Abstract
Objective
To report the clinical features of premature twin babies showing intersibling asymmetry
in their severity of retinopathy of prematurity (ROP) and analyze risk factors associated
with development of severe ROP between twin siblings with discordant ROP severity.
Methods
A retrospective study of records of 105 premature twin pairs was conducted. The criteria
for discordant ROP with an intersibling difference in ROP severity were as follows:
(i) two or more stages of difference in ROP between siblings, (ii) one sibling having treatment-requiring ROP and the other having no ROP or ROP that
regressed spontaneously, or (iii) one sibling having aggressive posterior ROP and the other having staged or no ROP.
Twin siblings were classified into two groups according to the severity of ROP (no
or less ROP and more severe ROP). We examined ocular features in twins having intersibling
asymmetry of ROP and analyzed perinatal risk factors for ROP.
Results
Of 105 twin pairs, 32 pairs (30.5%) showed intersibling asymmetry of ROP severity,
and 15 pairs (14.3%) showed ROP asymmetry in terms of need for ROP treatment. The
development of more severe ROP was associated with longer duration of oxygen supplementation
and greater frequency of total blood and packed red blood cell transfusion (p = 0.020, p = 0.045, and p = 0.036, respectively). Longer duration of oxygen supplementation remained a statistically
independent risk factor of severe ROP using multivariate logistic regression analysis.
Conclusions
Ophthalmologists caring for premature infants should be aware of the variable courses
and progressions of ROP between twin babies. Longer duration of oxygen supplementation
and greater frequency of blood transfusions were associated with higher ROP severity
in twins.
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Article Info
Publication History
Published online: June 11, 2021
Accepted:
May 16,
2021
Received in revised form:
April 6,
2021
Received:
November 2,
2020
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
