase, 17β-E2 can significantly ameliorate early OIR via NADPH oxidase�

PO-02retinopathy of prematurity in multiple infantsping wang, lijuan tao, xilang wang, xirong gaoHunan Childrens Hospital

Objectives: To investigate the clinic characteristics of ROP in twins or multiple infants�Methods: Premature infants admitted to Hunan children’s hospital Ophthalmology Department ＆ Neonatal Depart-ment from 2006 to 2011 were screened for ROP and recorded as ICROP stage, systemic complicins, clinical characteristics of ROP in multiple infants and singletons were analyzed�Results: 1� 3049 premature infants (BW ≤ 2000g,GA ≤ 35w), 25082 singletons, 7934 twins and 33 triples, underwent ROP screen� 394 patients (12�92%) were diagnosed with ROP, 1�17% of 4~5 stage, 16�24% of 2~3 stage, 82�59% of 1~2 stage� The incidence of ROP in multiple infant was higher than that in singleton group� Lower birth weight and gesta-tion age were more common in multiple infants�Conclusions: ROP developed more frequently and earlier in multiple infants than in singletons because birth weight and gestation age are more lower and often with systemic com-plications in multiple fetus than in single infants�

PO-03Clinical analysis of retinopathy of prematurity in cases with multiple gestational birthsTang Song, Zhang Guoming, Lian Zhaohui, Tan Wenjing, Guo JinlianShenzhen Eye Hospital,Shenzhen Ophthalmic Center of Medical College, Jinan University,Shenzhen 518034,China

Objective: To analyze the clinical incidence and treatment of retinopathy of prematurity (ROP) in multiple births infants�Methods: Retrospective analysis of retinal screening of the patients with multiple gestational births from June 2003 to February 2012, All infants were examined by digital pho-tography using the RetCam Digital Retinal Camera and binocular indirect ophthalmoscope� The data obtained were analyzed statistically�Results: A total of 1667 cases included twins 1582 cases,triplets 81 cases and quadruplets 4 cases,221 cas-es(13�25%) developed ROP�In all examined infants, ges-tation age ranged from 24�5 weeks to 41 weeks with the average weeks of 33�76 and the birth weight ranged from 700 grams to 3900 grams with the average weight 1753 grams�106 cases underwent treatment,and the ratio is 6�35%� Further analysis of the data obtained, the incidence of ROP is 12�57 % （199/1582）in twins,32�78%(20/81) in triplets and 50%(2/4) in quadruplets�Corresponding to the ratio of treat-ment is 6�13%(97/1582) in twins,13�5%(11/81) in triplets and 25%(1/4) in quadruplets�

Abstracts for Poster Presentation

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Conclusion: The overall incidence of ROP of multiple gesta-tional births has no increased significantly�With the increase of the number of births,the incidence of ROP and the ratio of treatment both showed significant growth�The results sug-gested we need to pay close attention to retinal screening for the patients of multiple births and prevent the risk of ROP in the clinical�

PO-04The effects of preterm birth on an animal model of oxygen-induced retinopathy in miceZhaojie Chu1, Yusheng Wang1, Guorui Dou1, Xiaojie Qu1, Ye Zhang2, Rong Li1

1 Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University2 Department of Infectious disease, Tangdu Hospital, Fourth Military Medical University

Purpose: The main risk factors of retinopathy of prema-turity (ROP) are low gestational age and low birth weight, which were mainly caused by preterm birth� Currently, the animal model of oxygen-induced retinopathy (OIR) in mice is adopted as the most widely used model in ROP associated researches� However, there are some limits regarding to the OIR models� Mice in the experiment keep normal term birth, and can not mimic the real pathogenesis status of human ROP patient� Thus, in the present study, we tried to investi-gate the pathological changes of retina when preterm birth mice are enrolled in the procedure of OIR�Methods: Preterm birth mice were obtained from pregnant C57BL/6 mice induced by intraperitoneal injection of lipo-polysaccharide (LPS)� Preterm and control mice (term pups born from saline treated dams) were placed in a high oxygen (75%) chamber by postnatal 7 day (P7), and recovered to normal air by postnatal 12 day� Mice were perfused with high molecular FITC-Dextran by P12, 15, 17, then retinas were whole-mounted and imaged by laser scanning confocal microscope� The VEGF mRNA was also detected in P12, 15, and 17� Cross-sections of retina were stained with hematoxy-lin and eosin (H&E), to allow for the identification of any preretinal neovascular tufts by P17� The whole retinal images were taken by microsope for observation of pathological changes such as retinal hemorrhage�Results: The preterm labor rates of pregnant mice and sur-vival of infants were 86�7% (13/15) and 74�7% (56/75), respectively� The birth weights of preterm mice were lower than control mice and so did the body weight during lacta-tion period� Leakage of retinal blood vessel was aggratated in preterm mice, and displayed by images of FITC-Dextran per-fused retinas, especially on P12 and P15� The non-perfused area of retina and the amount of preretinal endothelial cell nuclei was smaller than control on P17� VEGF mRNA level

in retinas was higher on P12 and P15, but lower on P17 com-pared with control mice� Retinal hemorrhage was observed in preterm mice group�Conclusions: When preterm birth mice were enrolled in the procedure of OIR, some pathological features such as retinal hemorrhage, severe retinal leakage and moderate retinal neo-vascularization were emerged, which were similar to clinical manifestations of ROP patients� These data may be signifi-cant in elucidation the mechanism of ROP�preterm birth,oxygen-induced retinopathy, retinopathy of prematurity, animal model

PO-05Proliferation and Activation of Retinal Microglia Promote Vascular Repair in the Mouse Model of Oxygen-induced RetinopathyXiaoshuang Jiang, Gezhi Xu, Yingqin NiDepartment of Ophthalmology, Eye & ENT Hospital of Fu-dan University,

Background: Retinal neovascularization (NV) is a major cause of blindness in ischemic retinopathies and cell-based therapy represents an emerging approach to correct the un-derlying vascular abnormalities� Microglia and its progenitor were suggested to play great role in stabilizing and facilitat-ing vascular repair, but there is problems about the cell trans-plantation� Macrophage-conlony stimulating factor is the main regulator of proliferation and activation of microglia� Here we investigated whether more activated microglia, pro-duced by stimulation of M-CSF, can accelerate the revascu-larization and NV regression in oxygen-induced retinopathy (OIR)�Methods: C57/BL6 mice were exposed to 75%±2% oxygen (P7-P12) and received intraperitoneal injection of M-CSF at post-natal day 12 (P12)� Clodronate liposomes were injected into the peritoneal cavity and vitreous of mice at P12 to eliminate retinal microglia� The eyes were collected at P15, P17, and P21 to analyze the retinal microglia and revascular-ization� Western blot, RT-PCR and immnunochemistry was applied to evaluate the retina M-CSF, CSF-1R and CD11b (marker of microglia)�Results: Retinal microglia made up a net between the vas-cular, providing connections� In OIR, microglia became acti-vated and reduced at early phase and increased at late phase� Intraperitoneal injection of M-CSF could induce retinal microglia proliferation at early phase, more amoeboid-like microglia located along the main blood vessel and was found in larger density in the NV area to facilitated normalization of the vasculature� The process of revascularization and NV regression were accelerated in the OIR with M-CSF injec-tion�Conclusion: Retinal microglia can proliferated through be-

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ing stimulated by M-CSF and promote the process of revas-cularization and NV regression in OIR model�Microglia, M-CSF, Proliferation, Activation, Oxygen-induced retinopathy

PO-06Aggressive posterior retinopathy of prematurity in triplets: a report of 2 cases.Yu Dong1, Dan Wang1, E Song1, Bo Zhang2

1 First Hospital of Jilin University, Department of Ophthal-mology, Changchun, PR China2 First Hospital of Jilin University, Department of Neurosur-gery, Changchun, PR China

Aggressive posterior ROP (AP-ROP) is identified as a rare, rapidly progressing and severe form of ROP� It occurs most commonly in zone 1, but might also be found in posterior zone 2� If untreated, it usually progresses rapidly to stage 5 disease in 3-4 days without exhibiting the classical course that includes stages 1-3� We report the diagnosis and treat-ment of 2 AP-ROP cases in triplets born at low birthweight and small gestational age� To our knowledge, this is the first report of triplets presenting with AP-ROP�A female infant (triplet 1) was born at 31 weeks’ gestational-age with birth weight of 1300 g� The mother of the triplets was a 38-year-old woman with pregnancy-induced hyperten-sion (PIH)� Retinopathy of prematurity (ROP) was present when he was screened at 33�5 weeks’ gestational age� Bi-lateral threshold ROP was reached at 34 weeks’ gestational age (zone 2 with plus disease) and the diagnosis of AP-ROP was made� Both eyes were treated with an argon ion laser via a 30-diopter lens anterior to the ridge� Regular inspections were carried out once a week� Her platelet count before laser treatment was 7410/L� No adverse cardiovascular or other complications were noted duringor after treatments� At ten-month follow-up fundus of both eyes showed well-regressed ROP in the lasered retinal periphery�Triplet 2 was a male infant at a birth weight of 1160 g who reached bilateral threshold AP-ROP on his screening exami-nation at 35 weeks of gestation (zone 1 with plus disease bilaterally)� Laser treatment was actualized the next day� The preoperative platelet count of this case was 21110/L � No sys-temic complications were noted� AP-ROP of both eyes was well regressed gradually throughout the ten-month follow-up period�The third triplet had more critical systemic diseases than his siblings at birth� Diagnoses of septic shock and acute conges-tive heart failure were made on the 6th day� The infant died of respiratory and circulatory failure without ROP screening examination�aggressive posterior retinopathy of prematurity, triplet, la-sered retinal periphery

PO-07Pleiotropic effects of Dll1-RGD in mice oxygen-induced retinopathyGuorui Dou1, Xingcheng Zhao1, Zhaojie Chu1, hua Han2, Yusheng Wang1

1 Dept.Ophtalmology, Xijing Hospital2 Dept.Developmental biology and medical genetics, Fourth Military Medical University

Purpose: Recent progress highlights Notch signaling in ischemia-related ocular angiogenesis� Delta like 1(Dll1), a critical Notch ligand in vascular development, has been identified as a potential facilitator of reparative angiogenesis� Here, we construct a novel fusion protein Dll1-RGD contain-ing RGD motif that can ligate endothelial cell (EC) integrin, to investigate its role on mice models of oxygen induced reti-nopathy by specific activation of Notch in EC�Methods: Dll1-RGD fusion was manufactured in E.Coli� The specification of this recombinant to EC was observed by adherence assay� Its Notch activating activity was detected in human umbilical vein endothelial cells (HUVEC) and down-stream genes� The role of Dll1-RGD on vascular growth was observed in neonatal C57BL/6J mice injected with Dll1-RGD subcutaneously� Bead assay, transwell chamber and tube formation were conducted to study biological behaviors of HUVEC treated by Dll1-RGD� Neonatal C57BL/6J mice was taken into 75% oxygen chamber from P7-P12 and were injected with Dll1-RGD subcutaneously on P12� The area of retinal angiogenesis was analyzed on P17�Results: Dll1-RGD greatly enhanced Notch signaling in EC� In vitro, the anti-angiogenic role of Dll1-RGD was identified in the endothelial cell sprouting, migration and tube forma-tion� In the developing retinal vascular formation, Dll1-RGD attenuated the growth of retinal vasculature, as branching loops and tip cells were greatly decreased� Specific activation of Notch by Dll1-RGD induced regrowth of retinal vessels following oxygen-induced retinopathy on P17� Pleiotropical-ly, it prevented the formation of preretinal neovascular tufts, but promotes formation of intraretinal capillaries following oxygen-induced retinopathy�Conclusions: Our data provide Dll1-RGD as a potential therapeutic strategy to ischemia-related ocular angiogenesis by enhancing Notch signaling in EC�Notch signal, oxygen-induced retinopathy, angiogenesis

PO-08Telemedicine detection of type 1 ROP in a distant neonatal intensive care unitDaniel WeaverBillings Clinic, Billings, Montana, USA

Purpose: To demonstrate the feasiblility of telemedicine

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screening for retinopathy of prematurity (ROP) by sum-marizing the results of our experience screening premature infants at a distant hospital in a rural location in the United States�Methods: Records of all premature infants remotely screened for ROP at a neonatal intensive care unit in Great Falls, Montana, USA, from January 1, 2007 to June 30, 2011 were retrospectively reviewed� The RetCam II imag-ing system was used to capture retinal images, which were then posted on a secure server for evaluation by one of two pediatric ophthalmologists� Infants suspected of having ROP approaching the criteria for laser treatment were transferred to a distant hospital in Billings or Missoula where a diagnos-tic examination was performed and treatment administered when indicated� All other infants received an outpatient diag-nostic examination within 2 weeks of discharge�Results: A total of 582 telemedicine examinations were per-formed on 137 infants during the study period� Of 13 infants transferred for referral-warranted ROP, 9 ultimately required laser treatment� Good outcomes were noted in all cases, with none progresssing to stage 4 or 5 ROP�Conclusions: Telemedicine ROP screening detected patients at a distant, medically underserved facility who were in need of laser treatment allowing prompt transfer with no poor out-comes over a 4�5 year period� Our experience demonstrates the utility of remote screening for ROP�This material is scheduled for publication in the June, 2012 issue of The Journal of the American Association for Pediat-ric Ophthalmology and Strabismus (J AAPOS)�Telemedicine, type 1 ROP, distant

PO-09EFFICACY OF COMBINE LASER-RANIBIZUMAB THERAPY FOR RETINOPATHY OF PREMATURITY WITH UMBRAL/PRE-UMBRAL AND “PLUS DISEASE”Luis Porfirio Orozco-Gomez, Leonor Hernandez-Salazar, Silvia Moguel-AncheitaRetina Department. National Center of Mexico.

Background: The “Early Treatment for Retinopathy of Pre-maturity Cooperative” reported 55�2% of failure using laser in zone 1 for retinopathy of prematurity treatment� We have to offer better alternatives for those patients�Objective: To evaluate the efficacy of combine laser-ranibi-zumab therapy for retinopathy of prematurity with umbral/pre-umbral and “plus disease” and to study the children de-velopment�Methods: This is a prospective, experimental, longitudinal and open study including less than 32 week of pregnant or less than 1500 g babies, having umbral/pre-umbral retinopa-thy or “plus” disease� The effect of treatment was analyzed

and the children development was determined�Results: We have studied 62 eyes of 32 patients� Born age was 29�9 +2�6 weeks� Born weight was 1,120+253g� The statistics demonstrated an important relation between reti-nopathy severity and low prematurity age and also a most probability of having an umbral/preumbral disease to 29�4 weeks age old or 1204 g weight� The Bayley scale reported: normal development in 23�5%, global retardation in 23�5%, psychomotor retardation but mental behavior normal 29�4%, mental retardation but psychomotor normal 23�5%� We dem-onstrated regression of retinopathy in all cases� Vascular tor-tuosity persistence was in 17�6%, without vascular dilatation, vitreous membrane development was in 11�7%�Conclusion: Laser-ranibizumab treatment has permitted a better control of retinopathy for umbral-preumbral and plus disease in this group of patients�retinopathy, prematurity, ranibizumab, laser.

PO-10Variations in the Morphology of ROP in Extreme PrematurityEd Schulenburg, Gina TsanaktsidisImperial College NHS Trust

Aims: To investigate the morphological differences of shunt lesions which occur in threshold disease of extreme prematu-rity� Also to investigate the retinal capillary bed at threshold in these cases�Method: An observational case series of 6 infants with a birthweight of less than 1000 grams and a gestational age of less than 26 weeks who displayed specific features of threshold disease� The variations were documented by colour photography and fundus flourescein angiography before laser treatment�Results: Stage III threshold ROP in extreme prematurity, may be characterised by a morphological variant different to that found in classic shunt formation at threshold� A poorly developed capillary bed was demonstrated in the already vascularised retina in some of the cases�Conclusion: This case series demonstrate that a morphologi-cal variation exists in extreme prematurity� Established plus disease can be reached without the typical arterio-venous shunts at the demarcation line� The lack of typical shunts may lead to an unnecessary delay in treatment in these cases and increase the risk of failed treatment� Plus disease remains the most reliable clinical sign indicating the need for treat-ment�Shunt lesions morphology, fluorescein angiography, vascular development, threshold disease

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PO-11Treatment of active stages of retinopathy of premature babies with the use of modern technologiesAlexandr Tereshchenko, Yury Belyy, Irina Trifanenkova, Margarita TereshchenkovaKaluga branch of S.N. Fyodorov “Eye Microsurgery” Fed-eral State Institute, Russia

Purpose: – to show the basic regulations of the complex ret-inopathy of prematurity (ROP) treatment with use of retinal pattern scanning laser coagulation and early vitrectomy�Materials and methods: Pascal pattern scanning lasercoagu-lation is performed for stage 2 ROP type 2, stage 3 ROP type 2 and subclinical stage and early clinical stage of aggressive posterior ROP (The academician S�N� Fyodorov Federal State Institution «IRTC «Eye Microsurgery» Kaluga brunch classification)� Early 3-ports 25G vitrectomy is performed if ROP progressing 2-4 weeks after the laser treatment�Results: In 2003-2011 823 different interventions for infants with active ROP was performed: 737 retinal lasercoagula-tions, 3-ports vitrectomy – 72, 3-ports lensvitrectomy – 14� Treatment efficacy was 98,6% for stage 2 and stage 3 ROP (regress of the disease occurred in 557 of 565 eyes), and 74,4% for aggressive posterior ROP (regress of the disease occurred in 128 of 172 eyes)� The total efficacy of the com-plex treatment was 92,9% (regress of the disease occurred in 685 of 737 eyes)�Conclusion: The basic regulations of the complex ROP treatment are early, within first 6 weeks of chronologic age, photocoagulation to delay progression of the retinal detach-ment and to stabilize vascularity, and early vitrectomy if ROP progressing after the laser treatment�retinopathy of prematurity, aggressive por example IFN-b or IFN-beta, etc.

PO-12“ROP-MORPHOMETRY” for retinopathy of prematurity quantificationAlexandr Tereshchenko, Yury Belyy, Irina Trifanenkova, Margarita TereshchenkovaKaluga branch of S.N. Fyodorov “Eye Microsurgery” Fed-eral State Institute, Russia

PURPOSE: To design a semiautomated three-dimensions image analysis software for quantification of ROP via retina and retinal vessels parameters�METHODS: The soft “ROP-MORPHOMETRY” is based on projection of wide-angle digital «RetCam» images on a spherical surface of the virtual three-dimensional eye globe model� An algorithm for digital retinal photos registration to receive three-dimensional fundus picture of any patient with

ROP is worked out� It is necessarily to make seven sequential retinal images� Image 1 is the central area, showing both disk and macula in preterm infant with ROP; image 2 occupies disk on the one side and ora serrata on the other nasal side; image 3 occupies macula on the nasal side and ora serrata on the temporal side; image 4 is an superotemporal area; im-age 5 is an inferotemporal; image 6 is an superonasal; and image 7 is an inferonasal area� The software projects two-dimensional retinal images on the three-dimensional spheri-cal surface of the eye globe virtual model� A user can be free in movements, rotation and ranging both images and the eye globe virtual model�RESULTS: The program allows to calculate all the retina and retinal vessels features, that play a role in ROP patho-logical process� It can calculate eleven parameters, which are necessary for objective determination and prognosis of ROP course� The main diagnostic and prognostic parameters are the major posterior pole blood vessels diameter and tortuos-ity index; vascularized and avascular retina square; an angle between the vascular arcades; localization of ROP patho-logical process in zone one, two and three� The software allows also calculating the diameter and tortuosity index for peripheric retinal vessels� We revealed that dilation and tor-tuosity of peripheric vessels testified to ROP progress� For example, the early morphometric features of aggressive pos-terior ROP that were revealed in fifty six eyes of twenty eight prematurely infants on fifth week of chronologic age, are: D arteries – 85,50±1,50 microns, D veins – 120,75±2,50 microns, Tortuosity index – 1,31±0,05, D peripheric vessels – 6,50±0,50 microns, Peripheric index – 1,40±0,04, Vascu-larized retina index – 0,24±0,05�CONCLUSION: ROP quantification by means of the soft-ware “ROP-MORPHOMETRY” for retina and retinal ves-sels three dimensional digital analysis has the potential to determinate subjectivity the ROP course and to optimize the timing of follow-up and treatment for ROP� Overall, computer-based image analysis could provide added value to telemedicine systems�retinopathy of prematurity, vascularized and avascular retina square, angle between the vascular arcades

PO-13Stages of providing comprehensive eye care premature children with retinopathy of prematurityAlexandr Tereshchenko, Yury Belyy, Irina Trifanenkova, Margarita TereshchenkovaKaluga branch of S.N. Fyodorov “Eye Microsurgery” Fed-eral State Institute, Russia

Purpose: functional results analysis of ophthalmologic help system for premature infants, which includes the full cycle of early revelation, treatment and regular medical check-up

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activities for patients with ROP in Central region of Russia�Materials and methods: Fields for ROP screening were per-formed in premature infants medical care units by clinic spe-cialists� Infants with revealed ROP were directed to Kaluga brunch of IRTC «Eye Microsurgery» for detailed diagnostic examination and subsequent treatment and monitoring�Results: In 2003-2011 454 fields in Kaluga, Tula, Bryansk, and Orel regions were made� 8861 infants were examined� ROP was found in 1834 infants (20,7%)� 823 different in-terventions for infants with active ROP was performed: 737 retinal lasercoagulations, 3-ports vitrectomy – 72, lensvitrec-tomy – 14� The total efficacy of the treatment was 92,9%�Conclusion: The ophthalmologic help system for premature infants in Central region of Russia combines all directions from detailed diagnostic to hich-technology treatment� It al-lows to reproduce one all over the Russian Federation terri-tory�retinopathy of prematurity, aggressive posterior retinopathy of prematurity, ophthalmologic help system

PO-14A Study of Characteristics on Retinal Vascularization of Preterm InfantXianqiong Luo, Jiangbo JiangGuangdong Province Women and Childrens Hospital

Background: With the improvement of perinatal care, the survival rate of preterm infants and the incidence of reti-nopathy of prematurity (ROP) is increasing� The purpose of this article is to study the relationship between retinal vas-cularization of different zone and gestational age, in order to explore the reasonable ROP screening time and follow-up duration for premature babies with ROP�Method: Prospective study� Data from infants with birth weight less than 2000g premature and low birth weight born or hospitalized in the Maternity and Child Care Centers of Guangdong Province during 1st Sep 2009 and 31st Aug 2010� Retinal examination in preterm infants should be performed by ophthalmologists who had sufficient knowledge and ex-perience to identificate the location and sequential retinal changes of ROP accurately using binocular indirect ophthal-moscope� The following schedule is 1 week for immature vascularization of zone 1, 2 weeks for immature vasculariza-tion of zone 2, 3 weeks for immature vascularization of zone 3� The correlation between the process of retinal vasculariza-tion and postmenstrual age is analysed by Spearman correla-tion analysis�Results: (1)The pocess of retinal vascularization is positive-ly related with postmenstrual age� The proportion of retinal vascularization at zone 2 and zone 3 on each postmenstrual age is significantly differ rent (P<0�05)� (2)The median gestational age of infants with full retinal vascularization at

zone 2 is 38 weeks (range 32�2-40�4 week), while the median age of infants with full retinal vascularization at zone 3 is 41 weeks (range 36�0-42�6 week)�Conclusion: For most prematurity infants, the retinal vas-cularization is still in progress after birth, which means it’s vulnerable to a wide range of interferences, that is a potential reason of ROP formation� Our study revealed that the full retinal vascularization completes in 41 weeks of gestational age� However, a moiety of prematurity would have dis-charged already at that time� Therefore, the follow-up exami-nation is essential and should be carried out on time�retinal, vascularization, prematurity

PO-15Study on the pathogenesis of prematurity retinopathyyijie chou1, Ling Wang2,2, Peisong Wang3,2

1 Chengdu Medical College affiliated kangqiao eye hospital group of ophthalmology hospital of AI ER2 Medical College of Qiingdao University Affiliated Hospital3 Medical College of Qiingdao University Affiliated Hospital

Objective: excessive inhalation of oxygen can cause retinop-athy of prematurity (ROP) is a fact that does not dispute, but also no unifying mechanism of conclusions; through animal experiment under high oxygen pressure (HBOT) state, detec-tion of retinal blood flow and plasma endothelin (ET - 1), insulin-like growth factor (IGF - 1) and oxygen free radicals, and excessive inhalation of oxygen relationship, explore the mechanism of retinopathy of prematurity;Methods: to measur:endothelin (ET-1), insulin-like growth factor (IGF-1), oxygen free radicals and retinal blood flow ander the HBOT condition;Results: Intraocular ET 1 content: (pg/ ml):is “0” in the control group;but,HBOT group of 24 hours to reach 96�53; and the last 5 hours of a high level of state; IGF 1 concentra-tion (ng / ml): control group: 7�42 ± 1�18;HBOT group:72 hours later, 19�81 ± 1�41; retinal MDA content: is obviously higher than the control group, and treatment times were positively correlated;retinal,blood flow (ml/min/g):control group is 16�8691 ;HBOTgroup:immediately after the treat-ment:0�2088;Conclusions: In the HBOTstate, Retinal and choroidal isch-emia is obvious;When to leave after HBOT, Enter a rela-tively hypoxic condition, Retinal/choroidal vascular rapid expansion and a lot of blood influx, formation of ischemia reperfusion injury;In ET,IGF-1 and oxygen free radicals under the common A lot of Neovascular proliferation in the avascular zone of the Premature infant, So,ROP formation!ROP pathogenesis

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PO-16Longitudinal Association between Thrombocytopenia and Retinopathy of PrematurityGil Binenbaum1,2, Anne Jensen1, Gui-shuang Ying2, Jiayan Huang2, Haresh Kirpalani1, Graham Quinn1,2

1 The Childrens Hospital of Philadelphia2 Scheie Eye Institute, University of Pennsylvania

PURPOSE: To evaluate the temporal course of the associa-tion between thrombocytopenia and subsequent development of severe ROP�METHODS: Retrospective case-control study� Cases (n=100) received laser photocoagulation for type 1 ROP, un-matched controls (n=100) developed no ROP or stage 1 ROP� All available serum platelet levels were abstracted� We com-pared proportions of cases versus controls with thrombocy-topenia (platelet level < 150,000 per mL) on a weekly basis from birth through the time of laser� Multivariate regression was used to adjust for gestational age, birth weight, culture-proven sepsis, and necrotizing enterocolitis�Results: For each post-menstrual age (PMA) week between 24 and 34, the proportion of cases with thrombocytopenia (range 43% to 100%) was double or nearly double that of controls (21% to 44%) (p valuesConclusions: Thrombocytopenia from birth through 34 weeks PMA was independently associated with subsequent severe ROP but not for later time periods� This finding sug-gests that a pro-angiogenic effect of platelets (e�g�, delivery of insulin-like growth factor 1) may play a role in normal retinal vascular development in infants at risk for ROP� The roles of a threshold effect or cumulative platelet deficit also warrant further investigation�ROP, thromboctyopenia, platelets

PO-17Aggressive posterior retinopathy of Prematurity: Risk factors for retinal detachment despite confluent laser photocoagulation.Gaurav Sanghi1,2, Mangat Dogra1, Neha Kumari1, Mohit Dogra1, Deeksha Katoch1, Amod Gupta1

1 Advanced Eye Centre,PGIMER,Chandigarh,India2 Grewal eye institute,Chandigarh,India

Purpose: To analyze risk factors for retinal detachment (RD) in eyes with aggressive posterior retinopathy of prematurity (APROP) treated with confluent laser photocoagulation�Methods: Records of infants undergoing laser treatment for APROP at a tertiary institute from January 2006 through June 2010 were analyzed retrospectively� Eyes with RD at presentation and lost to follow-up were excluded� We defined two groups based on outcome after confluent laser photoco-agulation: RD or favorable outcome� Two groups were com-

pared for birth weight, gestational age, post conceptional age at laser treatment, zone of APROP, preretinal hemorrhages, pre existing fibrovascular proliferation, tunica vasculosa lentis, number of laser spots ,relaser and new onset fibrovas-cular proliferation � Data was analyzed using univariate and multivariate logistic regression analysis�Results: One-hundred nineteen eyes of 61 infants underwent laser treatment for APROP� Ten (8�4%) eyes were excluded and 109 eyes (91�6%) included� Nineteen (17�4%) of 109 eyes progressed to RD� On univariate analysis, multiple fac-tors were associated with RD� Of these, all eyes with poste-rior zone 1 disease and all eyes developing extensive fibro-vascular proliferation (>3 clock hours) after laser progressed to RD� On multivariate analysis ,the most significant pre-dictors of RD were gestational age <29�5 weeks(p=0�006), hemorrhages(p=0�003), need for relaser(p=0�006) and new onset limited fibrovascular traction( (p=0�042)�Conclusion: A gestational age significant pre-laser risk fac-tors for RD in APROP� Of the post laser events, new onset fibrovascular traction is significantly associated with devel-opment of RD�APROP, retinal detachment, retinopathy of prematurity,laser photocoagulation.

PO-18Addressing the surgical pathology of stage 4 ROP- RETCAM based evaluation and timely surgical intervention.Salil Gadkari, Sucheta Kulkarni, Madan DeshpandeH V Desai Eye Hospital, Pune, INDIA

Purpose: to highlight the importance of clear understanding and documentation of surgical pathology of stage 4 ROP and its cor-rection by Pars Plana Vitrectomy using a 23 G vitreous cutter�Method: A retrospective case series of 17 eyes which we op-erated at our institute from July 2009 to March 2012� Careful RETCAM images were recorded pre and post surgery to fo-cus on (a) Posterior Pole, (b) Retro lental area, (c) and ridge area� All eyes underwent Pars Plana vitrectomy� We used a 23 G vitreous cutter for performing the dissection� Relief of vitreous traction resulting in flat retina at the posterior pole was considered as anatomical successResults: 14 eyes showed anatomical success with documented resolution of the surgical pathology after surgery� Causes of fail-ure in 3 eyes were also documented in the form of oral disinser-tion , iatrogenic break, and inadequate relief of VR traction�Conclusion: RETCAM based evaluation allowed to plan a proper preoperative strategy after understanding the surgi-cal pathology in greater detail and evaluate the success and shortcoming of the surgery� Added benefits included proper counseling of the parents and also for medicolegal reasons�ROP surgery, RETCAM

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PO-19Polymorphism of Structural Changes of Retina and Vitreous at 4 Degree of Cicatricial Retinopathy of PrematurityDmitry Ryabtsev, Ludmila Katargina, Ludmila KogolevaMoscow Helmholtz Research Institute of Eye Diseases

Purpose: to study structure of retinal folds and adjacent parts of the vitreous with 4 degrees of cicatricial retinopathy of prematurity (ROP) using a spectral-domain optical coher-ence tomography (SD-OCT)�Methods: We examined 28 children (35 eyes) with 4 degree of cicatricial ROP aged from 6 months to 16 years� In addi-tion to the traditional ophthalmic examination all patients underwent SD-OCT (Spectralis HRA+OCT, Heidelberg En-gineering, Germany)� We evaluated structure of the retinal folds and adjacent parts of the vitreous�Results: Ophthalmoscopic examination reveal following changes: avascular regions (35 eyes, 100%), shift of vascular bundle (34 eyes, 98%), extraretinal tissue (22 eyes, 63%), retinal folds (35 eyes, 100%), dystrophic and atrophic focus-es (15 eyes, 43%), tractional retinoshizis (13 eyes, 37%)� The study of SD-OCT scans revealed three types of extraretinal changes, that were found in all eyes, but that were presented in various combinations� Retinal folds had different struc-ture that allowed us to distinguish according to the structural features, the degree and direction of traction four of the most characteristic types�Conclusion: The structure of retinal folds depends on degree and direction of traction� We discovered the possibility of increase of retinal traction in cicatricial phase of ROP that demonstrates the importance of continuing research in this direction�spectral-domain optical coherence tomography, retinal folds

PO-20Retinal laser coagulation for retinopathy of prematurity under topical anesthesiaXunda Ji, Qi Zhang, Peiquan ZhaoDepartment of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Aim: To introduce technique of laser treatment for retinopa-thy of prematurity (ROP) under topical anesthesia�Method: 532nm green or 810nm diode laser was performed to treat threshold or pre-threshold ROP under topical anes-thesia� The patients were hold with a towel� Two assists help to hold the head and body� Laser photocoagulation using indirect ophthalmoscope was performed after delivery of al-caine eye drops� A depressor was used to rotate and stabilize the globe� The depressor was respectively held against the forniceal conjunctiva and eye ball to help for laser coagula-

tion of zone 1 and zone 2 adjacent to zone 1, and the rest part of zone 2 and zone 3� Hypertension glucose saline was used to keep the cornea moistened and avoid the corneal edema�Results: 131 ROP eyes (67 patients) received laser treat-ment� ROP regressed completely in 125 eyes� Complication during surgery was as follow� Corneal edema happened in 26 eyes� Corneal epithelium was scaled off for improve-ment of visualization in 3 eyes� Retinal hemorrhage due to over high energy of laser happened in 8 eyes� There was no severe systemic complications such as apnea� Post-operative complication is as follow during 2 weeks to 4months follow-up� Corneal edema happened in 3 eyes� Vitreous hemorrhage occurred in 2 eyes� Corneal edema and vitreous hemorrhage improved after drug treatment� Posterior synechia of the iris hampering observation of fundus occurred in 3 eyes� No reti-nal detachment was noted in the 3 eyes with B scan� Rheg-matogenous retinal detachment happened in one eye and was cured after vitreoretinal surgery� Untreated ‘skip’ areas oc-curred in 5 eyes� The second laser treatment was performed for the untreated ‘skip’ areas in the 5 eyes�Conclusion: Retinal laser coagulation for retinopathy of prematurity under topical anesthesia is a safe and effective method, especially for patients who can not undergo general anesthesia due to poor general condition�laser, treatment, retinopathy,

PO-21Efficacy and safety of Intravitreal Bevacizumab injection without Laser for Retinopathy of Prematurity as Primary Therapy: 6 year follow-up results with anatomical, functional, OCT and neurodevelomental analysisDr� Alay Banker, Dr� Deepa BankerBankers Retina Clinic and Laser Centre, Ahmedabad, India

Purpose: To evaluate 6-year safety and efficacy of intravit-real Bevacizumab(IB) in retinopathy of prematurity (ROP)� Methods: Prospective study of 141 eyes with ROP treated with IB without laser� Anatomical results (ROP regression, OCT), functional evaluation (ERG, VEP) and neurodevel-opmental anlysis (DQ score) were performed at 6 years� Results: All eyes showed regression of ROP and normal macula on OCT� 8/137(6%) had persistent peripheral avsacu-lar retina� There was normal retinal function (normal-VEP and ERG) and normal neurodevelopment score(normal DQ)� Conclusions: Our long-term follow-up study shows that IB seems to be safe and effective in treatment of ROP�Intravitreal Bevacizumab, ROP, threshold, laser, safety, ef-ficacy

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PO-22Aggressive posterior retinopathy of prematurity: Myopia at 1 year corrected age following successful laser treatment.Deeksha Katoch, Mangat Ram MS, Gaurav Dogra, Gaurav MS, Neha Sanghi, Amod MSDepartment of ophthalmology,PGIMER,Chandigarh,India

Purpose: To analyze the prevalence of myopia at 1 year cor-rected age in eyes following successful laser treatment for aggressive posterior retinopathy of prematurity (APROP)�Methods: We prospectively enrolled infants undergoing suc-cessful laser treatment for APROP at a tertiary center from January 2006 to December 2010� All enrolled infants under-went retinoscopy under cycloplegia at one year of corrected age� Refractive error was expressed as Spherical Equivalent (SE)� Myopia was defined as SE ≥ 0�25 diopter (D) and high myopia ≥ 5D�Results: Eight-six eyes of 45 infants underwent success-ful laser treatment for APROP� 3 infants (6 eyes) were lost to follow up� Eighty eyes of 42 infants were included� At 1 year follow up visit, 55 (68�75%) eyes had myopia and 20 (25%) had high myopia� The prevalence of myopia (88�9% vs�52�3%, p<0�001) and high myopia (41�7% vs� 11�4%, p=0�004) was significantly higher in eyes with zone 1 AP-ROP as compared to posterior zone 2 APROP� The preva-lence of myopia was higher (92�9% vs� 63�6%, p=0�053) and high myopia significantly higher (50% vs� 19�7%, p=0�042) in eyes with narrow temporal arcade than in eyes with nor-mal posterior poleConclusion: Myopia and high myopia are common in eyes successfully treated for aggressive posterior retinopathy of prematurity�Retinopathy of prematurity, aggressive posterior retinopathy of prematurity, APROP, ROP, Zone 1 ROP, Myopia, refrac-tive error.

PO-23Experience of Confluent Laser Photocoagulation in the Aggressive Posterior Retinopathy of PrematurityNatalia Pasechnikova, Nadezhda Bobrova, Vladimir Nau-menko, Sergey Katsan, Ekaterina ZaichkoThe Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine

Purpose: Analysis of the results of laser coagulation aggres-sive posterior retinopathy of prematurity (AP-ROP)�Methods: During the period from January 2009 to December 2011, in the Southern region of Ukraine were examined 2130 children� In 39 of them (1�8%) were diagnosed AP-ROP (77 eyes)� Weight at birth in this group ranged from 746g to

1830g, the mean birth weight was 1274 + 289g� Gestational age of infants ranged from 24 to 32 weeks, mean gestational age was 28 ± 2�5 weeks� All children at diagnosis were car-ried out AP-ROP confluent laser photocoagulation of avascu-lar zones of the retina, using a laser with a wavelength of 532 nm� The average number of shots was 3550 per eye� Laser coagulation was carried out on 4 – 7 weeks after birth�Results: A positive result of laser treatment has been reached in 92,2% of cases (71 eyes)� In 7�8% of cases (6 eyes) dis-ease progressed to stage 5� In 61% of cases (47 eyes) signs of regression of the disease were defined on the second week of observation� In 3�9% of cases (three eyes) required repeated laser photocoagulation, after which also marked a positive trend� Hyphema and anisocoria was observed in 5�2% of cas-es (4 eyes) after laser intervention� Two children died (four eyes are not taken into account)� In the course of observation the condition is normalizing�Conclusions: Our experience in treating AP-ROP showed high efficiency�laser coagulation, aggressive posterior retinopathy of pre-maturity, AP-ROP, retinopathy of prematurity

PO-24Efficacy and Safety of Bevacizumab (Avastin) as a Therapeutical Tool in Severe Retinopathy of Prematurity – the Romanian ExperienceSimona-Delia Talu, Constanta Nascutzy, Anne-Claudia Ste-fanut, Lucia-Maria Lotrean, Gabriela ZaharieDepartment of Ophthalmology,

Purpose: The study aims to evaluate the efficacy and safety of a single intravitreal injection of bevacizumab (Avastin) in severe Retinopathy of Prematurity (ROP)�Method: This is a retrospective study including all the consecutive infants who received intravitreal injection with bevacizumab (0�625 mg, 0�025mL) for severe ROP: aggres-sive posterior disease and stage IVA� The infants were exam-ined 6 – 7 days after the injection� If ROP showed evidence of progression, laser therapy was performed within 24 hours� The statistical analyses were performed with the program SPSS-15�Results: 34 infants were included into the study (68 eyes)� The mean birth weight was 1217�1 ± 328�7 grams (mean ± standard deviation; range 900 - 2300g); mean gestational age was 29�1 ± 1�9 weeks (range: 26-34 weeks); mean post-menstrual age at the time of injection was 35�4 ± 1�8 weeks (range: 31 – 40 weeks) and mean follow-up was 12,8 ± 5,5 weeks (range 2- 22 weeks)� 31 children (62 eyes) showed ag-gressive posterior disease, 2 children (4 eyes) presented stage IVA ROP and one case had aggressive posterior disease in one eye and stage IVA in the fellow eye� After the injection, ROP regressed bilaterally in 27 infants (79�41%), progressed

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bilaterally in 4 infants (11�76%) and regressed in one eye and progressed in the fellow eye in 3 infants (8�82%)� Of the 11 eyes with unfavorable outcome after Avastin injection, 10 were aggressive posterior disease (90�90%) and one was stage IVA ROP (9�09%)� Both mean birth weight and gesta-tional age in the unfavorable outcome group were slightly lower than the global ones: 1159�85 grams and 28�85 weeks respectively� The mean postmenstrual age at the moment of injection in the unfavorable outcome group was slightly higher than the global one: 36 weeks� The small sample of cases with unfavorable outcome and the little differences of the above mentioned parameters as compared to the whole group do not allow us to conclude in a statistically signifi-cant manner that the small birth weight, gestational age and delayed treatment influenced negatively the outcome after Avastin injection� No local or systemic side effect was noted� Laser photocoagulation was associated if ROP failed to re-gress� Finally, the retina was attached bilaterally in 32 cases (94�11%) and unilaterally in 2 cases (5�88%)� None of the cases from our study sample progressed towards bilateral retinal detachment�Conclusion: A single intravitreal bevacizumab injection of 0�625 mg, 0�025 mL, proved its efficacy and safety in severe ROP� Future prospective randomized trials are necessary in order to assess the long-term effects of bevacizumab for ROP�Bevacizumab, Avastin, Retinopathy of Prematurity

PO-25Retinal development of preterm ratrong li, xiang min yang, yu sheng wangDepartment of Ophthalmology, Xijing Hospital, Fourth Mili-tary Medical University, Xian, Shaanxi Province

Purpose: To investigate the retinal development process of preterm rats from animal models of preterm birth triggered by non-infectious or infectious means�Methods: Preterm labor was induced on Sprague-Dawley (SD) rats by caesarean section or intraperitoneal injection of lipopolysaccharide (LPS) or RU-486 on day 19 of gestation� The retinal structure and vascular development were com-pared between 3 groups of preterm rats and term rats at 1, 4, 7, 10, 14 and 21 days after birth (P1,4,7,10,14,21)� At each same time point, hematoxylin and eosin (H&E) was con-ducted to observe the morphological changes of retinas and isolectin IB4 was used to label the endothelial cells of whol-emounted retinas observed by a confocal fluorescence micro-scope� Electroretinogram (ERG) was performed on preterm rats induced by caesarean section as well as term rats at 14, 21, 28, 35 days after birth to avoid the effect of LPS or RU-486 on the results�Results: The retina developed to form 10 layers and the reti-

nal vessels growed from the optic nerve head toward periph-eral retina gradually from P1 to P14 in all newborn rats� The morphologic structure of retina and vascular growth process were almost the same in the preterm rats and term rats at each time point� However, ERG demonstrated that the retinal function was mature at P21 for term rats but at P28 for pre-term rats�Conclusion: Morphologically, preterm rats kept the same pace of development of retina with term rats before weaning� Functionally, the retina of preterm rats matured later than term rats� The mechanism of such difference needs further investigation�preterm birth; retina; development;

PO-26Systemic and Ocular Adverse Events After Intravitreal Bevacizumab in the Treatment of ROP: A Five-Year Follow-upMaria Ana Martinez-Castellanos1, Lihteh Wu2, Alay S� Bank-er3, Paola Dorta4, Andres Kychental4, Robison Vernon Paul Chan1, Hugo Quiroz-Mercado1

1 Asociación para Evitar la Ceguera en México. Hospital “Luis Sánchez Bulnes”. Mexico City2 Instituto de Cirugia Ocular, San José, Costa Rica3 Banker’s Retina Clinic and Laser Centre, Ahmedabad, In-dia4 Unidad de Oftalmología del Hospital de niños Roberto del Rio. Chile5 New York Presbyterian Hospital Weill Cornell Medical College, USA6 Denver Health. University of Colorado. Denver, Colorado.

Objective: To report the ocular and systemic adverse events associated with intravitreal bevacizumab in the treatment of ROP�Methods: Open label, uncontrolled, interventional retrospec-tive study� We included 334 eyes of 212 consecutive patients with treatment-requiring ROP who were managed with off-label IB, adverse events associated with this treatment were collected and analyzed�Results: A total of 68 local adverse events including worsen-ing of the retinal detachment, elevation of IOP, peripheral fibrous avascular membrane, vitreous hemorrhage, and avas-cular periphery� Systemic adverse events included 3 deaths that apparently were not related to intravitreal bevacizumab�Conclusions: After 5 years of follow up, IB appears to be safe for ROP, with treatable ocular adverse events� Systemic abnormalities may be sequelae of prematurity itself and not related to the medication� Longer follow-up is needed�Retinopathy of prematurity, bevacizumab, antiangiogenic, neurodevelopment, intravitreal injections, adverse events.

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PO-27Fluorescein angiographic findings in spontaneously-regressing stage 1 or 2 retinopathy of prematurityMaria Ana Martinez-Castellanos1, Andrea Portilla Demi-chelis1, Hugo Quiroz-Mercado1,2

1 Asociación para Evitar la Ceguera en México. Hospital “Luis Sánchez Bulnes”. Mexico City2 Denver Health. University of Colorado. Denver, Colorado.

Objective: To correlate the clinical and fluorescein angiogra-phy (FA) findings in infants with mild, ROP that underwent spontaneous regression�Methods: Retrospective case series of infants who under-went FA for evaluation of stage 1 or 2 ROP� FAs were cap-tured using a wide angle device under topical anesthesia� An intravenous injection of 0�1 ml/kg of a10% solution of fluo-rescein, was used� Infants noted to have macular abnormali-ties underwent additional imaging with OCT�Results: We included 20 eyes of 10 infants diagnosed with ROP stage 1 or 2 with spontaneous regression� In stage 2 we found in the junction between vascular and avascular retina diffuse leakage similar to the leakage pattern of pathological neovascularization, capillary free areas in the newly develop-ing area, dilatation of the vessels and irregular branching� As the eyes regressed to stage 1, we found some areas of hypo-perfusion and hyperfluorescence in distal developing vessels� FA showed variability in both retinal and choroidal filling patterns in stage 2 and 1� Regarding the macular area in stage 1 and 2, we found some areas of hyperfluorescence of peri-macular vessels in a pattern that suggested an exudative macular pathology� No abnormalities were noted on OCT imaging� Once the retinal vasculature reached the periphery, the vascular abnormalities regressed�Conclusions: By using FA, we distinguish the developing pattern of retinal vessels and recognized angiographic fea-tures of the junction zone between the vascularized and non vascularized retina� Our findings may help to understand the patterns of retinal vascular development in premature infants

PO-28Fluorescein Angiography macular abnormalities assessed by Optical Coherence Tomography in Retinopathy of PrematurityMaria Ana Martinez-Castellanos1, Fernando Shoonewolf1, Veronica Giordano1, Hugo Quiroz-Mercado1,2

1 AsociaciOn para Evitar la Ceguera en México. Hospital “Luis Sánchez Bulnes”. Mexico City2 Denver Health. University of Colorado. Denver, Colorado.

Objective: To describe macular abnormalities assessed by fluorescein angiography (FA) and OCT in eyes with retinop-

athy of prematurity (ROP) stage 2 and 3 with an ophthalmo-scopically normal-appearing posterior pole�Methods: Observational case series� Retinal FA using the Retcam II (Clarity Medical Systems, Pleasanton, CA) and hand held spectral domain Optical Coherence Tomography imaging (OCT) with the iVue (Optovue, Inc, Freemont, CA) were performed in premature babies with stage 2, threshold, and prethreshold ROP� FA was performed every 3 weeks un-til no evidence of the disease was observed�Results: We included 12 patients (24 eyes), of which 6 pa-tients (12 eyes) presented with an abnormal diffuse capillary leakage pattern in the macula despite a normal-appearing posterior pole as seen by indirect ophthalmoscopy� This leakage resolved spontaneously after a few(Be specific here� How many weeks?) weeks� OCT studies showed no cystic changes or edema� There was preservation of multiple inner retinal layers within the fovea and a normal-appearing macu-lar depression�Conclusions: ROP patients with macular changes seen on angiographic evaluation which resemble diffuse capillary leakage may present with no clinical or macular OCT abnor-malities� This pilot study provides previously unknown and valuable information in the follow up of patients with ROP� A larger sample size and follow up are needed�Retinopathy of prematurity, angiogram, optical coherence tomography, macula

PO-29Retinal Vascular Changes Following Intravitreal Anti-VEGF Therapy for Treatment Requiring Retinopathy of PrematurityMaria Ana Martinez-Castellanos1, Robison Vernon Paul Chan2, Hugo Quiroz-Mercado1,3

1 Asociacion para Evitar la Ceguera en Mexico. Hospital “Luis Sanchez Bulnes”. Mexico City2 New York Presbyterian Hospital Weill Cornell Medical College, USA3 Denver Health. University of Colorado. Denver, Colorado.

Objective: To describe the retinal vascular morphology in eyes treated with intravitreal bevacizumab (IB) for treatment requiring ROPMethods: Prospective, nonrandomized case series� We in-cluded six patients (12 eyes) diagnosed with stage 3, thresh-old or prethreshold ROP� Fundus photographs and Fluoran-giography (FA) were obtained before and after IB treatment using a wide-field digital pediatric imaging system�Results: Before treatment, FA showed vascular abnormali-ties, including capillary non-perfusion throughout the vas-cularized retina, shunting in the vascularized retina, a de-marcation line, and limited vessel development, new vessels leakage, and avascular periphery� After the treatment with

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the suppression of VEGF, FA showed obliteration of abnor-mal new vessels, followed by involution of the neovascu-larization, flattening of the demarcation line and subsequent growth of vessels to the capillary-free zones� During the fol-lowing weeks large areas devoid of microvessels were seen, 6 months post intravitreal injection of bevacizumab, vascular remodeling was seen with uneven spacing of the retinal cap-illaries and vascular loops in the areas that were previously devoid of vessels� In some patients, the retinal vessels in the far periphery never developed� Subsequently, these patients did not develop pathological neovascularization�Conclusion: Our study shows that even when the vascular pattern is abnormal after intravitreal anti-VEGF therapy, the creation of small vessels, the establishment of directional flow, the association with mural cells and the adjustment of vascular density to meet the nutritional requirements of the retina have been accomplished� Longer follow up, prospec-tive, multicenter studies to assess our findings�Retinopathy of prematurity, antiangiogenic therapy, VEGF, vascular changes, bevacizumab, ranibizumab.

PO-30Influence of Foveal Photoreceptor Sub-Elements on Visual Acuity in Premature Infants With and Without Retinopathy of PrematurityAnand Vinekar, Kavitha Avadhani, Munusamy Sivakumar, Mathew Kurian, Sherine Braganza, Bhujang ShettyNarayana Nethralaya Postgraduate Institute of Ophthalmol-ogy, Bangalore, India

Objective: To correlate inner retinal layer (IRL) migration, external limiting membrane (ELM), Photoreceptor Inner Segment-Outer Segment (IS-OS) and Outer Segment- Reti-nal Pigment Epithelium (OS-RPE) layers at the foveal centre imaged on the hand-held Spectral Domain OCT (Bioptigen Inc�, NC) with visual acuity in the first year of life�Methods: Fifty-seven Asian Indian premature infants un-derwent SD-OCT imaging between postmenstrual ages of 34 weeks and 12 months� Thirty-three (52�6%) infants were imaged at intervals of 3,6,9 and 12 months corrected age during which vision was additionally assessed with Teller acuity cards (TAC)� Sixty-four eyes (56�1%) historically had a maximum level of Type II (untreated) Retinopathy of Prematurity (ROP)� Two masked readers assessed the foveal photoreceptor sub-elements at each imaging session as per study protocol� Foveal morphology was correlated with vi-sion and the presence of ROP�Results: Kormoglov-Smirnoff test was performed on the data� Spearman’s Correlation Coefficient found that the presence of ROP correlated negatively with the presence of ELM (r= - 0�196;p= 0�039) and IS-OS (r= - 0�330;p< 0�001) observed on SD-OCT and positively correlated increased

visual acuity with the presence of foveal layers IRL fusion (r=0�391;p=0�002), ELM (r=0�340;p=0�007) and OS-RPE (r=0�309;p=0�015) at 0�01 level of 2-tailed significance�Conclusions: The study provides new insights into our understanding of foveal maturation in the first year of life� Subcellular photoreceptor specialization in premature infants correlates positively with improved visual acuity� Infants with Type II ROP show delayed development in foveal dif-ferentiation and maturation�foveal maturation, spectral domain OCT, ROP, vision

PO-31Did untreated, transient, subclinical foveal edema influence vision in premature infants? 1-year follow-up study with age and weight matched controlsAnand Vinekar, Parvathi Hari, Mathew Kurian, Kavitha Avadhani, Sherine Braganza, Bhujang ShettyNarayana Nethralaya Postgraduate Institute of Ophthalmol-ogy, Bangalore, India

Objective: To report the effect of transient, self-resolving, untreated ‘foveal edema’ detected on spectral domain opti-cal coherence tomography (SD-OCT) in premature infants with mild ROP previously reported by our group- on visual acuity and refraction at 1-year of corrected age�Methods: Retrospective analysis of 12 infants with previ-ously documented bilateral macular edema on SD-OCT and clinically normal foveae with spontaneously resolved ROP (group A) were age and birth-weight matched with 16 prema-ture infants with comparable severity of ROP but no foveal edema on SD-OCT (group B) and 12 premature infants with no ROP (group C)� The groups had visual acuity recording using Teller acuity cards (TAC) and cycloplegic retinosco-pies at 3,6,9 and 12 months corrected age respectively� For analysis, vision was converted to logMar and refraction to spherical equivalent�Results: Interestingly, one way analysis of variance and post-hoc testing using Bonferroni correction showed that vi-sual acuity of the edema group (A) was better than the group with no ROP (C) at 1-year (p=0�007)� The group with edema was also ‘more hyperopic’ than the other two groups at 12 months of age (p< 0�01)�Conclusions: We discuss these interesting observations by proposing 3 plausible theories based on current literature� We hypothesize how hyperopia induced by the edema could have serendipitously improved quantitative vision because of better accommodation, photoreceptor and foveal sub-cinical, anatomical changes and better neural adaptation� The limits and scope for further research are also discussed�foveal edema, SD-OCT, vision, premature

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PO-32“Imaging the Image” – Enhancing Image Characteristics of Retinal Images of Retinopathy of Prematurity Using An Indigenous Patent Pending Software (RetiView)Anand Vinekar1, Kavitha Avadhani1, Poornima Mohanachan-dran2, Samit Desai2, Amit Suveer2, Bhujang Shetty1

1 Narayana Nethralaya Postgraduate Institute of Ophthal-mology, Bangalore, India2 i2i TeleSolutions & TeleMedicine Pvt. Ltd, Bangalore, In-dia

Objective: To report the utility of an indigenously devel-oped, patent pending, signal processing based visualization software (“RetiView”) in detecting poorly visible and un-detected features in retinal images of infants with Retinopa-thy of Prematurity (ROP)�Methods: “RetiView” uses Anisotropic Diffusion Filtering (ADF) and Contrast Limited Histogram Equalization (CLA-HE) techniques for retinal image enhancement of noisy, low contrast retinal images� ‘Vesselness measure’ is calculated and a non-linear pseudo coloring algorithm is used for visu-alization and analysis of vascular structures� Three protocols were developed- “Grey Enhancement (GE)”, “Color En-hancement (CE)” and “Vesselness Measure (VNM)”� Vas-cular analysis of wide-field digital images of infant retinas with ROP obtained on the Retcam Shuttle was performed using “multiscale vessel enhancement filtering” techniques� Image enhancement of poorly discernible, clinically relevant features were analyzed in images of aggressive posterior ROP (APROP) and atypical ROP�Results: CE protocol allowed better visualization of capil-lary non-perfusion areas and enhanced the edge of vascular loops in APROP� GE protocols were used to study neovas-cularization� The VNM protocol was useful in determining the extent and distribution of the vessels including enhanc-ing traceability upto the ora serrata� Both protocols helped in delineating zones of avascularity, edge of zone 1 vessels and differentiating between vascular and fibrotic components within the extra-retinal fibrovascular proliferation�Conclusions: This pilot study demonstrates the successful feasibility of this indigenous software which enhances the visualization of clinically undetectable changes in atypical images of ROP non-invasively�Software analysis, digital imaging, Retiview

PO-33Comparing Cost-Utility Analysis Between “KIDROP” -A Tele-ROP Model With Alternate Strategies For Retinopathy Of Prematurity Screening In Remote Areas In India

Anand Vinekar1, Shainesh Gangadharan2, David Hazarika2, Clare Gilbert3, Mathew Kurian1, Mangat Dogra4

1 Narayana Nethralaya Postgraduate Institute of Ophthal-mology, Bangalore, India.2 Indian Institute of Management, Bangalore, India.3 London School of Hygiene and Tropical Medicine, London, UK.4 Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Objective: To report an economic analysis comparing an on-going Tele-ROP program (KIDROP model) with 3 alternate strategies for ROP screening in remote areas of IndiaMethods: The Karnataka Internet Assisted Diagnosis of ROP (KIDROP) project has been screening preterm babies for ROP in neonatal units (NU) in 6 districts in remote Kar-nataka, S� India since 2008, using a trained technician and the Retcam shuttle (Clarity MSI, USA)� This ‘index strate-gy’ was compared with three other strategies using Analytic Hierarchy Processing (AHP) i�e� 1) Mothers travel with their infants to the city for examination 2) ROP specialists exam-ine babies in the NUs using indirect ophthalmoscopy once a week and 3) One Retcam for a limited number of NUs, atleast one per district� Options 2 and 3 do not entail travel for mothers outside their parent district� The strategies were compared for 1) Cost to the organization 2) Cost to patients 3) Coverage of ‘at-risk’ population� Best and worst cases scenarios were generated and ranks comparedResults: In the ‘best-case’ scenario, KIDROP was the best strategy from the perspective of patients, the funding organiza-tion and the balanced perspective� In the ‘worst-case’ scenar-io, KIDROP was the best strategy for the organization, but for the patient and in the balanced scenario, the multiple Retcam model ranked first� Thus the KIDROP model ranked top in 4 of 6 situations� In all situations Tele-ROP ranked higher than strategies where the specialist or patient had to travelConclusion: In middle-income countries with high rates of severe ROP, majority of ‘atrisk’ infants in remote areas and non-existent ROP experts, the KIDROP screening model ap-pears to be the most cost-effective strategy� This model may serve in other regions experiencing the third epidemic of blindness in children due to ROP sharing similar constraintsCost-utility, Tele-ROP, KIDROP, rural, middle-income

PO-34Intravitreal bevacizumab for retinopathy of prematurity resistant to photocoagulationTomoko Tsukahara, Naoko Arita, Hideyuki Hayashi, Eiichi UchioTomoko Tsukahara

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Purpose: To present favorable result after intravitreal bevacizumab injection( IVB ) for cases with retinopathy of prematurity( ROP ) resistant to ablative photocoagulation( PHC )� Cases: Four eyes of four cases were treated by IVB for progressive angiogenic proliferation inspite of extensive retinal PHC� In two cases, fellow eyes had stage 4 traction retinal detachment� 0�625 mg bevacizumab was injected in all cases� Result: In all eyes treated by IVB, ROP regressed without retinal detachment or macular deviation, and no eye needed further treatment� Conclusion: IVB has compensatory effect with PHC on most serious ROP cases�IVB, conbination, PHC

PO-35How Early Do We Need to Initiate Retinopathy of Prematurity Screening to Improve Enrollment? Results of a Prospective Study from Rural IndiaAnand Vinekar1, Praveen Sharma1, Kavitha Avadhani1, Man-gat Dogra2, Mathew Kurain1, Bhujang Shetty1

1 Narayana Nethralaya Postgraduate Institute of Ophthal-mology, Bangalore, India2 Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Purpose: To compare the utility of initiating Retinopathy of Prematurity (ROP) screening prior to hospital discharge (‘early screening’) with screening first performed rely-ing on the pediatrician’s referral at the standard prescribed timeline (‘conventional screening’) in rural India�Methods: Two Government owned Level II neonatal units (NU’s) in two district headquarters in southern India were selected� One randomly selected for ‘early’ and the other for ‘conventional’ screening respectively� Both NU’s were comparable in level of infrastructure, population demograph-ics and inclusion criteria� In the early screening center, the first screening was performed at first contact with the ad-mitted infant, irrespective of the postmenstrual age (PMA), unless systemically unstable� In the conventional screening center, infants were first screened between 21 and 28 days of life, only when the pediatrician referred these infants� The yield of enrollment and the magnitude of treatment requiring cases that would be missed in each scenario were compared�Results: In the study period of 4 months, there were 107 (65 conventional vs 42 early), infants eligible for ROP screening enrollment� In the early group, 88�1% of these eligible in-fants were enrolled, compared to 38�5% in the conventional group (p=0�034)� In the conventional group, the main reason for non-compliance owed to the fact that most infants were discharged from the NU prior to the conventional screening timeline� Using the incidence of treatment requiring disease

as a surrogate for potential blindness, 4�8 babies would have been missed in the infants who missed enrollment in the con-ventional group compared to 0�4 babies in the early group, which is 12 times higher�Conclusion: Enrolling infants for ROP screening during their admission in the NICU, irrespective of their PMA, ensures that we capture the mothers’ contact information to schedule for subsequent exams� This pre-counseling im-proved the yield of enrollment� In this study, rural mothers seem less likely to present their infants for ROP screening once they are discharged from the NU, especially if the ROP team does not perform pre-counseling� This study suggests the need to re-look at the screening guidelines in India and other regions with similar demographics�Early screening, ROP, rural, guidelines

PO-36Integrating live-video consultation with remote reporting of ROP images on the tablet : The KIDROP experienceAnand Vinekar1, Munusamy Sivakumar1, Praveen Sharma1, Sham Banerji2, Bhujang Shetty1

1 Narayana Nethralaya Postgraduate Institute of Ophthal-mology, Bangalore, India2 i2i TeleSolutions and TeleMedicine Pvt Ltd, Bangalore, In-dia

KIDROP, Karnataka Internet Assisted Diagnosis of ROP provides tele-ROP services for over 70 neonatal intensive units in Karnataka state, South India� Most centers are in the rural, underserved regions of the state to which services are provided ‘at no cost’ to the patient� The project is a public-private partnership with the Ministry of Health and Family Welfare, Government of India� KIDROP was the first to use a tele-ROP app on the iPhone in 2009 to remotely view and re-port live images sent by non-physicians from the rural areas to the experts’ mobile phone dwelling in the city� This model has been cited by the Indian Institute of Management and the Harvard Business Review for its technological relevance�In this video presentation, we demonstrate our version of Tele-ROP version 2�0, wherein we have integrated a live video and voice call along with the software that enables ROP image viewing and reporting� This platform, allows the remote expert to establish a virtual connect with the family of the child even as he or she is reporting their child’s im-ages in real-time� This enhanced patient experience has im-proved their participation in the ROP screening program and increased follow-up for completing the screening schedule�Tele-ROP, KIDROP, iPad, Mobile, Tablet

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PO-37The ability of the neonatal management of severe ROP among the ELBW babiesNatalya Fomina, Elvira SaidashevaNorth-West State Medical University

The population of St� Petersburg is about 4�6 mln people� For about 170 babies with ELBW are born a year� As obstetri-cal and neonatal technology and skills advance, the survival rates of the very low birth weight infants have increased� In 2002 year the mortality of ELBW was 27%; in 2008 – 18%� The comparing of the morbidity of severe ROP of ELBW ba-bies had been made in 2008 in two NICUs of St�Petersburg� The threshold has been registered in 62% in NICU № 17 and only in 14% in NICU № 1� The morbidity of severe ROP is difference between NICUs� It depends of the level of the neonatal care and the equipments of NICUs� To improve this situation in NICU № 17 the protocol of the control of Sat O2 has been started since April 2012� It is composed with ac-cordance of two phases of pathogenesis of ROP for ELBW babies (before 32 w of postconceptional age Sat O2 should be less than 88 – 92% and after 32 w – more than 93%)� The observance of this protocol has been controlled by ophthal-mologist� Since this protocol has been used the morbidity of severe ROP among ELBW babies has decreased to 37�5% in NICU № 17 of St�Petersburg�ROP, ELBW babies

PO-38Plasma levels of Vascular Endothelial Growth Factor after intravitreal bevacizumab injection for infantsYuji Oshima, Yoko Fujita, Shigeo Yoshida, Shoko Tsuka-moto, Hiroshi Enaida, Tatsuro IshibashiDepartment of Ophthalmology, Graduate School of Medical Sciences, Kyushu University

Purpose: To evaluate the changes of plasma vascular endo-thelial growth factor (VEGF) levels after intravitreal bevaci-zumab injection (IVB) for infants with ROP or Coats disease�Methods: Peripheral blood samples from 7 infants (5 boys and 2 girls) were analyzed before and after IVB (0�5mg for ROP to either one eye or both eyes, 1�25mg for Coats dis-ease to one eye)� Plasma VEGF levels were determined by enzyme-linked immunosorbent assay (ELISA)� In addition, age, body weight, baseline characteristics and course of treat-ment were analyzed�Results: Seven cases received IVB treatment (five cases were ROP and averaged 35 weeks postmenstrual age; two cases were Coats disease and averaged six years of age)�

There were no systemic complications in the Coats disease cases� However, the five ROP cases were associated with chronic lung disease, respiratory distress syndrome, late on-set circulatory collapse, ventriculitis, and duodenal perfora-tion due to prematurity� The average plasma VEGF levels in the two cases of Coats disease before injection, and one day and one week after IVB were 456ng/ml, 75ng/ml, and 40ng/ml, respectively� In the five cases of ROP, the average plasma VEGF levels before injection and 1 day, 1 week, and 1 month after IVB were 688ng/ml, 667ng/ml, 115ng/ml, and 202ng/ml, respectively� There were no systemic or local side effects of IVB noted during the observation period�Conclusions: IVB reduces plasma levels of VEGF for a pe-riod of at least a few weeks following injection in infants�VEGF, bevacizumab

PO-39Effect of Topical Bromfenac in Retinopathy of PrematuritySarita Beri1, Pooja Mehta1, Rajesh Jain1, Pamela Dsouza1, Sushma Nangia2

1 Department of Ophthalmology,Lady Hardinge Medical College.New Delhi,India2 Department of Paediatrics,Lady Hardinge Medical Col-lege. New Delhi,India

Aim: To study the effect of topical Bromfenac on the pro-gression of retinal vascularisation in babies screened at ROP clinic�Study period: April 2011 to May 2012�Materials and methods: A total of 129 babies were screened and followed up (according to hospital guidelines) dur-ing this period� They were randomly divided into 2 groups� Group A : 67 babies on topical bromfenac twice a day and Group B: 62 babies on topical flurbiprofen twice a day� Topical drops continued till complete vascularisation of the retina�Observations: All babies had avascular retina at first visit of screening� 65 of the 67 (97�0%) babies in group A and 58 of the 62 (93�5%) babies in group B had complete vascularisa-tion at 40 – 44 weeks of PCA (post conceptional age)�In Group A, 2 babies had vascularisation till zone I on first visit� Vascularisation progressed to zone II by 40 weeks� ROP developed at 40 and 42 weeks in baby 1 and baby 2 re-spectively� ROP worsened at 45 weeks in both and required laser treatment� These babies had therefore less severe and delayed ROP despite having Zone 1 vascularisation at the first visit�In Group B, 2 babies (twins) developed early ROP at 35 and 36 weeks respectively� It progressed to prethreshhold ROP

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at 38 weeks PCA� Flurbiprofen was discontinued and topi-cal Bromfenac started� Improvement was observed within a week of bromfenac treatment and ROP showed complete regression by 42 weeks PCA�No ocular/systemic side effects of either drug were seen�Conclusion: Topical Bromfenac has positively altered the course of ROP�Bromfenac,retinal vascularisation,ROP regression

PO-40A NEW SCORING SYSTEM FOR RISK FACTORS OF ROP - A PILOT STUDYRajbir Singh Beri1, Shalini Garg2

1 Department of Paeditrics,St.Stephens Hospital,Delhi,India2 Department of Ophthalmology,St. Stephens Hospital,Delh,.India

In India,out of the 26 miillion annual live birhs,approximately 8�7% of the new borns are below 2000gms in weight�This would imply that almost 2 million new borns are at risk of developing ROP�National Neonatology Forum (NNF) recommends ROP screening for all preterm neonates who are born < 1750gm birth weight; also babies with 34-36 weeks gestation or 1750-2000gms birth weight if they have risk factors�Many studies have been published enumerating a list of risk factors� Each study has given importance to different risk factors� Hence neonatologists selecting babies for ROP screening have varying selection criteria’s�A scoring system for risk factors of ROP is being devised which would make selection criteria for screening of ROP more objective and uniform among neonatologists across the country�

Aim: of the study – To make a scoring system for all known risk factors of ROP�Method: – Preterm babies who fulfilled the NNF criteria for ROP screening and underwent treatment during the period of one year (2011-2012) were taken in the study �They were analysed for all the known risk factors�Results: A total of 122 babies were screened � Babies who died, went LAMA, or were lost to follow-up were excluded� Of a total of 122 babies 4 (3�3%) developed treatable ROP� Risk factors of babies with treatable ROP and 30 babies with no ROP was tabulated and compared�Logistic regression was done to analyse the impact (signifi-cance) of these risk factors on development of treatable ROP� Odds ratio was obtained and weightage was given to each risk factor�Conclusion: -On the basis of this weightage on various risk

factors, a scoring system was formulated, called the ROP RISK SCORE�treatable ROP,Risk factors,ROP Risk Score

PO-41Six years experience with use of bevacizumab in ROPSusana Teixeira1, Ana Rita Azevedo1, Cristina Santos1, Graça Pires1, Rosalina Barroso2, Antonio Melo1

1 Hospital Fernando Fonseca - Ophthalmology Service2 Hospital Fernando Fonseca - Pediatric Department

Objectives:To report retrospective consecutive case series of Type1 ROP (stage3+) treated by intravitreal injections of bevacizumab�Methods:Retrospective review of 26 premature infants (38 eyes) who received 0,03cc of intravitreaal bevacizumab for treatment of Type1 ROP (stage 3+ ROP) between Febru-ary 2006 and June 2012�Six infants (10 eyes) from 23 to 28 weeks of gestational age (mean 25,9) received intravitreal bevacizuman as a combined rescue treatment for progressive ROP after peripheral laser ablation and twenty infants (28 eyes) from 24 to 29,6 weeks of gestacional age (mean 25,6) received intravitreal injection of bevacizumab as a primary treatment� Seven infants received bilateral treatment and ten received laser in the other eye� Twenty-six eyes (16 infants) had Zone I ROP, two eyes (2 infants) had posterior zone II ROP and ten eyes (8 infants) had zone II ROP� The follow-up varies between 6 months and 6,3 years�Results:Thirty-six eyes (25 infants) were successfully treat-ed with primary injection or combined treatment (only one injection of intravitreal bevacizumab) with no local or sys-temic apparent complications� In two eyes (1 infant) it was necessary to perform a second injection at month 3 and one of the eyes had a late relapse (one year) with progression to stage IV (retina successfully attached after lens spare vitrec-tomy)�All the eyes with Zone I and posterior zone II ROP treated with laser developed high myopia in opposition to the eyes primarily injected�Conclusions: Intravitreal injection of bevacizumab seems to be effective and safe in Type 1 ROP as a primary or com-bined treatment� Dose, timing and follow-up visits are sub-jects that need additional research�ROP, bevacizumab, Zone I

PO-42Vascular findings eyes after intravitreal bevacizumab for ROP

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Susana Teixeira, Cristina Santos, Susana Pina, Graça Pires, Filomena Silva, Antonio MeloHospital Fernando Fonseca - Ophthalmology Service

Porpuse: To report retinal vasculature findings in eyes that had primary treatment with intravitreal bevacizumab because of type I (stage 3+) ROP�Methods: Retrospective review of 17 infants (22eyes) that had primary treatment with intravitreal bevacizumab for Type 1 (stage 3+) ROP� From those eyes, 16 had Zone I ROP, 2 had posterior Zone II ROP and 4 had Zone II ROP� The minimum follow up is 1 year and the maximum is 5 years�Results: All eyes with zone I and posterior zone II ROP presented avascular peripheral areas in a variable extension� No eye with zone II ROP had avascular retinas� In 2 eyes (1 baby) we had recurrence of the disease that progressed to stage IV in one eye (had a lens spare vitrectomy with good anatomic results) and ablative treatment was done in the oth-er eye� All the other eyes have no recurrence of the disease with stable avascular areas� In 8 eyes we find some engorge-ment of the posterior pole vessels (without the presence of proliferative disease) and vascular abnormal branching of the peripheral vessels with shunting�Conclusions: Intravitreal bevacizumab injection induces re-gression of acute stages of ROP allowing a continued vascu-larization of the peripheral retina� In some cases we can find different patterns of vascularization that we must carefully follow up as we can have late recurrences of the disease�ROP, avascular, bevacizumab,

PO-43First results of treatment of active retinopathy in KazakhstanAlfiya Gabaidulina1, Dana Jamanbekova1, Gulnara Utegeno-va1, Altynshash Jaxybayeva1, Nataliya Fomina2, Rasa Bag-doniene3

1 National Research Center of Maternity and Child Health, Astana, Kazakhstan2 North West State Medical University, St. Peterburg, Russia3 Eye care and treatment centre REGA, Vilnius, Lithuania

Introduction: At present, the most effective method of pre-venting disease progression and prevention of severe ROP (retinopathy of prematurity) stages that lead to visual impair-ment and blindness, is the use of transpupillary laser coagu-lation, the effectiveness of which is 87�5-92%�In 2011, in Kazakhstan the National Research Center of Ma-ternity and Child Health started research project “Introduc-tion of innovative diagnostic and therapeutic technologies for retinopathy of premature infants”�

Methods: All children with type 1 ROP had the transpu-pillary laser coagulation of avascular zones under general anesthesia� The technique is to block the maximum pos-sible area of the avascular retina, approaching the volume of coagulation by 100%� The procedure LCR is carried out under mydriasis using special blepharostat for newborns and sklerocompressor� For the coagulation of the retina, we used Constellation Vision System (Alcon)�Results: During the first half of 2012, we carried out laser coagulation of 30 premature infants with type 1 ROP� Two weeks after the coagulation of the retina, we observed first signs of stabilization of the process in twenty-six (26) chil-dren, such as disappearance of convoluted arteries and pro-tuberant veins� After 3-5 weeks there was regression of neo-vascularization and arteriovenous shunts, the normal growth of blood vessels was restored� Full stabilization process was within 1-3 months after the treatment� Due to the observed progressive proliferating process, four children after 2 weeks of observation had a second round of LCR� One child had an unsuccessful outcome – transition to 4-5 stage�ROP, laser coagulation

PO-44Comparing 500 laser treatments from a rural vs urban cohort from Southern India: Four year KIDROP experienceAnand Vinekar, Praveen Sharma, Muralidhar Gayakwad, Munusamy Sivakumar, Krishnan Narasimha, Bhujang ShettyNarayana Nethralaya Postgraduate Institute of Ophthalmol-ogy, Bangalore, India

Objective: To report the demographic profile and treatment outcome of 500 laser procedures detected and treated during the Karnataka Internet Assisted Diagnosis of ROP (KIDROP) screening program in rural and urban Karnataka state, India�Methods: A retrospective analysis of the KIDROP data-base from 54 neonatal units for the period September 2007 through December 2011 was performed� Infants who had undergone laser photoablation in both eyes for ETROP grade disease and a minimum follow up of 6 months were recruited for analysis� All sessions were documented on the Retcam (Clarity MSI, USA)� The cohort was divided into two groups: Group A: Rural infants, who were screened and treated in the rural peripheral centers� Group B; Urban infants, who were selected from semi-urban and urban centers� All treatments were performed by a single surgeon using 532 nm green la-ser (Iridex Medical, USA)� The two groups were compared for differences in demographics, disease and outcome�Results: Of the 612 lasers performed in the KIDROP data-base, 500 were included for analysis� Of these, 230 (46%)

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were from rural and 270 (54%) infants from urban centers respectively� The mean birth weight and gestational ages of the two groups were comparable (p> 0�05)� The median age of treatment in both groups was 39 weeks postmenstrual age (PMA)� There was a predominance of male infants treated in the rural (72�3%) compared to urban infants (56�8%)� The proportion of Type 1 ROP vs Aggressive posterior ROP (APROP) was 83% vs 17% in rural and 86% vs 14% in ur-ban respectively� An overall favorable structural outcome was achieved in 94�4% of rural and 97�6% of urban treated babies� A 100% of Type 1 treated eyes achieved favorable outcome in both groups� Of the 15 babies with unfavorable outcome, 13 were lost to follow-up or died before disease resolution could be documented, 1 received intravitreal beva-cizumab and 1 infant underwent lens-sparing vitrectomy�Conclusions: This is the largest multi-center laser outcome reported thus far and the first from a rural cohort� The study demonstrates that a predominantly larger proportion of male infants undergo treatment especially in the rural areas� Gen-der bias cannot be ruled out� ROP characteristics in rural infants, including aggressive posterior disease is comparable with their urban counterparts� A screening protocol with photo-documentation, strict surveillance and timely and ade-quate laser treatment results in over 95% successful outcome in rural and urban infants alike�ROP,laser, outcome, APROP, rural, India

PO-45Development of vision in babies undergoing successful vitreoretinal surgery for advanced ROPSalil Gadkari, Sucheta Kulkarni, Kuldeep Dole, Sudhir Taras, Madan DeshpandeH V Desai eye hospital, Pune India

Purpose: to quantify the visual recovery in babies who un-derwent successful vitreoretina surgery for stage 4 and stage 5 ROP using serial examinations to assess improvement in vision�Methods: Prospective non interventional study with a follow up period of at least one year from sept 2009� Con-secutive babies recruited who had undergone successful vitreoretina surgery and had only one seeing eye (5 patients) following surgery or had successful VR surgery both eyes for the same stage of ROP �Successful VR surgery was defined as an anatomical outcome with a flat retina at the posterior pole� Vision was recorded monthly with a Taylor visual acu-ity chart after correction of the refractive error�Results: 6 ba-bies had stage 4b disease while 1 baby had stage 5� 5babies had under gone lens sparing vitrectomy while 2 had vitrec-tomy with lensectomy�2 babies had vision of 1�3cpd at 55cm or better, one had 0�44cpd at 55cm, while 3 had 0�22cpd at

55cm and one was ambulatory but could not fixate on the chart� 3 babies showed improvement in vision during the pe-riod of study�Conclusion: Visual improvement and develop-ment was noted in our small series� Early detection and Lens sparing vitrectomy contributed to better visual outcomes� Regular follow up and correction of refractive errors was im-portant to visual development in the post op periodROP surgery

PO-46On the impact of tunica vasculosa lentis to ROP treatmentRasa Sirtautiene1, Rasa Bagdoniene2

1 Dept. of ophthalmology Vilnius university hospital San-tariskiu clinics2 Eye care and treatment centre REGA, Vilnius, Lithuania

Purpose: To analyse the importance of the tunica vasculosa lentis (TVL) in the treatment outcome of threshold ROP�Material and Methods: The study was performed at the Vilnius University Children’s Hospital between years 1995 - 2009� Consecutive infants who reached threshold ROP and underwent treatment at the post conceptual age (PA) > 34weeks were included into the study cohort comprising 365 babies� The tunica vasculosa lentis was found bilaterally in 80 infants (160 eyes)� This group was labelled TVL (+) group� The rest of the investigated infants (285) formed the TVL (-) group (560 eyes)�Results: Cryo- or laser/cryotherapy was applied on 719 eyes (365 infant) with threshold ROP� Treatment was applied once in 666 eyes� 145/159 eyes of the TVL (+) group and 521/560 eyes of the TVL (-) group underwent a single treatment ses-sion� The tunica vasculosa lentis disappeared in 134 eyes af-ter the first session of therapy� The treatment was successful in all of these eyes�The treatment was carried out twice in 12 eyes with TVL and in 35 eyes without TVL� 6 eyes were treated three or four times�The total number of failures were 46 eyes (28 infants): 20/159 eyes (12�5%) in the TVL (+) group and 26/534 eyes (4�9%) in the TVL (-) group� (OR: 2�95, 95% CI: 1�6-5�4)�All the failed eyes belonged to Zone I disease�Conclusions: Eyes with persistent TVL pose a greater risk of unfavourable outcome after therapy for threshold ROP�Disappearance of the tunica vasculosa lentis after the treat-ment of threshold ROP was directly proportional to favour-able effect on fundus�tunica vasculosa lentis, ROP outcomes

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PO-47Smart phone: An innovative tool for telemedicine approach in ROP diagnosisSucheta Kulkarni, Nilesh Kakade, Pravin Narwadkar, Prof� Col� M DeshpandeH. V. Desai Eye Hospital, Pune, India

Aim: We conducted research to validate teleophthalmology model for diagnosis of ROP using transmitted images on smart phone using software, against “gold standard ”wide field digital photographic images interpreted by two separate medical retina specialists�Methods: ROP screening was done using portable pediatric fundus camera (Retcam shuttle, Clarity medical systems, USA)�Enrolled infants underwent one or more serial ex-aminations to diagnose ROP �Standard set of images was uploaded on a server using a software �First ophthalmologist made diagnosis based on digital photographic images while second ophthalmologist made diagnosis based on transmitted images on smart phone (i phone) �Both were masked to each others’ findings throughout the study�Results: Total 117 examinations (233 eyes) were enrolled for the study� Results showed good agreement between both methods of diagnosis � Not a single case of severe ROP was missed while using smart phone based diagnosis�Conclusion: This innovative tool can help formulate new public health strategies to strengthen eye care of preterm ba-bies in country like India where very few trained specialists are available to take care of vast number of babies�smart phone, teleophthalmology, ROP

PO-48Role of Socioeconomic factors in incidence ROPSucheta Kulkarni, Kuldeep Dole, Pravin Narwadkar, Prof� Col� M DeshpandeH. V. Desai Eye Hospital, Pune, India

Introduction: ROP is fast emerging as an important cause of Childhood Blindness in developing countries like India� The Socioeconomic factors may have a role in neonatal care that a preterm child may receive, as the higher level NICU care may be available at higher cost� The compliance for follow up of treatment related to ROP is going to be affected with socioeconomic status of the family�Aim: To evaluate the role of socioeconomic factors in inci-dence of ROP�Methods: We interviewed parents of 150 preterm babies ei-ther screened or treated by us to find out their socioeconomic class according to Kuppuswami socioeconomic scale� We also noted the level of NICU care each of them received�

These were analyzed and compared with presence of ROP and progression to treatable ROP stage�Results: Treatable ROP developed in significantly higher member of babies from lower Socioeconomic Class, most of which came from level 1 NICUs from government Hospital�Conclusion: Strategies need to be formulated at government level to improve neonatal care in developing countries�

PO-49Retinal vasculitis and Aggressive posterior ROP occurring in a preterm infant: A case reportSucheta Kulkarni, Nilesh Kakade, Pravin Narwadkar, Prof� Col� M DeshpandeH. V. Desai Eye Hospital, Pune, India

We report a case of retinal vasculitis and APROP coexisting in a preterm infant�This child with gestational age of 28 weeks and birth weight of 1448 grams was screened for ROP at 5 weeks of chrono-logical age �Initial screening examination showed white occludedposte-rior pole blood vessels in all four quadrants �Retinal blood vessels were immature in zone I and there was no ROP�Subsequent examination within 48 hours showed nondilating pupils with presence of plus disease suggestive of aggres-sive posterior ROP and also diffuse lipid exudation all over �The patient underwent aggressive laser treatment immedi-ately �On day 4 of ROP laser treatment, child was diagnosed to have fungal sepsis and started with systemic antifungal immediately�During a week after first laser session, child needed two additional laser sessions� Both retinal vasculitis and APROP regressed eventually after treatment�Retinal vasculitis can be a premonitory sign of systemic in-fection in a baby �This could also result in fast progression of ROP�retinal vasculitis, APROP

PO-50Macular formation at children with ROP according with optical coherence tomographyLudmila Katargina, Janina Rudnitskaya, Ludmila Kogoleva, Dmitriy RjabcevHelmholtz Moscow Research Institute of Eye Diseases

Purpose: research of the structural development of macula at children with ROP using OCTMaterials and methods: Macular areas status of 53 babies (62 eyes) aged 2-36 months with favorable ROP stages was observed using OCT� 34 eyes had laser treatment in active

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stage of ROP� Examinations of clinical signs of ROP were performed using RetCam II� Central foveal thickness, total macular volume, foveal depression were measured by Stratus OCT 3000 (Carl Zeiss Meditec Inc�)�Results: Values of foveal thicknesses, and total macular vol-umes showed wide variation in all age groups� MV tended to decrease and FT to decrease with the children’s age (p < 0,05)� The percentage of eyes having no foveal depression reduces with age (93% at 6 months, 71% at 6 to 12 months and 35% at 25-36 months)�Conclusion: The process of macular formation in ROP is influenced by a combination of factors: gestational age of birth, stage of ROP and the prophylactic treatment received (laser – and/or cryocoagulation)�ROP, macula development, children, optical coherence to-mography

PO-51Subgroup Analysis by Gender and Race of Clinical Risk Index for Babies Illness Severity Subscore as a Predictor of Severe Retinopathy of PrematurityMichael Yang1 Abrahamson Pediatric Eye Institute, Cincinnati Childrens Hospital Medical Center2 Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

PURPOSE: We previously showed that race, gender, and Clinical Risk Index for Babies subscore (CRIBSUB) were independent predictors for severe ROP warranting surgery (ROPWS)� The purpose of this study was to analyze whether CRIBSUB was an independent predictor of ROPWS for eyes in subgroups of male, female, black, or non-black infants�METHODS: Among 712 eyes of 357 infants (401 to 1250 g birth weight) admitted to the University Hospital of Cincin-nati from 1998-2003, there were 292, 306, 219, and 379 eyes in male, female, black, or non-black infant subgroups, re-spectively, with CRIBSUB data� Multiple logistic regression analysis included variables of birth weight, gestational age, CRIBSUB, multiple birth status, race, and gender� General-ized estimating equations were used to account for inter-eye correlation� Eyes with ROPWS, the outcome variable, either had classic threshold ROP or, in a few eyes, zone I or poste-rior zone II ROP with plus disease�RESULTS: Multiple logistic regression analysis showed that CRIBSUB was an independent predictor for ROPWS for the eyes of male (PPP = 0�11; OR 1�17 0�97-1�42) or black (P=0�14; OR 1�17 0�95-1�45) infants�CONCLUSIONS: Early illness severity as measured by CRIBSUB was predictive of ROPWS for the eyes of male

or non-black infants, but not for the eyes of female or black infants� This finding may suggest the presence of protective factors in female or black infants that lessen the impact of illness severity on ROP outcome�CRIB score, gender, race, illness severity, ROP

PO-52Asymmetric revascularisation pattern after intravitreal bevazicumab for acute posterior ROPBirgit Lorenz1, Melanie Jaeger1, Mechthild Hubert2, Reinald Repp3, Dirk Faas4, Monika Andrassi-Darida1

1 Department of Ophthalmology, Justus-Liebig-University Giessen, Universitaetsklinikum Giessen und Marburg, Gies-sen Campus, Germany2 Red Cross Childrens Hospital Siegen, Germany3 Childrens Hospital Fulda, Klinikum Fulda, Germany4 Childrens Hospital Justus-Liebig-University Giessen, Uni-versitaetsklinikum Giessen und Marburg, Giessen Campus, Germany

Purpose: To describe the asymmetric vascular pattern in acute and aggressive posterior retinopathy of prematurity (ROP) during natural history and after intravitreal bevaci-zumab injection�Design: Interventional case seriesParticipants: Thirteen preterms with acute ROP in zone I or posterior zone II or aggressive posterior ROP (AP-ROP)�Methods: Preterms referred to treatment from 4 neonatal intensive care units according to screening protocols were examined clinically and with digital wide-angle fundus pho-tography and fluorescein angiography (FLA)� Bevacizumab was injected intravitreally at a dose of 0�312 mg in 0�025 ml per eye in cases of zone I disease or reduced fundus visibility because of dilated tunica vasculosa lentis or reduced media transparency in posterior zone II�Main Outcome Measures: Classification by zone prior to treatment applying ICROP and ICROP revisited for both nasal and temporal periphery� Regression of acute ROP, eventual recurrence, and development of vascularisation post treatment by serial fundus photography and FLA�Results: In 9/13 cases with acute posterior ROP stage 3+ was located in posterior zone II temporally but in zone I na-sally� Three cases were assigned to AP-ROP� Post-injection vascularisation showed large vascular arcades with circum-ferential shunting in the nasal periphery central to the vascu-larisation border� The temporal vascular growth was normal�Conclusion: Naso-temporal asymmetry at the time of treat-ment may lead to differences in classification� The revas-cularisation pattern after intravitreal bevacizumab could indicate an effect of bevacizumab on vessel development

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depending on differences in maturation stage in the nasal versus the temporal retina at treatment�

PO-53Retinopathy of Prematurity screening results in the Government and Private Neonatal Units in Rural India: Data from 16 remotely managed KIDROP outreach centers using the Retcam and Tele-ROPAnand Vinekar, Muralidhar Gayakwad, Ravishankar Maski, Munusamy Sivakumar, Praveen Sharma, Bhujang ShettyNarayana Nethralaya Postgraduate Institute of Ophthalmol-ogy, Bangalore, India

Objective: To report the first year data from 16 outreach centers in the northern region of Karnataka State managed by trained non-physicians and remotely supervised by ROP specialists of the Karnataka Internet Assisted Diagnosis of ROP (KIDROP) teamMethods: The neonatal units (NU’s) of 5 Government owned district hospitals, 4 Private Medical College Hospi-tals and 7 Private stand-alone NU’s were enrolled into the ROP screening program� A trained team of non-physicians visited these NU’s every week in a fixed schedule� All in-fants below 2000 grams at birth were recruited for screening� Retcam images (Clarity MSI, USA) were obtained at each visit� The national average of 9% of all admissions was used to calculate the ‘at-risk’ population� Wherever allowed, par-ent counseling was performed by the KIDROP team� The KIDROP team used the mobile phone to contact parents to schedule visits� Screening and treatment was performed at no cost to the patient� For the purpose of the study, the sup-port from the neonatal unit’s staff was graded as poor, aver-age or good� The yield of enrollment and the proportion that completed follow-up was analyzed along with the incidence and severity of ROP�Results: Fourteen of the 16 NU’s maintained admission registers and were included for analysis� During the study period, 9062 admissions in the NU’s were recorded� The projected enrolment was 816 infants� Of the 817 (100�1% of projected) infants recruited, 222 infants (27�2%) had any stage of ROP, and 50 infants (6�1%) required treatment� The average incidence of any stage and treatable ROP in the Government hospitals was 17�9% and 2�1%, Private medical colleges was 29�5% and 8% and Private NU’s was 34�7% and 9�4% respectively� Only 330 infants (40�4%) completed follow up, although none with Type 1 or Type 2 high risk at last screening were lost to follow-up� NU’s with uncoop-erative pediatric support staff had the lowest enrolment and follow-up�Conclusions: This is the first multi-center rural data for ROP

screening from a middle-income country� Lack of awareness among the medical and paramedical staff in the NU’s, in-adequate infrastructure in the hospitals, low socio economic background, lack of education among the parents, unwilling-ness to travel for repeat visits are some of the special chal-lenges in the rural scenario� Lack of robust hospital admis-sion data is almost universal� This initial learning has helped us refine techniques and introduce new practices for improv-ing the program in the expansion phase�Rural, Middle-income country, Tele-ROP, Screening, Out-come, Pediatrician

PO-54Course of Refractive status and ocular growth in preterm babies - A 1 year Follow UpMuralidharan Ponnurangam2,1, Sarita Beri1,1, Sushma Nan-gia1,1, Rajesh Jain1,1, Pamela D Souza1,1

1 Lady Hardinge Medical College, New Delhi2 Sanjeevani Hospital, NTPC Singrauli, Uttar Pradesh

Aim: To Study the Course of Refractive Status and Ocular Growth in Preterm babies over a period of 1 year�Study DesignHospital based, Prospective, Observational studyMaterial and Methods: The study included all preterm neonates attending ROP screening clinic from October 2010 to December 2010� A total of 36 preterms were screened for ROP at 4 weeks of age� The babies were divided into two Groups based on development of ROP; Group A - 5 babies with ROP and Group B - 31 babies without ROP� They were followed up for a period of 1 year at 3, 6 and 12 months of age� At each visit - Refractive status was assessed under cy-cloplegia (Tropicamide) using streak retinoscope and biomet-ric analysis for ocular growth was done using USG A scan (Nidek US 3300)� Analysis was done using Excel Software�Results: All babies in Group A had early stages of ROP� Refraction at 1st visit is of lower hypermetropia in Group A (+1�83±0�44) as compared to Group B (+2�66±1�41), (p<0�08)� This difference gained statistical significance at 3 months (Group A +1�75±0�61 and Group B +2�86±0�71) (p<0�001) and 6 months of age (Group A +1�75±0�42 and Group B +3�44±0�57) (p<0�001)� At 12 months both Groups A and B had similar refractive status (Group A +2�62±1�38 and Group B +2�85±0�88) (p<0�28)�Axial length and Vitreous length is statistically larger in Group A than Group B at 3, 6 and 12 months (p<0�001)� Anterior chamber depth is lower at 3 and 6 months in group A than Group B, but at 12 months it is similar to Group B� Lens thickness is always statistically higher in Group A as compared to Group B at 3, 6 and 12 months (p<0�01)�

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Conclusion: Refraction in Group A (Babies with ROP) is of lower hypermetropia as compared to Group B (Babies with-out ROP) up to 6 months of age and it becomes similar at 12 months of age�Ocular growth is different in Preterm babies with ROP and without ROP� There has been a decreased anterior segment growth up to 6 months of age in Group A (with ROP), which corroborates to anterior segment arrest in babies of ROP in the early period of ocular growth�Refractive Status, Ocular Growth

PO-55Diagnostics and treatment of aggressive posterior retinopathy of prematurityAssel Sharipova, Lukpan OrazbekovKazakh Eye Research Institute

Aggressive posterior retinopathy of prematurity (APROP) is the most dangerous and fulminant form of the retinopathy of prematurity (ROP) that results in most cases to blindness�Aim: To analyze the clinical course and efficacy of laser treatment of aggressive posterior retinopathy of prematurityMaterial and methods. 15 prematured infants with APROP with the birth weight of 1061�54±189 gram and gestational age 27�28±1�93 weeks were under the follow-up� Indirect binocular ophthalmoscopy and digital retinoscopy were used for diagnostics� Transpupilar lasercoagulation of the retina by diode laser with 532 nm and 810 nm was performed to 12 infants� The parents of 3 infants refused from surgery�Results: First clinical signs were revealed at 32�4±1�1weeks of postconceptual age (PCA)� There were symmetrical le-sion, retinal vascularization of the zone 1 was in 60 %, with involvement of the zone 2 was in 40 %� Vessel returning to the optic disc was in 33 %� Demarcated ridge at 3-5 o’clock from the nasal side was detected in 73�3 %� The initial tortu-osity and dilatation of the end vessels were determined from the temporal side�The positive result of laser treatment was reached in 83 % (10 patients, 18 eyes)� To 2 patients (2 eyes) the additional lasercoagulation was performed, the disease was regresssed after treatment� Despite to the treatment in 16�6% ROP was progressed to stage 5�Conclusion: The increase of incidence of APROP is a cause for the early screening and early aggressive treatment� The efficacy of in-time laser treatment is 83%�aggressive posterior retinopathy of prematurity, laser treat-ment

PO-56Quantitative characteristics of the hemodynamic parameters in active phase of retinopathy of prematurityAssel Sharipova1, Kuralay Zhazykbayeva2

1 Kazakh Eye Research Institute2 International centre of vision protection

Retinopathy of prematurity (ROP) is the vasoproliferative retinal lesion that leads to blindness�Material and methods: Colour doppler imaging in ophthal-mic artery (OA), central retinal artery (CRA) and short pos-terior ciliar arteries (SPCA) performed in 40 prematured in-fants (72 eyes) with ROP and mean gestational age 36�44 ± 1�82 weeks� I stage of the ROP was diagnosed in 21 eyes, II stage in 24 eyes, III stage in 27 eyes� Control group included 20 prematured infants (39 eyes) without ROP and gestational age 36�05±1�8 weeks� Maximal systolic velocity (V sist), end diastolic velocity (V diast) and resistive index (RI) were measured�Results: There was not significant changes of Vsist in OA between two groups (p>0�05)� The diastolic velocity was de-creased in ROP II and ROP III (p<0�01), increase of RI up to 0�8 and more (p<0�001) in all stages�In CRA the V diast decrease in to 2�5 times in infants with ROP I and in to 8 times in ROP III than in control group, RI was increased in to 1�4 times� Significant changes of quan-titative parameters of V diast and RI in ROP III were found not only in comparison with control group, but also between the stages of ROP (p<0�001)�There were not significant differences between ROP I and ROP II in SPCA� But the significant increase of RI and sharp reduce of V diast in ROP II revealed (p<0�001)�Conclusion: The diastolic velocity and resistive index in OA and, especially, in CRA and SPCA in different stages of ROP is high significant�retinopathy of prematurity, Colour doppler imaging

PO-57Transscleral photocoagulation in retinopathy of prematurityMartin Flores-Aguilar1,3, Alicia Flores2, Leticia Hernandez3, Bricia Cordoba2

1 Medical & Surgical Retina Celaya, Mexico2 General Hospital Celaya, Mexico3 Childrens Hospital Queretaro, Mexico

Objective: To evaluate the efficacy and safety of transscleral photocoagulation in threshold retinopathy of prematurity (ROP)�

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Methods: 232 eyes of 116 preterm infants (28-33 weeks ges-tation) were treated by laser photocoagulation (solid state), one eye of each patient was treated transsclerally while the contralateral eye by traspupillary photocoagulation�Results: 116 eyes treated transpupillary showed signs of re-gression at 72 hrs after application while 104 transsclerally treated eyes had signs of regression at 96 hrs, 5 required re-treatment� No adverse effects were observed except for small areas of pre-retinal bleeding in 10 eyes treated transsclerally�Conclusion: Our results suggest that transscleral photoco-agulation is as effective for threshold ROP as transpupillary application with minimal complications and complete resolu-tion of the retinopathy�Transscleral, threshold, retinopathy of prematurity

PO-58Refractive status and presence of strabismus in preterm babies with ROPMilena Vujanovic1, Gordana Stankovic-Babic1, Ana Oros2, Sonja Cekic1

1 Clinic of Ophthalmology Nis2 Clinic of Ophthalmology NoviSad

PURPOSE: To evaluate the refractive status and presence of strabismus in babies born prematurely with retinopathy of prematurity (ROP) in region of Nis, Serbia�METHODS: The retrospective study included 71 babies (41M:30F), aged nine months, born prematurely with ROP( ≤ 37 GS and/or birth weight ≤ 2000g) examined a the Clinic of Ophthalmology Nis, Serbia� All children underwent a full ocu-lar examination, including cyclopegia refractive errors, ocular alignment, anterior and posterior segment examinations and ultrasound examination - total axial length were measured�RESULTS: Of the 71 babies studied, 30 (42%) had mild retinophaty of prematurity (ROP stage1, ROP stage 2) and 41(58%) had severe ROP ( ROP ≥ stage 3)� In group of ba-bies with severe ROP 33(80%) were treated by laserphoto-coagulation� The most common refractive error in group of mild ROP was hyperopic astigmatism (47%)� In group with sever ROP where the laser treatment is not applied the most freqent is myopic astigmatism 8eyes(64%), but in group where the laser treatment is applied the most common is myopic astigmatism 13(39%) and also mixed astigmatism 14(42%)� Strabismus was present in 5(17%) cases in group of mild ROP, in 3(37%) cases in group with severe ROP without laser treatment, and in 5(15%) cases in group with laser treatment�CONCLUSIONS: Premature infants had high rates of re-fractive error� Uncorrected refractive errors are closely asso-ciated with ambliopia, so it is necessary in this population of

children to chek at time refractive statusrefractive error,strabismus,ROP

PO-59Ocular morbidity in preterm children without retinopathy of prematurityGordana Stankovic-Babic1, Milena Vujanovic1, Sonja Cekic1, Ana Oros2

1 Clinic of Ophthalmology Nis2 Clinic of Ophthalmology NoviSad

PURPOSE: To investigate ocular morbidity in children born prematurely without retinopathy of prematurity (ROP) in re-gion of Nis, Serbia�METHODS:The population-based study was carried out in 102 children (45 M :57 F) born prematurely without ROP( ≤ 37 GS and/or birth weight ≤ 2000g) in the three years period 2009-2011 in Clinic of Ophthalmology Nis, Serbia� All chil-dren underwent a full ocular examination, including cyclope-gia refractive errors, ocular alignment, anterior and posterior segment examinations and ultrasound examination - total axial length were measured�RESULTS: Fifteen (14�7%) subjects had strabismus� Hyper-metropia had 59 (58%) subjects, hypermetropic astigmatisms had 40 (39%) subjects, myopia 2 (2%), and mixtus astigma-tism had 1(1%) subjects, without subjects’ myopic astigma-tism and anisometropia� Iris coloboma had 3 subjects; iris and choroidal coloboma had 3 subjects� � Total axial length was significantly correlated with both gestational age at birth (r=0�822, P<0�001) and birth weight (r=0�569, P=0�003)�CONCLUSIONS: According to the literature, the preva-lence of strabismus, amblyopia, and anisometropia may be higher in preterm children without ROP than in age-matched, normally delivered children� Although the incidence of ophthalmologic problems in the ROP group is considerably higher, the incidence in the non-ROP group still turned out unexpectedly high�refractive error,strabismus,ROP

PO-60Clinical Utility of an Indigenous, Patent Pending Software Algorithm for Automatic Detection of Stages of Retinopathy of PrematurityAnand Vinekar1, Joshi Manisha2, Tanya Susan Mathews1, Ye-shaswini Nagaraj1

1 Narayana Nethralaya Postgraduate Institute of Ophthal-mology, Bangalore, India2 Department of Medical Electronics, BMS College of Engi-neering, Bangalore, India

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Purpose: To evaluate the clinical utility of a software algo-rithm developed using MATLAB to automatically detect ‘the ridge’ in Retinopathy of Prematurity images, obtained on the Retcam (Clarity MSI, USA)�Methods: Thirty Retcam images of Asian Indian infants pre-viously validated to have stage 2 ROP by a ROP specialist using indirect ophthalmoscopy were included for analysis� The ridge was marked on printed copies of these images and scanned before analysis� A MATLAB software code (MATLAB R2009b) was evolved using a novel algorithm using multilevel vessel enhancement methods to enhance tubular structures� Accuracy and utility of the software was assessed using two scores� 1) Image based analysis, wherein the length and position of the ridge were criteria� If > 75% of the length of the ridge was detected, it was considered a true positive (TP)� If an area other than the ridge was detected, it was considered as a false positive (FP)� 2) Pixel based analysis, wherein the images marked by the physician were converted to a binary image and compared to a binarized im-age of the algorithm� Pixels that belonged to the ridge were considered TP and those outside as FP� Sensitivity analysis was performed using both scores�Results: The image based scores showed acceptable clini-cal accuracy� The sensitivity for the mean of 30 images was 92�3% and positive predictive value (PPV) was 85�7%� In the pixel based score, there was more variability in the results and the overall sensitivity was 60�4% (20�9 – 84�3) and PPV 52�8% (27�7-82�1)Conclusions: This pilot data using our patent pending (#use-rid000175) software algorithm shows an acceptable accuracy in detecting stage 2 ROP on digital images� The pixel-based validation needs further refinement� Future scope lies in fully automating the software to detect and classify stages of ROP� The utility of a software based algorithm in a tele-medicine network for triaging and classifying ROP images appears plausible with further research�Software detection, ROP, algorithm, MATLAB

PO-61Retinopathy of prematurity screening trialsT�K� Botabekova�, A�U� Sharipova�, A�S� TuletovaKazakh Research Institute of Eye Diseases

Objective: Recently retinopathy of prematurity (ROP) has become a frequent cause of preterm infants’ eye disability�The study aims to evaluate ROP screening results�Methods: The study objects were premature infants born weighing up to 2499 grams and gestational age of 34 weeks� The studies were conducted in major neonatal centers in Al-maty� ROP screening and monitoring of the state of immature

retina was carried out based on international experience� Re-search methods included indirect binocular ophthalmoscopy and digital retinoscopy�Results: 397 preterm infants were examined between 2011 and June 2012 and ROP was identified at 177 children (44�5%)� ROP frequency during the study increased from 36�2% in 2011 to 62�9% in by mid-2012� Percentage of pa-tients with severe disease forms due to the back aggressive retinopathy of prematurity increased from 6�06% to 8�97%� The largest ROP proportion was observed in infants born weighing 500 to 999 grams - 84%, with bodyweight between 1000 and 1499 - 60%� In case of 1500 to 1999g weight cat-egory ROP was 14% and in newborn weighing over 2000g ROP was not observed�Manifestation terms occurred at 34,2 ± 1,54 week of post-conceptual age (PA) and significantly varied depending the stage of disease� ROP stage I was observed in 34,89 ± 1,23 weeks of PA, ROP stage II - 33,98 ± 1,3 weeks of PA, ROP stage III - 35,83 ± 1,2 weeks of PA; APROP - 32,4 ± 1,1 weeks of PA�Conclusion: The main criteria for ROP screening in Kazakh-stan is birth weight below 2000 g, gestational age less than 34 weeks� Increased ROP and APROP frequency in the study population justifies earlier screening�screening, retinopathy of prematurity

PO-62Role of oral dextrose in pain management during laser treatment of ROP babies under topical anaesthesiaSubina Narang, Manisha Kataria, Deepak Chawla, Sunandan SoodGovernment Medical College Hospital, Chandigarh

Objective: Recently published guidelines recommend use of sucrose in neonates undergoing painful procedures� The study was carried out to evaluate efficacy of oral dextrose with topical anaesthesia in providing pain relief during laser therapy in retinopathy of prematurity (ROP) babies using premature infant pain profile (PIPP) score�Methods: Prospective, randomized, double blind case con-trol study� The study included 24 babies with type 1 ROP undergoing laser treatment� The mean birth weight was 1136�3±460�9 grams and the mean period of gestation was 29�1±2�2 weeks� Babies were randomly divided using com-puter generated tables into group 1 (given topical paracaine instilled twice at 10 minutes interval before laser treatment) and group 2 (administrated oral 2 ml of 25 % dextrose 10-15 minutes before procedure with topical anaesthesia as in group 1)� During the procedure, an infant pulse oxymeter

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was applied to infant’s foot and a digital camera was posi-tioned approximately 1 meter from the baby� The infant’s face was videotaped and physiologic responses (heart rate and oxygen saturation) were continuously recorded� A valid and reliable PIPP score was developed based on 30-second observations that compared baseline indicators to phases throughout a procedure�Results: The two groups were comparable in sex distribu-tion, birth weight, period of gestation, stage, extent of ROP and duration of laser treatment� There was no significant difference in PIPP scores in the two groups throughout the procedure (p=0�9)�Conclusion: Oral dextrose does not give any additional ben-efit of decreasing pain in preterm babies with ROP during laser procedure�pain relief, ROP, laser, anaesthesia

PO-63ROP treatment-RetCam documented studyAna Oros1,2, Branislava Dedovic Bjelajac2

1 Medical Faculty Novi Sad2 Institut for Neonatology Belgrade

Purpose: RetCam has been used for the evaluation of ana-tomic outcome in acute ROP in posterior zone after intravit-realy application of anti-VEGF drug� The anti-VEGF therapy was performed with aim to stop pathological angiogenesis, to allow the rising of normal retinal vasculature and the devel-opment, differentiation and maturation of macular elements�Setting: The pathogenesis of ROP involves a complex re-lationship among avascular retina, immature retinal vessels, oxygen levels, and signal transduction� Vascular proliferation

of new retinal vessel growth is induced by molecular messen-gers from the hypoxic, avascular retina� In these conditions the development of retina a special of macula, is difficult�Methods: The study includes 90 eyes of 45 babies with se-vere stages of posterior ROP to whom the anti-VEGF drug has been installed intravitrealy� The variant morphology of severe forms of posterior ROP has been documented with RetCam� RetCam analysis was performed during follow up period of six months�Results: Favorable anatomic outcome has been achieved in eyes of all babies with application of one dose of anti- VEGF therapy, excepted in four eyes of two babies, where two doses are aplicated� In all cases the activity of ROP was regressed� The development of vascular network was achieved� The anatomic conditions of vasculature have been documented by RetCam� Pattern analysis was documented in framework of 6 months� The regression of activity starts with reduction of vessels engorgement and decreasing of conges-

tion of ridge if was present� The sings of te therapeutic ef-fects are evanescence of neovascularization, losing multiple branching of retinal vessels at the junction of avascular and vascular retina, evanescence of arreial tortuosity and venal dilatation as well as the ridge disappearing� Temporal and na-sal arcades are growing to the periphery� Capillary network is developed as well as main arcades�Conclusion: The application of anti-VEGF drug has been performed in cases of severe form of posterior ROP, where the localization of ischemic processes was in large retinal area and in the macular region to� During evaluation of thera-peutically effects of antiVEGF drug installed intravitrealy, system of RetCam offers the possibility for analysis of the el-ements of developing network of blood vessels of the retina�I have no financial disclosureROP, anti-VEGF agents, RetCam documentation

PO-64Refractive Status of Eyes Treated for Retinopathy of Prematurity (ROP) with Bevacizumab alone versus Laser at 4 years follow-up.Alay Banker, Kinnari THakkar, Khushboo Patel, Shilpi Shah, Usman Memon, Chatura HutheesingBankers Retina Clinic and Laser Centre, Ahmedabad, India

PURPOSE: To prospectively evaluate refractive outcomes of eyes with ROP treated with bevacizumab alone versus la-ser at 4 years follow up�MATERIAL & METHODS: Prospective study of 58 eyes of 29 infants� 36 eyes were treated with only bevacizumab without laser, 16 eyes were treated with laser & 6 eyes, with both laser and avastin� At 4 years age, all children underwent atropinized refractive evaluation� Based on cycloplegic reti-noscopy, they were prescribed glasses depending on his/her age and degree of refractive error�RESULTS: The bevacizumab alone treated eyes at 4 years showed a mean spherical equivalent(MSE) of -3�519 DS� 6/36 eyes were high myopic (-10�50 DS)� The laser group at 4 years showed a MSE of -3�578 DS� 3/26 eyes were high myopic (-13�16 DS)� The eyes treated with laser & avastin at 4 years age showed MSE -2�30 DS� There was no significant differ-ence in reractive errors between the three groups (p=0�657)CONCLUSION: Our 4 year follow-up study shows that ROP management can cause myopia irrespective of the treat-ment modality� There was no difference in the amount of myopia between the only bevacizumab treated, only laser and combined treated groups� Contrary to the earlier belief, our study shows that treating ROP with only bevacizumab does not lead to a decrease in treatment induced myopia�ROP, Bevacizumab, Laser, refraction

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PO-65Gujarat ROP Telemedicine Network for Diagnosis of Retinopathy of PrematurityAlay Banker, Shilpi Shah, Bijen Choksi, Sumeeta Mudaliar, Krishna Kapadia, Deepa BankerPolio Foundation Hospital, Ahmedabad

Purpose: To report the initial experiences of the Gujarat ROP Network for Diagnosis of Retinopathy of Prematurity telemedicine initiative�METHODS: One hundred forty two consecutively enrolled infants who met ROP examination criteria (infants with a birth weight ≤ 2000 g and/or period of gestation (POG) ≤ 34 weeks) were included in the study and were screened at 8 NICUs between 1 May 2012 through 14 July 2012 with the RetCam Shuttle and evaluated by one ROP expert ( Dr� ASB)� At least 7 standard images were obtained in each eye� Outcomes included referral-warranted disease, need for treatment and anatomical outcomes� Infants suspected of having ROP approaching the criteria for laser treatment were transferred to a hospital, where a diagnostic examination was performed and treatment administered when indicated�RESULTS: A prospective analysis of 376 eyes imaged with Retcam from the Gujarat ROP Network is reported here� In the initial 3-month period, the Gujarat ROP telemedicine screening initiative had not missed any referral warranted ROP� Calculated sensitivity and specificity was 100% and 95%, respectively� No patient progressed to retinal detach-ment or other adverse outcomes�CONCLUSIONS: The Gujarat ROP telemedicine screening initiative for ROP, the first in Western India has proven to have a high degree of sensitivity and specificity for identi-fication of referral warranted disease� These results indicate that telemedicine may improve accessibility of ROP screen-ing�ROP, telemedicine, Retcam

PO-66Retinopathy of Prematurity in East ChinaYu Xu1, Jiakai Li1, Yang Dong1, Qi Zhang1, Xin Huang2, Xiaohong Zhou3, Peiquan Zhao1

1 Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine2 Department of Ophthalmology, Eye & ENT Hospital of Fu-dan University3 Department of Ophthalmology, Childrens Hospital, Fudan Universtiy

Objective: To study the incidence of retinopathy of prema-turity (ROP) in the eastern China, the rate of treatment and

outcomes in all premature infants born at Shanghai from Jan 2010 to Jan 2012�Methods: A prospective cohort observational study on 2332 premature infants born at Shanghai, from Jan 2010 to Jan 2012 with birth weight equal to or less than 2000g or a gesta-tional age at birth of 32 weeks or less� All of the preterm ba-bies were screened for ROP at 4 weeks after birth� The main clinical outcome was the occurrence of ROP at any stage�Results: The incidence of ROP in the 2332 infants who were screened was 17�4%� Threshold disease occurred in 118 of the patients (3�6%) and aggressive posterior disease occurred in 17 of the patients (0�7%), all of them received laser treat-ment� 32 of the treated patients needed a second laser see-sion� Five of the re-treated group needed lens-sparing vitrec-tomy after progression to stage 4 of ROP�Conclusion: The incidence of ROP in this study was similar to the international results reported� One third of the infants with ROP needed laser photocoagulation� High incidence of retinopathy and high laser treatment necessity was showed among newborns under 28 weeks of gestational age or under 1000g of birth weight�retinopathy of prematurity; treatment; screening; China

PO-67Look What Else We Found! Clinical entities serendipitously detected on Retcam imaging during routine ROP screeningAnand Vinekar, Padmamalini Mahendradas, Kavitha Avad-hani, Parvathi Hari, Munusamy Sivakumar, Praveen SharmaNarayana Nethralaya Postgraduate Institute of Ophthalmol-ogy, Bangalore, India

Objective: To report the spectrum of anterior and posterior segment diagnoses that were detected serendipitously dur-ing routine Retinopathy of Prematurity (ROP) screening in a one-year period�Methods: A retrospective review of all Retcam (Clarity MSI, USA) imaging sessions during the year 2011 performed on infants born either < 2000 grams at birth and / or < 34 weeks of gestation recruited for ROP screening was performed� Hospital records of infants who received cross consultation between the ROP services and other departments were also retrieved� Images were reviewed and verified with the clini-cal outcome and treatment details where present� All infants had undergone a minimum of 7 images at each session, which included the dilated anterior segment, disc and macula center and the four quadrants using the 130 (ROP) lens� All images in each session were evaluated for this study� All in-fants had atleast one imaging session between 2 weeks and 14 weeks of postnatal age�

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Results: Of the 1450 new infants recruited in 2011, there were 106 (7�3%) with a diagnosis other than ROP� Anterior segment diagnoses comprised of 37 (34�9%) cases and in-cluded 14 eyes with clinically significant cataract, 3 with lid abnormalities, 5 with anophthalmos, 1 with microphthalmos and 8 with corneal diseases� Posterior segment diagnoses were 69 (65�1%) cases and included, 33 cases of self resolv-ing, superficial, retinal hemorrhages, 4 cases of cherry red spots and 15 cases of neonatal uveitis of infective etiologies including Toxoplasma retinochoroiditis (6), Fungal (2), Bac-terial (3), Mycobacterium Tuberculosis (1), Rubella retinitis (1), Cytomegalovirus (1) and Varicella retinitis (1)� Other retinal vascular conditions detected included Familial Exu-dative Vitreoretinopathy (12), Coats disease (2) and Inconti-nentia Pigmenti (1)� Importantly, 2 eyes with Retinoblastoma were detected which were clinically proven and managed�Conclusions: This study emphasizes the importance of digi-tal imaging of the infant eye� Visually significant, potentially life threatening and even treatable conditions were detected serendipitously during routine ROP screening which may have been missed or detected late otherwise� This pilot data may be used to advocate for a possible universal infant eye-screening program using digital imaging� Further research to determine its cost utility is warranted�RETCAM, imaging, diagnosis, retinoblastoma, hemorrhages, cataract, uveitis

PO-68The introduction of retinopathy of prematurity prevention in Shenzhen from 2003 to 2012Guoming Zhang, Song Sang, Jian Zeng, Ruyin Tian, Jinlian Guo, Wenjing Tan, Lin Shu, Yilin Yao, Hui ZhangShenzhen Eye Hospital

OBJECTIVE: To determine the incidence of ROP and se-vere ROP in Shenzhen from 2003 to 2012�METHODS: This was a retrospective,observational,descriptive,hospital-based study� Our subjects were preterm babies with BW < 2,000 g and > or = 2,000 g who received oxygen therapy and born between July 2003 and June 2012� Ges-tational age (GA),birth weight (BW), supplemental oxygen therapy, acute respiratory distress syndrome (ARDS), sepsis, blood transfusion, and phototherapy were assessed�RESULTS: Seven thousand, eight hundred and twenty-six newborn infants were evaluated� Mean BW +/-standard de-viation (SD) was 1850�64 +/- 530g and Mean GA +/- SD was 32�74 +/- 2�62 weeks� Incidence of ROP was 11�3% includ-ing 6�1% in prethreshold and 5�2% in threshold stages�CONCLUSIONS: The results show that the incidence of both any ROP and ROP in Shenzhen needing treatment are

comparable to other studies�retinopathy of prematurity,epidemiology,treatment

PO-69Fractal analysis of Images of AP ROPMaja Kostić1, Anna Oros1, Nebojša T� Milošević2, Herbert F� Jelinek3

1 University Eye Clinic, Novi Sad, Serbia2 Department of Biophysics, Belgrade, Serbia3 School of Community Health, Charles Stuard University, Albury, Australia

Objective: This paper explores the possibility of applying frac-tal analysis to images of blood vessels in the human retina with aggressive posterior retinopathy� The fractal analyses of retinal images with aggressive posterior retinopathy are higher than the fractal dimensions of the images of retina after laser therapy� Aggressive posterior disease is rapidly progressive retinopa-thy� Increased tortuosity of arterioles and venous dilation (plus disease) is present in all 4 quadrants of zone 1 and sometimes in posterior zone 2� It does not sequentially advance through stage 1 to 3, but often advances to stage 5� It seems important to recognize these eyes, because without treatment, they will progress to stage 5� Laser treatment was conducted under the su-pervision of neonatologist, who monitors and oversees the vital functions of the preterm babies� Since the broad zone ischemic retina it is necessary to put a large number of laser spots which requires a longer time of treatment�Methods: RetCam documentation was performed before laser treatment and 1 week after� The digital images of each retina were processed by Image J, specialized software for image analysis� The color image was converted into gray-scale and each blood vessel in the image was reconstructed using the specialized subroutine known as “Trace Contour“� Such generated images of the retinae were analyzed by frac-tal analysis�Results: Fractal analysis was performed using the box-counting procedure, incorporated into Image J, and for each image the box-counting dimension was obtained� The box counting procedure “covers” the image with sets of squares� Each set was described by the size of the square edge� The corresponding number of squares necessary to cover the im-age was presented as a function of the size of square edge� The box dimension was obtained as an absolute value of the (negative) slope of the log-log relationship between number of squares and the size of the square edge�Conclusion: The results of fractal analysis indicate that the blood vessels in the retinae with AP-ROP are more complex and irregular in shape than those after the surgery�fractal analysis, images, APROP

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PO-70A correlation of birth weight to refractive outcomes in treated pre threshold Retinopathy of Prematurity children.Alokesh Ganguly, Abhijit ChattopadhyayPriyamvada Birla Aravind Eye Hospital

Purpose: To compare the prevalence of refractive errors in treated pre threshold ROP babies weighing below and above 1250 grams at birth�Setting : A tertiary care referral institute in eastern India�Methods: This was an observational cohort study including thirty nine infants who had been screened for ROP between January 2007 and December 2009 who developed pre thresh-old ROP in both eyes and were treated by laser and followed up for refractive changes� Refractive errors were measured by cycloplegic retinoscopy at 6 months post conceptional age and at 2 years of post natal age� Cycloplegia was induced by administering 0�5% tropicamide and 5% phenylephrine hydrochloride eye drops at 60, 55, and 50 min before the refractive examination� All retinoscopic examinations and measurements of the refractive index were performed by an experienced pediatric ophthalmologist�Results: There were twenty three infants below 1250 gms birth weight in Group A and sixteen infants above 1250 gms weight in Group B� At 6 months post conceptional age the cycloplegic retinoscopy revealed a mean spherical equiva-lent of -3�925 ( SD 4�456 ; CI -95% CI- (-1�817 to 1�0326) in Group A and 0�4766 {SD 2�7359 ; 95% CI-(-0�5098 to 1�4630)} in Group B� At 2 years post natal age the cycolple-gic retinoscopy revealed a mean spherical equivalent of -0�887o { SD 4�8348 ; 95% CI- (-2�322 to 0�5488)} in Group A and 0�0150 {SD 2�6467 ; 95% CI-(-0�9392 to 0�9692)} in Group B� The unpaired ‘t’ test carried out between the two groups revealed a two tailed p value of 0�2272 which was not significant�Wilcoxon-Mann-Whitney U Two sample test was applied to Group A and Group B at 6 months which revealed a p value of 0�9169 and to Group A and Group B at 2years which revealed a p value of 0�7672� These were also not sig-nificant�Conclusions: The prevalence of refractive errors were not statistically significant between the two groups at 6months of post conceptional age and at 2 years of post natal age� This may signify that the higher prevalence of refractive errors in lasered ROP children is not related to the birth weight but is in some way exclusively linked to the changes induced by the la-ser treatment to the physiological process of emmetropisation� Thus all lasered ROP children require equally vigilant screen-ing for refractive errors irrespective of their birth weights�Refractive errors ; birth weight ; pre threshold retinopathy of prematurity.

PO-71ROP in Babies with Birth Weight less than 1000gm.Abhijit Chattopadhyay, Alokesh Ganguly, Soumen Mandal, Suvankarsri PalPriyambada Birla Aravind Eye Hospital, Kolkata

Objective: This study is done to see the severity of ROP in babies weighing less than 1000 gm at birth�Method: Records of first 650 babies screened in our hospital were retrospectively checked for the inclusion criteria�Results: 52 babies were included� All were having ROPs� One baby expired after the first follow up� Total 26 babies needed treatment, being typeI ROP� It was 50% of the total number of babie which was heighest in any category studied till now� The number of days of oxygenation were also calcu-lated between typeI and typeII ROP which was not found to be of much significance�Coclusion: The birth weight of less than 1000gm carry the highest risk of developing blinding ROP as an independent risk factor�ROP, Baby, 1000gm

PO-72Macular OCT findings in ROP patients treated with both laser and bevacizumabCristina Moreira-Santos, Rita Azevedo, Susana Pina, Mário Ramalho, Catarina Pedrosa, Susana Teixeira, António MeloHospital Prof. Doutor Fernado Fonseca

Objective: To describe macular optical coherence tomogra-phy (OCT) findings in children with history of retinopathy of prematurity (ROP) treated with both laser and bevacizumab�Methods: Clinical records and OCT (Stratus OCTTM Carl Zeiss Meditec) findings of the first 3 patients treated with both laser and bevacizumab at our hospital were reviewed� Control group were patients who only had laser treatment� One eye from each patient was randomly chosen� The main outcome measure was foveal and parafoveal retinal thick-ness�Results: 7 eyes of 7 patients with type 1 (stage 3+) disease were studied� All eyes were submited to laser ablation of pe-ripheral retina� The bevacizumab group (3 patients) recieved secondary intra-vitreal injection (0�03mL 25mg/mL)� On the bevacizumab group, at three years of age, mean parafoveal retinal thickness was 219μm, mean foveal thickness was 208μm, with mean foveal depression of 11μm� On the control group (4 patients), aged between five and six years of age, mean parafoveal retinal thickness was 256μm, mean foveal thickness was 243μm, with mean foveal depression of 13μm� The Wilcoxon rank-sum test showed no statistical

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difference between both groups�Conclusions: recent studies in the literature have shown a reduced foveal depression in premature infants with or whithout ROP comparing with normal full-term children� We report the same findings in this series of children treated with both laser and bevacizumab�OCT bevacizumab

PO-73Clinical Features of Smoldering ROP Occurring Spontaneously and Subsequent to Anti-VEGF TherapyKhaled Tawansy, Natalia Matti, Eugene Ng, Enrique ArizaChildrens Retina Institute, Pasadena CA

Objective: To describe clinical features of a distinct and atypical phenotype of ROP manifesting delayed retinal vas-cular maturation and late onset retinal detachment�Methods: Retrospective chart review of 8,560 preemies at risk for ROP followed in Southern and Central California over the past 11 years by Children’s Retina Institute� Those not receiving laser ablation and manifesting persistent pe-ripheral retinal non-perfusion with cicatricial changes or late onset retinal detachment beyond 50 weeks post conception were reviewed�Results: Two distinct populations were identified: 1) eyes with minimal ROP that does not meet standard treatment criteria whose retinas failed to completely vascularize and 2) eyes that received bevacizumab for ROP stage III plus in Zone I or Posterior Zone II within or outside of the BEAT-ROP study with resolution of plus and neovascularization but failed to recover and vascularize to the ora or had late cica-tricial changes� Both groups manifested variable gestation at birth (22-30 weeks) , and prolonged arrest of retinal vascular maturation with persistent peripheral non-perfusion� Both displayed multiple fibrotic dry ridges/ shunts suggesting a stuttering pattern of vascular growth or fibrovascular plaques in anterior zone II or zone IIII� Plus disease and extra-retinal neovascularization were minimal, while thick sub-retinal lipid exudation posterior to the ridge was common� Macu-lar dragging and late onset (56-607 weeks post-conception) retinal folds and detachments were seen in both populations before anticipatory ablative laser was advocated� Eyes that failed to vascularize to within 2 disc diameters of the ora serrata at 70 weeks post conception did not show significant further develpment over the subseqent 20 weeks� Circumfer-ential traction occurring adjacent to the crystalline lens was managed with small gauge vitrectomy and scleral buckle� Fluorescein angiography at 60-70 weeks post conception revealed a leaking brush border with super-numerous feeder

vessels mimicking FEVR and guided ablative laser� This form of ROP represents 15% (81 of 550) of preemies treated within the past decade� They had a high incidence (65%) of neurogic anomales, including intra-ventricular hemorrhage grade 3-4, periventricular leokomalacia and microcephaly which may be associated with early insult to the peri-papil-lary mesenchyme� Extended follow- up well beyond the due date until full vascular development has been achieved or un-til the non-perfused zones are ablated is required to prevent late complications�Conclusions: Smoldering ROP is an emerging phenotype associated with aborted vascular development and late trac-tional complications that needs greater consideration in the era of anti-VEGF treatment for aggressive ROP and survival of very low birth weight preemies�ROP, Phenotype, Clinical, Retinal Detachment, Macular Dragging, Cicatricial

PO-74Vascular Regression Patterns After Intra-Vitreal Bevacizumab for Zones I and Posterior Zone II Stage 3 Plus ROPEugene Ng, Khaled Tawansy, Enrique Ariza, Natalia MattiChildrens Retina Institute, Pasadena CA

Objective: To describe patterns and timing of retinal vascu-lar development and retinal detachment in neonatal eyes with acute posterior ischemic ROP treated with intra-vitreal beva-cizumabPurpose: To study the effect of intra-vitreal bevacizumab on timing and extent of retinal vascular development in poste-rior ischemic ROP, including regression of plus, resolution or cicatrization of neovascularization, recovery of intrinsic reti-nal vessels, and late complications associated with persistent peripheral non-perfusion and/or fibrovascular proliferation including macular dragging and retinal detachment�Methods: Retrospective review of clinical notes, fundus drawings and photographs, and fluorescein angiograms of 30 preemies who received bilateral intra-vitreal bevacizumab as first-line therapy for ROP Stage 3 Plus Zone II and IIp (diameter < 3X fovea to disc) within or outside of the BEAT-ROP study� Patients were followed indefinitely until retinal vessels reached the ora serrata or complications occurred requiring treatment�Results: Intravitreal bevacizumab at a dose of 0�625 mg re-sulted within 48 hours in uniform resolution of plus disease and diminution of flat and elevated neovascularization in the absence of cicatrization (crunch phenomenon)� Retinal vascular development was simultaneously stunted and did not show signs of progression until 4 weeks after injection�

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In 48/60 (80%) of eyes, retinal vessels extended to within 2 disc diameters of the ora serrata by 60 weeks post concep-tion, while the remaining 12/60 (20%) had persistent periph-eral non-perfusion by 60 weeks� Four of these 12 (33%) had silent abrupt termination of vessels in a brush-border pattern, while the remaining 8 (67%) had vascular changes, including dilated and leaky end-terminal buds (2/12, 17%), an active ridge with fluorescein staining (2/12, 17%), and fibrous con-traction with macular dragging (2/12, 17%) or retinal detach-ment (2/12, 17%)� In 2 cases of retinal detachment, onset was later (52 vs� 41 weeks) than in non-bevacizumab eyes and associated with less vascular activity (lower VAS) and multiple ridges (stuttering growth pattern)�Conclusions: Preemies receiving bevacizumab for posterior ischemic ROP had good initial response with regression of plus and neovascularization, but some will develop later complications associated with a Smoldering form of ROP, in-cluding late macular dragging and retinal detachment� Close follow up of these neonates is warranted until retinal vessels reach the ora serrata, which may extend beyond 6o weeks post conception, or until vascular and fibrous complication warrant intervention with ablative laser or vitreo-retinal sur-gery�ROP, Clinical, Anti-VEGF, Bevacizumab, Retinal Detach-ment

PO-75Vascular Activity Score as a Marker of Disease Burden and Prognosis in Neonatal ROPEnrique Ariza, Khaled Tawansy, Eugene Ng, Natalia MattiChildrens Retina Institute, Pasadena CA

Objective: To develop a useful quantitative measure of disease activity in ROP that can guide therapeutic decision making and relate to anatomic prognosis�Purpose: To describe the clinical experience at one center with multiple pediatric retina surgeons of a quantitative grading system that correlates with disease burden, need for intervention with laser ablation or anti-VEGF therapy, and prognosis with surgery�Methods: A quantitative grading scale was devised based on retrospective observations from 100 consecutive eyes with ROP that underwent wide-field photographic imaging and fluorescein angiography� Five parameters of vascular activity were given a score from 0 to 2, including activity of tunica vasculosa lentis and hyaloidal artery, extent of plus, width and height of ROP ridge, presence of pre-retinal or vitre-ous hemorrhage, and extent of intra-retinal or extra-retinal neovascularization� The resulting cumulative score was then used to predict the likelihood of anatomic success in a series

of 310 eyes that underwent vitreous surgery for ROP-associ-ated retinal detachment, as well as 20 eyes that had the score modified by intra-vitreal bevacizumab therapy before retinal detachment surgery�Results: A VAS of 0-10 was given for each eye that under-went vitreous surgery based on independent study of the wide-field photographs and fluorescein angiograms� In eyes that underwent bevazicumab therapy, VAS was determined on the day of injection and at vitreous surgery 5 to 10 days later� Eyes were then divided into 5 groups based on score (0-2, 3-4, 5-6, 7-8, 9-10), and mean anatomic success was determined for each� All eyes receiving bevacizumab had a reduction of VAS by a mean of 4�5 points (2-8)� A linear re-lationship was discovered between VAS and retinal reattach-ment rate for eyes undergoing vitrectomy for retinal detach-ment in vascularly active ROP� A VAS of 0-2 corelated with a 10% rate of retinal reattachment, while a VAS of 9-10 cor-related with a 95% rate of stable retinal re-attachment� The use of bevacizumab in eyes with VAS of 5-10 was associated with a better surgical outcome than similar eyes that did not recieve anti-VEGF and approached rates of eyes whose base-line VAS was 0-4� �Conclusions: VAS may be a useful quantitative measure of ROP disease activity that can estimate anatomic prognosis with vitreous surgery in the setting of retinal detachment and help guide use of anti-VEGF therapy�ROP, Clinical, Vascular Activity, Retinal Detachment

PO-76TREATMENT OF AP-ROP BY INTRAVITREAL INJECTION OF BEVACIZUMAB – 1 YEARS FOLLOW UP RESULT.Nguyen Xuan Tinh1, Do Nhu Hon1, Nguyen Quoc Anh2

1 National Institute of Ophthalmology, Hanoi, Vietnam2 National Hospital of Obstetric and Gynecology, Hanoi, Vietnam

Purpose: To evaluate the mid term result of intravitreal in-jection of bevacizumab (avastin) in treatment of AP- ROP after more than one year follow up�Patient and Method: 212 eyes of 106 babies with AP-ROP were included, mean birth weight was 1�261 ± 276g (range from 700- 2000g), mean of gestation age is 29�6 ± 1�7 weeks (from 25 – 33 weeks)� All eyes were treated by a single intravitreal injection of avastin 0�025ml (0�625mg)� Recurrent ROP was treated by a repeated injection� All pa-tients was followed up more than one year�Result: 97�6% (207/212 eyes) of AP- ROP was completely regressed after the primary avastin injection� The recurrent ROP was seen in 0�94% (2/212 eyes)� 1�4% (3/212 eyes)

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ROP was not completely regressed due to extraretinal fibro-sis contraction causing macular fold or retinal detachment� These incomplete regressed ROP have been seen in ROP at zone 1 with very high ridge before treatment� One patient having bilateral exophthalmos with mild elevated intraocular pressure was recorded as complication of treatment�Conclusion: With more than 1 year follow up, intravitreal injection of avastin injection seems an effective treatment for AP- ROP, the success rate was 97�6%� However, long term follow up is needed for local and systemic side effect�

PO-77Five Years Follow up of Intravitreal Bevacizumab Therapy in the Treatment of Retinopathy of Prematurity. Anatomical, Functional, and Neurodevelopmental AnalysisMaria AnaMartinez-Castellanos1, Gerardo Garcia-Aguirre1, Robison Vernon Paul Chan2, Hugo Quiroz-Mercado3

1 Asociacion para Evitar la Ceguera en Mexico. Hospital “Luis Sanchez Bulnes”. Mexico City2 New York Presbyterian Hospital Weill Cornell Medical College, USA3 Denver Health. University of Colorado. Denver, Colorado.

Objective: To report our findings after five years follow up in a group of infants treated with intravitreal bevacizumab (IB) for treatment requiring ROPMethods: A prospective, logitudinal study was performed in 18 eyes of 13 premature infants treated with IB for ROP� The eyes were divided into three groups: group I, eyes with stage 4a or 4b that had no response to conventional treatment (n=4); group II, eyes with threshold ROP that were difficult to treat with conventional treatment (n=5); group III, eyes with high risk prethreshold or threshold ROP (n=9)� Neovas-cular regression, anatomical findings, functional testing, and neurodevelopmental outcomes were recorded�Results: Regression of neovascularization and normal vascular growth was found in all patients� At five years of follow up, no abnormalities were found in neurodevelop-ment� In groups II and III, retinal function was conserved 5 years after IB as assessed by ERG, refraction and VA� Best corrected visual acuity (BCVA) in groups II and III ranged from 20/20 to 20/200 (7 eyes with BCVA=20/20; 4 eyes with BCVA=20/25; 1 eye with BCVA=20/40; 1 eye with BCVA=20/80; 1 eye with BCVA=20/200)� All except one patient displayed visual acuity of 20/200 or worse�Conclusions: Our findings suggest that intravitreal bevaci-zumab as a treatment for retinopathy of prematurity may be a safe and effective therapy at 5 years of follow up in this small series

Bevacizumab, antianagiogenesis, ROP, ERG, retinopathy of prematurity, Neurodevelopment

PO-78Blindness Prevalence Rate In Patients Treated For Retinopathy Of Prematurity Using Off Label Bevacizumab As Monotherapy In The Blindness Prevention Program In Two Secondary Healthcare Hospitals In Mexico, Three Years Follow UpMaria Ana Martinez-Castellanos1,2,3, Jorge Morales1

1 Asociacion para Evitar la Ceguera en Mexico. Hospital “Luis Sanchez Bulnes”. Mexico City2 Hospital de Especialidades “Belisario Dominguez” Gobi-erno del Distrito Federal. Mexico City3 Hospital Materno-Perinatal “Monica Pretellini” Instituto de Salud del Estado de Mexico.Toluca,Mexico

Objective: To describe the prevalence of blindess in patients treated with off label intravitreal bevacizumab for treatment requiring ROP in the blindness prevention program (BPP) established in May 2009 in the Neonatal Intensive Care Unit (NICU) of two secondary healthcare hospitals in Mexico with no access to laser o cryotherapy�Methods: This is a prospective analysis of 461 premature infants with birth weight < 2000 grams or gestational age < 34 weeks, admitted to the Neonatal Intensive Care Unit of two secondary healthcare hospital in a one year period� The infants underwent eye examinations between their 4th and 6th week of life, patients diagnosed with treatment requiring retinopathy of prematurity (stage 3, prethreshold or thresh-old) were injected with 0�03cc of off label intravitreal beva-cizumab under topical anesthesia, follow up was performed with complete ophthalmological and systemical examina-tions�Results: During period between May of 2009 and May of 2012, 461 patients with risk factors to develop ROP un-derwent ophthalmological exploration, 56 eyes (12�14%) required treatment after developing stage 3 ROP� After a one year period, none of the treated eyes developed blindness nor serious ocular complications�Conclusions: In this small sample, our low level of blind-ness prevalence in patients diagnosed with treatment requir-ing ROP treated with bevacizumab suggest that intravitreal antiangiogenic therapy seems to be a promising treatment as monotherapy for ROP patients with no access to technologi-cal devices as laser or cryo to provide conventional treatment for this devastating disease� Multicenter comparative studies are required to regulate its use�Bevacizumab, antianagiogenesis, ROP, ERG, retinopathy of prematurity, Neurodevelopment

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PO-79Comparison of Optical Coherence Tomography Macular Findings in 5 Year-Old Patients with a History of Pre-Threshold or Threshold Retinopathy of Prematurity Treated with Intravitreal Bevacizumab as MonotherapyMaria Ana Martinez-Castellanos1, Alberto Hernandez-Var-gas1, Robison Vernon Paul Chan2, Hugo Quiroz-Mercado1

1 Asociacion para Evitar la Ceguera en Mexico. Hospital “Luis Sanchez Bulnes”. Mexico City.2 New York Presbyterian Hospital Weill Cornell Medical College, USA3 Denver Health. University of Colorado. Denver, Colorado.

Objective: To compare the optical coherence tomography (OCT) macular findings in 5 year-old patients with a his-tory of pre-threshold or threshold retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IB) as mono-therapy�Methods: In a case-control study, iVUE OCT (OptoVue) imaging of the macula was performed on 5 year-old patients with history of ROP treated with intravitreal bevacizumab� The same OCT imaging was performed in healthy patients who were born full-term and were 5 years of age at time of imaging� The findings were correlated with ophthalmoscopy and visual acuity�Results: Nine eyes of 5 patients were treated with IB for threshold or pre-threshold ROP between september 2005 and June 2006� Mean gestational age at birth was 29�2 weeks� The 9 eyes had a median best-corrected visual acuity of 0�01 logMAR� The control group had 0�00 logMAR� The OCT showed a normal macular depression in both groups, mean thickness 202 µm (range 184-218 µm) in the ROP group and mean 210 µm (range 173-234 µm) in the control group, p=0�0001� No vitreoretinal disorders were observed�Conclusions: OCT imaging showed no anatomical differ-ence or macular thikness between both groups� Larger stud-ies should be performed to confirm these findings�Bevacizumab, retinopathy of prematurity, antiangiogenic, bevacizumab, optical coherence tomography

PO-80Proliferative retinopathy of prematurity is associated with low serum levels of adiponectinChatarina Lofqvist1, Gunnel Hellgren1, Ingrid Hansen-Pupp2, Colman Hatton3, Lois Smith3, Ann Hellstrom1

1 Department of Ophthalmology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden2 Department of Neonatology, Clinical Sciences, University

of Lund, Lund, Sweden3 Department of Ophthalmology, Childrens Hospital and Harvard Medical School, Boston, US

Introduction: Adiponectin (APN) is almost exclusively produced by adipose tissue� The production is downregu-lated by weight gain, angiotensin II, oxidative stress, and testosterone as well as proinflammatory cytokines, including tumor necrosis factor α (TNF-α) and interleukin (IL)-6� In the oxygen-induced mouse model of ROP APN suppresses TNF-alpha-induced inflammatory changes and blocks retinal neovascularization� Furthermore, an association between APN serum levels and postnatal growth of preterm infants has been reported� Since we have found previously a link between poor postnatal growth and later development of pro-liferative ROP, these results suggest a potential link between APN and development of ROP� The aim of this study was to investigate if there is a link between postnatal longitudi-nal development of serum adiponectin levels after birth and ROP�Methods: A prospective cohort study was performed in forty-seven very preterm infants (median (range) gestational age (GA) 25�8 (23�0-28�7) weeks with weekly blood sam-pling from birth to PMA 36 weeks� ROP was determined ac-cording to the International ROP classification�Results: Twenty-eight children had no signs of any ROP and nineteen infants had proliferative ROP� APN levels at birth were low in both groups and showed a similar continu-ous increase occurring up to postmenstrual age (PMA) 30 weeks irrespective of GA at birth� For both groups between PMA 24 to 31 weeks adiponectin levels increased 10-fold, then rapidly decreased� There was a significant correlation between mean adiponectin levels at PMA 33-36 weeks and mean weight SDS at PMA 33-36 weeks (r2=0�40 p=0�001)� Furthermore infants who developed proliferative ROP, had significantly lower levels of adiponectin between PMA 33-36 weeks (corresponding to the time for the induction of prolif-erative ROP) compared to the group with no ROP, p=0�019�Conclusion: Our results show that the serum level of APN is lower during the proliferative phase, in infants who develop severe ROP� Further studies of the mechanism of action and expression are necessary to determine if the correlation be-tween circulating levels of adiponectin and retinal neovascu-larization is causal or merely secondary to postnatal weight gain�Adiponectin, Growth, ROP

PO-81Reduced number of ROP screening examinations with the use of WINROP in infants with a GA>28

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weeks at birthCarola Pfeiffer Mosesson, Chatarina Lofqvist, Margareta Hok-Wikstrand, Anna-Lena Hård, Ann HellstromDepartment of Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Go-thenburg, Gothenburg, Sweden

Reduced number of ROP screening examinations with the use of WINROP in infants with a GA>28 weeks at birthWINROP is an online surveillance algorithm that uses longi-tudinal postnatal weight measurements to help predict early those infants at high risk for developing treatable retinopathy of prematurity (ROP)� The purpose of study was to validate the number of screening examinations before (2009) and af-ter (2011) implementation of new screening guidelines using WINROP at the Pediatric Ophthalmology department at The Queen Silvia Children’s Hospital in Göteborg, SWEDEN in infants with a gestational age (GA) >28 weeks and 6 days�Methods: Weekly postnatal measurements were entered into WINROP, which signaled an alarm when the rate of weight gain decreased compared with healthy control subjects� In 2011, if the child had a GA >28 weeks and 6 days at birth and no alarm the new guidelines were to perform the first ex-amination at a chronological age of 6 weeks� The cumulative percentage of number of screening examinations was then calculated for the years 2009 and 2011�Results: In 2009 the cumulative percent for one screening examination was 2%, for two examinations 40% and for three examinations 80%, in 2011 the cumulative percent for one screening examination was 49%, for two 63% and for three examinations 77% respectively�Conclusions: New screening guidelines with the use of WINROP reduces the number of ROP screening examina-tions in infants with a GA at birth >28+6�Reduced number of ROP screening examinations with the use of WINROP in infants with a GA>28 weeks at birth

PO-82Description of a clinical phase II trial with IGF-I/IGFBP-3 supplementationAnn Hellström1, Jan Borg2, Chatarina Löfqvist1, Lois Smith3, Ingrid Hansen-Pupp4, David Ley4

1 Department of Ophthalmology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden2 Premacure AB, Uppsala Science Park, Uppsala, Sweden3 Department of Ophthalmology, Childrens Hospital and Harvard Medical School, Boston, US4 Department of Neonatology, Institute of Clinical Sciences, Lund University, Lund, Sweden

ROP is a multifactorial disease affecting very immature ba-bies whose neonatal period is characterized by oxygenation abnormalities, lack of nutrients and factors missing after loss of maternal/fetal interaction, feeding difficulties, insulin insensitivity and a poor immune system resulting in poor weight gain and multi-organ dysfunction�A large number of risk factors have been identified� Low neonatal serum IGF-I is closely related to later ROP and a study of supplementation with rhIGF-I (NCT01096784) is currently taking place and will be discussed�IGF-I, IGFBP-3, ROP, Intervention

PO-83Evaluation of effect and influence factors of vitreous surgery for advanced retinopathy of prematurityJiakai Li, Qi Zhang, Zhaoyang Wang, Peiquan ZhaoDepartment of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine

Objective: To observe the clinical effects of vitreous surgery for advanced retinopathy of prematurity(ROP) and evaluate influence factors of vitreous surgery for stage 5�Methods: This is a non-random and retrospective study� 58 eyes of 40 infants with advanced ROP who underwent vitre-ous surgery were recruited� The 58 eyes included 16 eyes of stage 4a, 7 eyes of stage 4b, 35 eyes of stage 5� The average follow time was 17�01 months� Anatomical outcome of retina after surgery was recorded by binocular indirect ophthalmo-scope and RetCam Ⅱ digital camera system; Visual outcome was tested by grating acuity test（lea grating ™）, and was converted to Snellen acuity values to analyse� For those who cannot cooperate to accomplish the test, we use hand move, light percepting and non-light percepting to record visual outcome�Results:The mean gestational age is 29�75 weeks and mean birth weight is 1439�50g� The mean follow-up is 17�01 months� The anatomical outcome is 100% for stage 4a(16/16 eyes), 71�43% for stage 4b(5/7 eyes), and 34�29% for stage 5(12/35 eyes)� Out of 16 eyes of stage 4a, 3 eyes were absent of visual function test� In the rest 13 eyes of stage 4a, VA of 6 eyes(46�15%) was between 0�03 and 0�07; 5 eyes(38�46%) were hand move; 2 eyes(15�39%) were light perception� Out of 7 eyes of stage 4b, 2 eyes(28�57%) accomplished grat-ing acuity test with VA of 0�008 and 0�017 respectively; 1 eye(14�29%) was light perception; 2 eyes(28�57%) were light perception; 2 eyes(28�57%) were non-light perception; Out of 35 eyes of stage 5, 5 eyes were absent of visual function test� In the rest 30 eyes of stage 5, VA of 2 eyes(6�67%) was 0�004; 4 eyes(13�33%) were hand move; 12 eyes(40�00%)

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were light perception; 12 eyes(40�00%) were non-light per-ception�Conclusion: Anatomical and visual outcome of stage 4a ROP is the best� Vitreous surgery can halt the progression of stage 4a� It can achieve reattachment in stage 4b and 5 par-tially and improve the visual outcome to some degree�Retinopathy of prematurity, retinal detachment, stage 4 and stage 5, vitreous surgery

PO-84Stage 5 Retinopathy of Prematurity – Demographic and Clinical Profiles of Patients at a Tertiary Eye Care Centre in IndiaPadmaja Kumari Rani, Devendra V Venkataramani, Sub-hadra JalaliL V Prasad Eye Institute

Objective: Stage 5 retinopathy of prematurity (ROP) is de-fined by the presence of complete (tractional) retinal detach-ment� It is the end result of untreated or inadequately treated ROP and is associated with a very poor visual prognosisMethods: In this paper, we retrospectively reviewed the de-mographic and clinical profiles of babies who either directly presented to us with, or subsequently developed stage 5 ROP� We have established a comprehensive neonatal intensive care unit based ROP program ( ITCROPS-Indian twin cities ROP Screening Program) in twin cities in 1999�Results: Stage 5 ROP was diagnosed in 321 babies examined between 1994 and 2012� Of these 207 were male (63�9%) while 117 were female� The average age at presentation was 66 weeks (range 4-874 weeks)� The average gestational age was 29�6 weeks with a range of 23-42 weeks (data for 309 babies), and the average birth weight was 1�28 kg with a range of 0�5-2�75 kg (data for 303 babies)� 158 babies were from the state of Andhra Pradesh in southern India, of which 57 were from the twin cities of Hyderabad-Secunderabad, where our centre is located� The remainder were from nearly every state of the country; 3 were referred from neighbouring countries�In the first 5-year period (1994-1999), 22 of the 33 babies (66%) seen were from the state, of which 12 were from the twin cities (36�4% of the total); the remainder were form other parts of the country� In the next 5-year period (2000-2004), 42 of 69 babies (61%) were from the state, of which 23 were from the twin cities (33% of the total)� 27 were from other states of the country� In the third 5-year period of 2005 to 2009, 61 of the 144 babies seen (42%) were from the same state, of which 21 were from the twin cities (14�6% of the total)� From 2010 till date 75 babies have been seen; 33 were from the same state, and only 6 were from the twin

cities (8% of the total)�18�7% of the babies came from socio-economically disadvantaged families, and these babies were treated completely free of charge�Conclusion: There is definite reduction of rop blindness in twin cities over the last decade� This can be attributed to presence of a Neonatal intensive care unit based ROP screen-ing program established in 1999�ROP, STAGE V, Demography, Clinical Profile

PO-85Repetitive laser treatment for retinopathy of prematurityPing Fei, Qi Zhang, Xunda Ji, Peiquan ZhaoDepartment of Ophthalmology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, China

Purpose: To report the clinical characteristics and outcomes of premature infants undergoing repetitive laser therapy for threshold or type 1 prethreshold retinopathy of prematurity (ROP) treated in our hospital�Patients and Methods: A retrospective review of the medi-cal records of premature infants with a primary diagnosis of ROP undergoing laser therapy for threshold or type 1 pre-threshold disease from Jan 1, 2011, to June 30, 2012�Results: Totally 96 eyes of 48 patients diagnosed as thresh-old ROP or type 1 prethreshold ROP got laser therapy� Among all 96 eyes, ROP regressed completely in 84 eyes (87�5%)of 43 patients after primary laser treatment� 11 eyes (11�5%) of 6 patients regressed after repetitive laser therapy� The remaining 1 eye (1�0%) progressed after primary laser therapy, and got vitrectomy combined with C3F8 tampon-ade after primary laser therapy� The mean gestational age of patients undergoing first laser therapy was 29�4weeks� The mean weight was 1352�5 g� The mean gestational age when laser photoablation was initiated was 37�7 weeks� The repeti-tive laser was done average two weeks after the primary laser therapy�Conclusion: Delayed primary laser, insufficient laser spots, severe ROP and poor follow up after the primary laser therapy will lead to the need for repetitive laser� Repetitive laser indirect ophthalmoscope photocoagulation is somehow effective in threshold and type 1 prethresho1d ROP who are not controlled by the primary laser therapy．Retinopathy of prematurity, laser photocoagulation, repeti-tive

PO-86Silicone oil in the surgery of retinopathy of prematury

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Yu Xu, Xunda Ji, Jiakai Li, Qi Zhang, Peiquan ZhaoXinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine

Objective: To report anatomic outcomes, as well as compli-cations, after using 1000-centistoke silicone oil as a retinal tamponade for the treatment of retinopathy of prematurity (ROP)�Methods: A retrospective study of ROP patients who under-went vitrectomy with silicone oil as the retinal tamponade between 2010 and 2012� Anatomic outcomes include com-plete retinal attachment and macular attachment� Complica-tions include rates of secondary intraocular pressure eleva-tion (>30 mmHg), hypotony (Results: Nine eyes of 9 patients were included in the series, with a mean follow-up time of 12 months� At the last exami-nation, complete retinal attachment and macular attachment was obtained in 4 eyes (44�44%) and 6 eyes (66�67%), re-spectively� Visual acuity was preserved in 2 eyes (22�22%)� The visual acuity could not be determined in 5 eyes due to the age of the patients� Two eyes had repeated injections of oil, and two eyes had oil removal without reinjection� Three eyes (33�33%) had elevated IOP, one eye (11�11%) had cor-neal opacity and no eye had emulsification�Conclusions: Retinal reattachment was achieved in the majority of eyes using vitrectomy and silicone oil retinal tamponade� Use of 1000-centistoke silicone oil can be con-sidered in the management of complex retinal detachments associated with retinopathy of prematurity�retinopathy of prematurity; silicone oil; retinal detachment

PO-87Results of ROP Screening in 400 Consecutive, at Risk Pre Term BabiesDr� Raj Kumar Sharma, Dr� Anshu Sahai, Dr� Amisha Gupta, Dr� Vikram Singh Khoisnamsahai hospital and research centre

Aim: To study the incidence & severity of ROP and the as-sociated risk factors for the development of ROP in pre term babies�Materials and methods: A retrospective study of 400 con-secutive pre term babies screened� History, incidence, sever-ity recorded by a single retina specialist� Inclusion criteria - all preterm babies ≤ 36 weeks of gestational age, of birth weight ≤ 2000 gm� Exclusion criteria - All babies Born at > 36 weeks of gestation and birth weight > 2000 gm, With ma-jor congenital anomalies, Who died before complete follow up examination or did not come for follow up as per sched-ule�

RESULTS: Mean birth weight was 1442�14 gm, mean ges-tational age 31�27 wks, post conception age at first examina-tion was 35�64 wks and at worse examination was 36�26 wks PCA� At first examination 62�75% babies had mature retina, 11�75% had immature retina(without ROP), stage 1 ROP was seen in 14% babies, stage 2 in 9�5% and stage 3 in 2% of babies� Overall ROP developed in 28�25%� Of these babies, stage 1, 2, 3, and 4 in 14%, 5%, 8�75% and 0�5% respective-ly� 3% pts had prethreshold disease, 7�25% had threshold and 7�25% babies had plus disease� Treatable ROP was present in 7�75% babies (70�97% - zone 2 and 29�03 – zone 1)� 2 babies with stage 4 ROP were referred to higher centre for further management� On the basis of univariate analysis, the follow-ing variables were identified as significant and subjected to multivariate analysis: GA ≤ 32 weeks, RDS, apnea, duration of oxygen therapy and mechanical ventilation� Out of these only RDS emerged to be independent risk factor for devel-opment of ROP� RDS, apnea and mechanical ventilation emerged as significant risk factors for progression to severe ROP� ROP is seen in more mature bigger babies also, who had associated illness�Conclusion: Incidence of ROP is likely to increase as more no of smaller babies survive due to improved neonatal care services� Screening of all babies with GA ≤ 32 wks and screening of sick bigger babies, upto ≤ 36 wks of GA or ≤ 2000 gm birth weight should be done�ROP, treatable ROP, risk factors,

PO-88Prevention of blindness from retinopathy of prematurity in Mexico: cross sectional study of the quality of neonatal care and programs for controlLuz Consuelo Zepeda-Romero2, Clare Gilbert1

1 London School of Hygiene and Tropical Medicine2 Hospital Civil de Guadalajara

Background: Retinopathy of prematurity (ROP) is the com-monest cause of avoidable blindness in children in Latin America, including Mexico�Objectives: To estimate the number of infants at risk of ROP annually; to assess the quality of neonatal care and coverage and quality of programs for ROP in selected neonatal inten-sive care units (NICUs) and states in Mexico�Methods: Routine sources and national data were used to estimate the number infants with birthweights (BW) ≤ 1500g and their survival� A cross sectional study of 32 large NICUs was undertaken in 5 states in July 2011, giving preference to NICUs in the government health system� In each NICU data were collected on capacity and occupancy, number of preterm babies admitted and their survival in 2010� Data

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were collected using the WHO ’s health system framework on human resources, equipment, financing, health manage-ment information systems (HMIS), service delivery, and leadership and governance� Argentinean norms were used as benchmarks�Results: At least 600 infants are at risk of blindness from ROP each year� In 35�6% of shifts nurse:baby ratios were in-adequate� Only 30% (0-100%) nurses were adequately quali-fied and almost half were inadequately remunerated� Only a third (49/152, 32%) of nurses knew of the ROP guidelines; 51 (33%) were trained in resuscitation and 51 (33%) knew the correct oxygen saturation levels� Only 26% (0–100%) incubators had oxygen blenders, and 80% (231–100%) had equipment to monitor oxygen� In all NICUs, routine HMIS data (e�g� sepsis rates) were only collected on babies with BWs ≤ 2,500g i�e� not on those most at risk of ROP (i�e� BW ≤ 1500 g)� Only 41% of 153 preterm babies observed had oxygen saturation levels within recommended levels; 51% had levels that were too high and in 58 (38%) babies alarms were switched off� Correct lower and upper limits were set for 80 (52%) and 24 (16%) babies respectively� Leadership and governance were lacking, particularly at night and week-ends�Only 12 (38%) NICUs had regular ROP programs; 11 (34%) had no program and 9 (28%) had irregular programs� Only a quarter of incubators 96/372 (26%) had access to laser treatment in the NICU, 95 (26%) had no access to treatment while 181 (42%) had access to Avastin or were transferred for laser elsewhere�Conclusions: and recommendations: The control of ROP blindness in Mexico is deficient in many areas� Neonatal care needs to be improved, by increasing the number, qualifica-tions and remuneration of nurses� Equipment for safe oxygen delivery needs to be improved, technical guidelines imple-mented, and coverage of ROP programs increased�ROP neonatal-care programs

PO-89Avastin and laser treatment for ROPYI Chen, XIaoxin Li, Jianhong Liang, Hong YinPeking University Peoples Hospital

OBJECTIVE: To compare the efficacy of intravitreal beva-cizumab injection and laser treatment for retinopathy of pre-maturity (ROP) patients�MATERIAL AND METHOD: A total of 25 advanced ROP patients (50 eyes) whose both eyes suffer from type 1 or threshold ROP were enrolled in this study� Both eye were randomized to intravitreal bevacizumab injection or laser treatment at Peking University People’s Hospital� The base-

line characteristics including gestational age, postmenstrual age of first injection, anterior and posterior segment changes were recorded and the effect of the treatment and complica-tions after the treatment were compared�RESULTS: Most of the ROP were regressed after AVASTIN or laser treatment� In Avastin injected eyes, totally 3 eyes (12%) developed retinal detachment� In laser group, totally 5 eyes (20%) developed retinal detachment� More laser treat-ment patients developed retinal detachment than AVASTIN treatment patients� There were no treatment related endo-phtalmitis, cataract or retinal tears were observed during the follow up�CONCLUSION: Both intravitreal bevacizumab injection and laser are effective treatments for ROP cases� The safety of AVASTIN injection needs further investment�ROP Laser AVASTIN

PO-90An Updated Study Of The Use Of Bevacizumab In The Treatment Of Patients With Pre-Threshold Retinopathy Of Prematurity In TaiwanWei-Chi Wu1, Hsi-Kung Kuo2, Po-Ting Yeh3, Chung-May Yang3, Chi-Chun Lai1, San-Ni Chen4

1 Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan and Chang Gung University, Col-lege of Medicine, Taoyuan, Taiwan2 Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan and Chang Gung University, College of Medicine, Kaohsiung, Taiwan3 Department of Ophthalmology, National Taiwan University Hospital, Taipei;4 Department of Ophthalmology, Changhua Christian Hos-pital, Changhua, Taiwan and School of Medicine, Chung-Shan Medical University;

Purpose: To investigate the effectiveness and complications associated with the use of bevacizumab, an anti-vascular en-dothelial growth factor agent, in the treatment of pre-thresh-old retinopathy of prematurity (ROP)�Design: A multi-center, retrospective case series study�Methods: Data from patients who had received intravitreal injections of bevacizumab (IVBs) for the treatment of ROP were collected from 4 medical centers in Taiwan� The main outcome measures were the regression of ROP and the com-plications that were associated with the IVBs�Results: In total, 162 eyes from 85 patients were included in the study� After receiving IVBs, 143 eyes (88%) exhibited ROP regression� Fourteen eyes (9%) required additional laser treatment for ROP regression after the absence of a positive response to the IVB� Three eyes (2%) progressed to stage 4

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ROP and required vitrectomies to reattach the retinas� Two eyes (1%) received 1 additional IVB to decrease persistent plus disease� All of the eyes (100%) had attached retinas af-ter the various treatments that they received� The major ocu-lar complications that were associated with IVBs included vitreous or preretinal hemorrhage in 2 eyes (1%); cataract in 1 eye (1%); and exotropia in 1 eye (1%)� No noticeable sys-temic complications related to the IVBs were observed�Conclusions: IVB appears to be an effective and well-tol-erated method of treating pre-threshold ROP� Laser therapy may still be required as a backup treatment for patients who do not respond to an IVB or for those in whom ROP worsens following an IVB injection�

PO-91Current practices of sedation, respiratory support and outcomes in patients requiring laser retinopexy for ROPMian UK1,2, Jonesbamman C Angert R1,2, Kyle Kovacs1,2

1 Dept of Ophthalmology and Visual Sciences, Montefiore Medical Center / Albert Einstein College of Medicine, NY, USA.2 Dept of Pediatrics. Montefiore Medical Center / Albert Einstein College of Medicine, NY, USA.

Objective: To examine current practices of sedation, respira-tory support and outcomes in patients requiring laser retino-pexy for threshold ROP�Methods: A retrospective chart review included 70 patients treated at Weiler NICU from 2006-2011� A descriptive comparison was done: Group A (n=34), intubated, Group B (n=7), emergently intubated, and Group C (n=29), not intu-bated�Results: Gp B babies were smaller in BW 668g, (SD91) and GA 24�7 weeks, (SD 0�92) than Gp A and C combined 723g (SD 188), 25�6 weeks SD 1�42)� There was no difference in postmenstrual age at treatment� 97�1% of Gp A, 87�5% of Gp B and 69�0% of Gp C had severe BPD� During the procedure, 11�8% of Gp A babies, 100% of Gp B babies, and 24�1% of Gp C babies had a cardiorespiratory event (CRE)� In the 24 hours before and after surgery, the increase in CRE’s was from 14% to 37% in all patients, while Gp B had no pre op CREs� Average change in post-op respiratory support lasted approximately 24 hours in all groups� Versed and Fentanyl, alone or combined, were most commonly used� Chloral Hydrate was used in 4 patients in Gp B� An average of 2�9, 2�14, and 1�9 doses of sedation were given in Gp A, B and C, respectively�Discussion: Even though the patients requiring emergent in-tubation were stable before treatment, babies with more pre-

maturity and lower birth weight might fair better with elec-tive intubation� Elective intubation did not alter patient’s clinical course� Post treatment patients should be watched more carefully as CREs increased in all groups�

PO-92The usage of RetCam II in the diagnosis of infantile eye diseasesQi Zhang, Ping Fei, Pei-quan ZhaoDepartment of Ophthalmology, Xinhua hospital affiliated to Shanghai Jiaotong University School of medicine. Shanghai 200092, China

Purpose: ：To evaluate the usage of RetCam II in the ex-amination of infantile eye diseases�Methods: ：All infants less than 12 months old examined by RetCam II in our hospital from January to June, 2012 were included in this analysis� Birth history and family his-tory were recorded�Results: Totally 903 infants were included in this analysis, including 458 (50�72%) infants with normal fundus of both eyes, 25（2�77%）cases with abnormal anterior segment, 392（43�41%） cases with abnormal fundus, 13 （1�44%） cases with eye diseases combined with systematic disease, 2 （0�22%） cases of eye trauma, 13 cases of phthisis bulbi� Among all the examined infants, there were 208 （23�03%） ROP patients, 66 （7�31%）FEVR patients, 45（4�98%） PHPV patients and 33（3�65%）congenital cataract patients�Conclusion: RetCam II is very useful in the early diagnosis of infantile eye disease, especially those congenital and he-reditary fundus diseases�

PO-93Mortality and Major Morbidity among Very Low Birth Weight (VLBW) Infants: Important Clinical Context for ROP ScreeningAgnieshka Baumritter, Kelly Wade, Graham Quinne-ROP Study Group

Purpose: To describe clinical conditions such as necrotizing enterocolitis (NEC), sepsis, chronic lung disease (CLD), and death, that may occur during 32-40 weeks postmenstrual age (PMA) in the very low birth weight (VLBW) infants� As the PMA of onset of severe retinopathy of prematurity (ROP) coincides with this period of premature infant development, these conditions must be considered in determining the im-pact on feasibility, safety, and relative cost-effectiveness of detecting or treating severe ROP�Methods: A systematic review of literature on ROP and the

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neonatal outcomes for the VLBW population infants in US and Canada (BW < 1500g)�Results: Almost 90% of VLBW deaths occur by the 28th day of life (21% mortality <28 days to 1�6% after 28 days on av-erage), with mortality rates decreasing with increasing birth weight� 5-10% of VLBW infants develop NEC with 25% presenting later than 30 days after birth� The rate of NEC is an estimated 1-2% after 30 days� The peak onset of NEC was approximately 32 weeks PMA, Late bacterial or fungal infections occur in approximately 15% of VLBW infants� These morbidities expose infants to additional diagnostic, therapeutic and surgical interventions, increase the length of stay, and increase costs�Conclusions: Morbidities that occur during the period of highest risk for ROP must be recorded and systematically evaluated when determining the feasibility, safety and rela-tive cost-effectiveness of the modalities of ROP screening and treatment�

PO-94Telemedicine Approaches to Evaluating Acute-phase ROP - e-ROPGraham E� Quinnthe e-ROP Study Group

Purpose: To describe the design and conduct of a NIH-fund-ed clinical study for evaluating the validity, reliability, feasi-bility, safety, and relative cost-effectiveness of a telemedicine system to detect eyes of at-risk babies in need of a diagnostic evaluation by an ophthalmologist experienced in retinopathy of prematurity (ROP)�Methods: Approximately 2000 babies with birth weights of <1251g are being enrolled in 12 clinical centers in the US and Canada� Each baby undergoes routine ROP diagnostic evaluations by a study-certified ophthalmologist� Starting at 32 weeks postmenstrual age, digital images of six standard fields for each eye are obtained by a non-physician certified retinal imager using a wide-field digital camera and uploaded to a central server� Imaging of each eye of a baby continues until hospital discharge or until retinal vessel maturity is noted, ROP regresses, or the eye is treated for ROP� Masked non-physician trained readers grade images using a standard protocol� The images are evaluated for the presence of plus disease, any ROP in zone I, or stage 3 ROP by two trained readers and adjudicated for discrepancy� A subsample of images is graded by 3 ROP experts� These gradings will be compared to the results of diagnostic examinations conduct-ed by study certified ophthalmologists masked to the results of digital imaging�Results: Thus far, 22 retinal imagers have been certified to

perform imaging for the study and 27 ophthalmologists (both pediatric ophthalmologists and retinal specialists) are certi-fied to conduct the eye examinations� 3 non-physician read-ers and 3 physician ROP experts have been trained and certi-fied in grading images uploaded from the central server to standardized monitor systems� Direct web-based data capture on tablet computers is being used for data collection�Conclusions: The study will assess the validity, reliability, feasibility, safety and relative cost-effectiveness a telemedi-cine system� The outcome of the study will provide impor-tant information on the use of a systematic approach with digital imaging of at risk babies to determine those eyes that need careful diagnostic evaluation by an ophthalmologist ex-perienced in ROP� Such an approach offers the opportunity to improve quality of care, access, and efficiency of ROP care�

PO-95Incidence of ROP at Government Wenlock Hospital in Mangaloremanjunath kamathkasturba medical college

All children reffered from Paediatrics Department with birth weight of less than 1500 G and born before 32 weeks of ges-tation were screened for ROP�Study was done from Jan 2010 to Jan 2012�A total of 48 children were screened of which 22 were males and 26 females2 children had stage 1 ROP, 1 had stage 2 and 1 had stage 3 ROP�

PO-96Applying screening criteria for retinopathy of prematurity in preterm infantsHui YangThe First Affiliated Hospital of Xiamen University

Purpose: To describe retinopathy of prematurity among Xia-men preterm infants and evaluate the efficacy of applying current screening guidelines�Material and Methods: In this retrospective, we collected data on preterm infants who were referred by their neona-tologist for ROP screening at Xiamen First Hospital between Jan� 2005 and Dec� 2010� According to the Screening criteria of our country� Additionally, older preterm infants considered at risk for ROP by the neonatal intensive care unite were screened� Initial examinations begin 4~6 weeks after birth or at 32 weeks postconception� Routinely opthalmologic exami-nations used by the indirect opthalmoscopy and the scleral

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depression� All infants were followed-up until a stable retinal situation was reached�Results: Retinopathy of prematurity was detected in 9�97% of 672 neonates who had eye examinations� Including 38 eyes suffering from stage 1, 60 eyes suffering from stage 2, 4 eyes suffering from stage 3, 16 eyes suffering from stage 3 with plus disease(zone 3) , 10 eyes suffering from stage 3 with plus disease(zone 2) , 2 eyes suffering from stage 4, 2 eyes suffering from stage of AP-ROP� Favorable outcome was observed in 26 infants who had undergone photoco-agulation; 3 infants developed retinal detachment with plus disease and performed vitretectomy� 4 infants died� The occurrence rate of ROP in the infants with the birth weight ≤ 1000g、 1001-1500g、1501-2000g、≤ 2500g was 56�76%, 12�83%, 5�10%, 3�42%, respectively; the occurrence rate of ROP in the infants with the gestational age ≤ 32 weeks, ≤ 34weeks was 82�09%、95�52%�Conclusion: The criteria for ROP screening programs should be designed according to local conditions� In our country, screening all premature babies with a gestational age less than 34 weeks or a birth weight less than 2000g appears to be appropriate�Birth Weight , Neonates, Premature Infants, Retinopathy of prematurity, Screening Criterion

PO-97Risk Factors and Late Stage of ROP. Giant Babies in Indonesian CasesDian E Yulia1, Julie D Barliana2, Ria Sylvia3, Florence Ma-nurung1, Rita S Sitorus1

1 Department of Ophthalmology, Faculty of Medicine, Uni-versity of Indonesia,2 Undaan Eye Hospital, Surabaya, Eastern Java, Indonesia3 Jakarta Eye Center, Jakarta, Indonesia4 On behalf of Indonesia National Committee in ROP and Premature Babies

Purpose: To study the spectrum of Gestational Age (GA) and Birth Weight (BW) as risk factors associated with late

stage ROP�Materials and Methods: Retrospective analysis of 160 eyes (80 babies ) with late stage ROP (stage 4B or 5)�All babies referred from other units to one of the three ROP Centers, and diagnosed as late stage ROP during the year of 2010-2011 were evaluated� Data on GA, BW and other risk factors were retrieved from the parents and/or the neonatolo-gists/ophthalmologists referred the babies to us�Results: There were 80 infants with late stage ROP included in the study� The mean post menstrual age (PMA) was 61,5 weeks (32 weeks – 416 weeks), all of them were “outborn babies”� The mean BW and GA was 1328�9 g (range 600-2100g) and 28�7 weeks (range 24-38 weeks), respectively�Of these infants, there were 48 infants (60%) with GA < 28 weeks; 15 infants (18�8%) with 29-30 weeks; 14 infants (17�5%) with 31-32 weeks; no infant with 33-34 weeks; and 3 infants (3�8%) with > 35 weeks�ROP related blindness predominantly (55%) developed in in-fants with BW of >1000-1500 g (n=44,), 14 infants (17�5%) weighed < 1000g, 12 infants (15%) weighed >1500-1750g), and 8 (10%) weighed >1750-2000g and 1 infant weighing >2000g (1�3%)�Conclusions: In emerging or developing countries as Indo-nesia, more mature and weighing babies may still at risk of sight threatening ROP� Other risk factors such as septicemia, blood transfusions are associated with these circumstances, which need to anticipate�Implementation of ROP screening guidelines in Indonesia has not been fully performed in all units across the nation, resulting in unexpected ROP related blindness�Developing countries, heavy babies, risk factors, retinopathy of prematurity, screening guidelines

Documents

· 2 Dear Colleagues: On behalf of the organizing committee, we cordially invite you to attend the World ROP Congress III, an international conference on retinopathy of prematurity