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RETROLENTAL FIBROPLASIA: The Role of Hemorrhage in Its Pathogenesis

RETROLENTAL FIBROPLASIA: The Role of Hemorrhage in Its Pathogenesis Abstract A STUDY was undertaken to evaluate the role of vitamin E in prophylaxis of retrolental fibroplasia. Serial ophthalmoscopic examinations thus far made on 72 premature infants weighing less than 1,650 Gm. at birth have established the importance of hemorrhage, an unexpected finding, as a precursor of the fully developed disease. Previously retinal hemorrhages have been described only in isolated case reports and have not been given sufficient emphasis in pathogenesis. METHODS All infants weighing less than 1,650 Gm. on admission to the nursery for premature infants of the New York Hospital—Cornell Medical Center were given routine ophthalmoscopic examinations. The initial examination was usually made prior to the removal of the infant from the incubator, and subsequent examinations were carried out at weekly intervals during hospitalization. After discharge periodic examinations were made in a special follow-up clinic. For infants over 6 months of age, when indicated, examination was performed with the References 1. Gordon, H. H.; Levine, S. Z., and McNamara, H.: Feeding of Premature Infants: Comparison of Human and Cow's Milk , Am. J. Dis. Child. 73:442 ( (April) ) 1947.Crossref 2. The aqueous dispersion of dl-alpha-tocopherol acetate was supplied by Hoffmann-LaRoche, Inc., Nutley, N. J. 3. This infant had shown marked vessel changes while in the hospital. A period of 18 days elapsed before the next examination, which showed neovascularization, angiofibrous proliferation and early retinal detachment. 4. Far peripheral sector elevation of the retina was incidentally observed in three infants with otherwise normal retinas. In each instance on subsequent examination the retina was entirely normal. These transient retinal elevations were not considered to be a part of the disease. 5. King, M. J.: Retrolental Fibroplasia: A Clinical Study of 238 Cases , Arch. Ophth. 43:694 ( (April) ) 1950.Crossref 6. Terry, T. L.: Fibroblastic Overgrowth of Persistent Tunica Vasculosa Lentis in Premature Infants IV. Etiologic Factors , Arch. Ophth. 29:54 ( (Jan.) ) 1943.Crossref 7. Reese, A. B., and Payne, F.: Persistence and Hyperplasia of the Primary Vitreous (Tunica Vasculosa Lentis or Retrolental Fibroplasia) , Am. J. Ophth. 29:1 ( (Jan.) ) 1946. 8. Reese, A. B.: Persistence and Hyperplasia of Primary Vitreous: Retrolental Fibroplasia, 2 Entities , Arch. Ophth. 41:527 ( (May) ) 1949.Crossref 9. Levine, S. Z., and Gordon, H. H.: Physiologic Handicaps of the Premature Infant: Their Pathogenesis , Am. J. Dis. Child. 64:274 ( (Aug.) ) 1942.Crossref 10. Owens, W. C., and Owens, E. U.: Retrolental Fibroplasia in Premature Infants , Am. J. Ophth. 32:1 ( (Jan.) ) 1949. 11. Gilger, A. P.: Retrolental Fibroplasia in Prematurely Born Children , Am. J. Ophth. 32:917 ( (July) ) 1949. 12. Unsworth, A. C.: Retrolental Fibroplasia: A Preliminary Report , Arch. Ophth. 40:341 ( (Sept.) ) 1948.Crossref 13. Terry, T. L.: Fibroblastic Overgrowth of Persistent Tunica Vasculosa Lentis in Premature Infants: II. Report of Cases; Clinical Aspects , Arch. Ophth. 29:36 ( (Jan.) ) 1943.Crossref 14. Reese and Payne.7 Reese.8 15. Klien, B. A.: Histopathologic Aspects of Retrolental Fibroplasia , Arch. Ophth. 41:553 ( (May) ) 1949.Crossref 16. Owens, W. C., and Owens, E. U.: Retrolental Fibroplasia in Premature Infants: Studies on the Prophylaxis of the Disease; the Use of Alpha-Tocopherol Acetate , Am. J. Ophth. 32:1631 ( (Dec.) ) 1949. 17. Maumanee, A. E.; Hellman, L. M., and Shettles, L. B.: Factors Influencing Plasma Prothrombin in the Newborn Infant: The Effect of Antenatal Administration of Vitamin K on the Incidence of Retinal Hemorrhages in the Newborn , Bull. Johns Hopkins Hosp. 68:158 ( (Feb.) ) 1941. 18. Kinsey, V. E., and Zacharias, L.: Retrolental Fibroplasia: Incidence in Different Localities in Recent Years and Correlation of Incidence with Treatment Given Infants , J. A. M. A. 139:572 ( (Feb. 26) ) 1949.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

RETROLENTAL FIBROPLASIA: The Role of Hemorrhage in Its Pathogenesis

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1951 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1951.02040030630001
Publisher site
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Abstract

Abstract A STUDY was undertaken to evaluate the role of vitamin E in prophylaxis of retrolental fibroplasia. Serial ophthalmoscopic examinations thus far made on 72 premature infants weighing less than 1,650 Gm. at birth have established the importance of hemorrhage, an unexpected finding, as a precursor of the fully developed disease. Previously retinal hemorrhages have been described only in isolated case reports and have not been given sufficient emphasis in pathogenesis. METHODS All infants weighing less than 1,650 Gm. on admission to the nursery for premature infants of the New York Hospital—Cornell Medical Center were given routine ophthalmoscopic examinations. The initial examination was usually made prior to the removal of the infant from the incubator, and subsequent examinations were carried out at weekly intervals during hospitalization. After discharge periodic examinations were made in a special follow-up clinic. For infants over 6 months of age, when indicated, examination was performed with the References 1. Gordon, H. H.; Levine, S. Z., and McNamara, H.: Feeding of Premature Infants: Comparison of Human and Cow's Milk , Am. J. Dis. Child. 73:442 ( (April) ) 1947.Crossref 2. The aqueous dispersion of dl-alpha-tocopherol acetate was supplied by Hoffmann-LaRoche, Inc., Nutley, N. J. 3. This infant had shown marked vessel changes while in the hospital. A period of 18 days elapsed before the next examination, which showed neovascularization, angiofibrous proliferation and early retinal detachment. 4. Far peripheral sector elevation of the retina was incidentally observed in three infants with otherwise normal retinas. In each instance on subsequent examination the retina was entirely normal. These transient retinal elevations were not considered to be a part of the disease. 5. King, M. J.: Retrolental Fibroplasia: A Clinical Study of 238 Cases , Arch. Ophth. 43:694 ( (April) ) 1950.Crossref 6. Terry, T. L.: Fibroblastic Overgrowth of Persistent Tunica Vasculosa Lentis in Premature Infants IV. Etiologic Factors , Arch. Ophth. 29:54 ( (Jan.) ) 1943.Crossref 7. Reese, A. B., and Payne, F.: Persistence and Hyperplasia of the Primary Vitreous (Tunica Vasculosa Lentis or Retrolental Fibroplasia) , Am. J. Ophth. 29:1 ( (Jan.) ) 1946. 8. Reese, A. B.: Persistence and Hyperplasia of Primary Vitreous: Retrolental Fibroplasia, 2 Entities , Arch. Ophth. 41:527 ( (May) ) 1949.Crossref 9. Levine, S. Z., and Gordon, H. H.: Physiologic Handicaps of the Premature Infant: Their Pathogenesis , Am. J. Dis. Child. 64:274 ( (Aug.) ) 1942.Crossref 10. Owens, W. C., and Owens, E. U.: Retrolental Fibroplasia in Premature Infants , Am. J. Ophth. 32:1 ( (Jan.) ) 1949. 11. Gilger, A. P.: Retrolental Fibroplasia in Prematurely Born Children , Am. J. Ophth. 32:917 ( (July) ) 1949. 12. Unsworth, A. C.: Retrolental Fibroplasia: A Preliminary Report , Arch. Ophth. 40:341 ( (Sept.) ) 1948.Crossref 13. Terry, T. L.: Fibroblastic Overgrowth of Persistent Tunica Vasculosa Lentis in Premature Infants: II. Report of Cases; Clinical Aspects , Arch. Ophth. 29:36 ( (Jan.) ) 1943.Crossref 14. Reese and Payne.7 Reese.8 15. Klien, B. A.: Histopathologic Aspects of Retrolental Fibroplasia , Arch. Ophth. 41:553 ( (May) ) 1949.Crossref 16. Owens, W. C., and Owens, E. U.: Retrolental Fibroplasia in Premature Infants: Studies on the Prophylaxis of the Disease; the Use of Alpha-Tocopherol Acetate , Am. J. Ophth. 32:1631 ( (Dec.) ) 1949. 17. Maumanee, A. E.; Hellman, L. M., and Shettles, L. B.: Factors Influencing Plasma Prothrombin in the Newborn Infant: The Effect of Antenatal Administration of Vitamin K on the Incidence of Retinal Hemorrhages in the Newborn , Bull. Johns Hopkins Hosp. 68:158 ( (Feb.) ) 1941. 18. Kinsey, V. E., and Zacharias, L.: Retrolental Fibroplasia: Incidence in Different Localities in Recent Years and Correlation of Incidence with Treatment Given Infants , J. A. M. A. 139:572 ( (Feb. 26) ) 1949.Crossref

Journal

A.M.A. Journal of Diseases of Children – American Medical Association

Published: May 1, 1951

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