Journal Reading Thursday, July 6th ,2017

DEPARTEMENT OF OPHTHALMOLOGY UNIVERSITY OF SRIWIJAYA

MOH. HOESIN GENERAL HOSPITAL
PALEMBANG
2017
 Introduction
Cessation of ROP is seen The one
vascular in babies important
development born < 32 cause of this
in premature weeks ; disease is
neonates weighing high O2
ROP <1500 g exposure
Hb in newborns is approximately 80% HbF and 20% HbA
HbF decreases after birth to 5% in a 6-month-old and 1% at age 3-4 years
Relative hypoxia permits the vascularization of tissues to continue by performing
upregulation in VEGF and similar mediators.
An increase in transported oxygen can lead to cessation of vascular development
by causing a decrease in vasopeptides
 Purpose

To investigate the effect of HbF and HbA levels on

development of ROP in premature infants
 Subjects and Methods

From January 2013 -

April 2014

Premature babies born <35

weeks gestational age
The Faculty of Medicine Apgar score <7
Ethics Committee of
Karadeniz Technical
University
Table 1. Characteristics of the premature babies in the study
Statistical Analysis
analyzed using SPSS 22.0
Compatibility with normal distribution was
determined using the Kolmogorov Smirnov test
Measurement data was compared using the t test.
babies sex
weight gain
receipt of mothers milk
corticosteroid (CS)
surfactant intake
phototherapy
blood transfusion and length of mechanical ventilation
stage and zone of ROP
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 Results
Because Hb variants can vary depending on
gestational age, premature babies were classified
according to this parameter. Statistical analysis of
babies with and without ROP revealed a significant
variation between HbF and HbA levels up to week
40 gestational age (P < 0.05), whereas there was no
significant at week 44 gestational age and
subsequently (P . 0.05). See Table 4
 HbF and HbA levels were measured from collected blood
samples
HbA1b was determined during Hb variant measurement
but was not included in analyses since this is not a major
Hb
HbF and HbA were first investigated to determine
whether they vary by sex, but no statistically significant
differences were observed (P = 0,694 and 0,184,
respectively)
 When premature babies were divided into sub
groups (ROP or no ROP), mean birth weight and
gestational age differed significantly between
groups
By contrast, HbF and HbA did not differ significantly
at birth, but a significant difference was
determined at measurements performed at 1 and 2
months
However, the difference between Hb variants was
insignificant at month 3 (P >0.05 for all). See Table 3
There was a significant correlation between
hemoglobin variants with blood transfusion
ANCOVA testing eliminating the effect of transfusion
was used in the comparison of Hb variants in the
infants with and without ROP.
The results showed that there was no significant
differences between HbA and HbF values at month 1
between development of ROP and HbA at month 1
(r =-0.31, P = 0.034) and 2 (r = 0.34, P = 0.029). No significant correlation
was found between development of ROP and Hb variants at birth and at
month 3 (HbA: r = -14, P =0.306 [birth] and r= -0.71, P = 0.629 [month 3];
HbF: r = 0.046, P = 0.754 [birth] and r = 0.123, P = 0.401 (month 3)

One important factor that can affect Hb variants in premature babies is a

blood transfusion. Transfusion was performed in 25 infants (51%). All
blood for transfusion was from adults and was provided from blood bank
of the hospital. The mean blood transfusion volume was 30.2 18.1 ml
(1080 ml). Mean birth weight and gestational age differed significantly
between babies receiving blood transfusion and those without transfusion
(P 5 0.001). When Hb variants were compared, HbA and HbF values also
differed significantly at 32, 36, and 40 weeks gestational age, whereas
HbA and HbF levels in infants with and without blood transfusion did not
differ significantly at birth and 44 weeks gestational age and subsequently
(Table 5).
Table 3. Hb Variants in babies with/without ROP by
premature babies time of birth
Table 4. HbF, HbA and Hb1Ab values by gestasional
age in babies with and without ROP
Table 5. Hb levels in babies with
and without blood
Discussion
Critical Appraisal
Is the background of the study cleary
stated?
Yes, it is
Postoperative astigmatism is important for children
because it may affect the clarity of vision and
subsequently may contribute to amblyopia.
Recent reports suggest that the amount of
astigmatism after cataract extraction in children
undergoes a spontaneous decline.
What is the main problem of this
study ?
There was the lack of sufcient information for the
amount of astigmatism after cataract surgery in
children with different types of incisions.
What is the objective of this study ?

To compare the amount of astigmatism with clear

corneal incision and scleral incision with IOL
implantation in children aged between 6 months
and 12 years of age
 What is the type of this study ?
Retrospective, comparative case series
What is the conclussion of this
study ?
This study was valid and both of the tehniques
applicable in our centre.
Table 1. Characteristics of the premature babies in the study
Table 2. Hb variant values in babies born at term and
premature babies