GRUPO ROP MÉXICO Retinopathy of Prematurity Authors Foreword Dr. Humberto Ruíz Orozco Ophthalmologist Surgeon President of the Mexican Society of Ophthalmology Chapter 1 Dr. Marco Antonio de la Fuente Torres Master in Medical Sciences Definition and Ophthalmologist Surgeon Specialty in Retina national reality Former president of the Mexican Retina Association Director General of the Regional Hospital of Specialty in the Yucatan Peninsula [email protected] Chapter 2 Dr. Cecilia Castillo Ortiz Surgeon Ophthalmologist with Specialty in Retina Pathophysiology Physician Assigned to the Ophthalmology Service of the High Specialty Regional Hospital in the Yucatan Peninsula [email protected] Chapter 3 Dr. Mónica Villa Guillén Pediatrician Perinatal triggering Specialty in Neonatology Deputy Director of Medical Assistance factors Children’s Hospital of Mexico “Federico Gómez” [email protected] Chapter 4 Dr. María Verónica Morales Cruz Pediatrician Rational Specialty in Neonatology Head of Neonatology at the National Medical Center “20 de Noviembre” management of 02 ISSSTE [email protected] Chapter 5 Dr. Marco Antonio Ramírez Ortiz Ophthalmologist Surgeon Current classification Doctor of Medicine (MD) Master of Public Health (MSP) Children’s Hospital of Mexico “Federico Gómez” [email protected] Chapter 6 Dr. Gabriel Ochoa Máynez Senior Medical Ophthalmologist Surgeon Screening criteria Head of the Retinal Subsection of the Central Military Hospital [email protected] Chapter 7 Dr. Juan Carlos Bravo Ortiz Ophthalmologist Surgeon Cryoagulation Former president of the Mexican Retina Association Former head of the Hospital of Pediatrics CMN Siglo XXI IMSS Treatment [email protected]. Chapter 8 Dr. Leonor Hernández Salazar Ophthalmologist Surgeon Transpupillary Laser Specialty in Retina and Vitreous Head of the Retinal Department of the Ophthalmology Service Treatment National Medical Center “20 de Noviembre” ISSSTE [email protected] Retinopathy of Prematurity 4 Chapter 9 Dr. Martín Flores Aguilar Ophthalmologist Surgeon Transscleral Laser Specialty in Retina and Vitreous Center Retina Unit Treatment [email protected] Chapter 10 Dr. Luis Porfirio Orozco Gómez Ophthalmologist Surgeon Combined Specialty in Retina and Vitreous Head of the Ophthalmology Service Laser-Ranibizumab National Medical Center “20 de Noviembre” ISSSTE Treatment Former president of the Mexican Retina Association [email protected] Chapter 11 Dr. María Ana Martínez-Castellanos Ophthalmologist Surgeon Monotherapy with Specialty in Vitreous and Retina Association to Avoid Blindness in Mexico Hospital “Luis Sánchez Bulnes” I.A.P an anti-angiogenic Maternal-Perinatal Hospital “Mónica Pretellini” Institute of Health of the State of treatment Mexico [email protected] Chapter 12 Dr. Violeta Robredo Torres Ophthalmologist Surgeon Stage IV Surgery Specialty in Retina and Vitreous Ophthalmological Institute “Fundación Conde de Valenciana” (Scleral Buckling) [email protected] Chapter 13 Dr. Enrique Ariza Camacho Ophthalmologist Surgeon Stage 4b Vitrectomy Specialty in Retina and Vitreous Ophthalmological Institute “Fundación Conde de Valenciana” [email protected] Chapter 14 Dr. Hugo Quiroz Mercado Ophthalmologist Surgeon Stage V Surgery Specialty in Vitreous and Retina Former president of the Mexican Retina Association Director of Ophthalmology Denver Health Medical Center Professor of Ophthalmology University of Colorado [email protected] Chapter 15 Dr. Luz Consuelo Zepeda Romero Ophthalmologist Surgeon RETCAM Master in Public Health in Ophthalmology Coordinator of the Program “No más niños ciegos: Detección y Tratamiento opor- tuno de la Retinopatia del Prematuro” Pediatrics Division Guadalajara Civil Hospital FAA Chapter 16 Dr. Silvia Moguel Ancheita Master in Neuroscience Long-term follow-up Ophthalmologist Strabismologist Surgeon Head of the Strabismus Department at the National Medical Center “20 de Noviembre” ISSSTE smoguel@prodigy. net.mx Chapter 17 Dr. Vanessa Bosch Canto Ophthalmologist Surgeon Rehabilitation Master of Sciences National Institute of Pediatrics [email protected] 5 Grupo ROP México Foreword The number of published scientific articles increases dramatically year by year. More than one million papers are published annually in more than 15,000 spe- cialty journals presenting new information on technological and biomedical ad- vances related to medicine. Regarding retinal diseases in the pediatric age, the delicate mechanisms of cel- lular biology and molecular engineering have been discovered and described that are capable of creating, maintaining and regulating neuronal, glial and vas- cular cells. From these myriad findings, it is possible to extract the rational ex- planation of the function and development of the retina and the molecular patho- physiology of vitreoretinal diseases. Currently, there are technological advances in the field of ocular biometry, infor- mation management and retinal imaging that allow information to be obtained safely and reliably. In the same way, we have micro-mechanical instrumentation, computerized laser systems, and highly accurate molecular agents. Together, biology and technology have modified at a rapid pace the clinical evaluation of the retina and the capacity for therapeutic intervention. The book Retinopathy of Prematurity edited by the Mexican group of retinopathy of prematurity led by Dr. Luis Porfirio Orozco, and the most outstanding clini- cians and researchers in the area of pediatric retina provide us with 17 chapters with the most relevant findings in the area. It comprehensively covers the public health area and reviews fundamental pathophysiological aspects in the devel- opment of the disease, giving emphasis to the development of the diagnostic and therapeutic approach of one of the most important vascular retinal disorders today. There is no doubt that this volume is of necessary reference for all those who are facing this potentially devastating disorder in the patients’ vision and its reper- cussions in the social environment. Dr. Humberto Ruíz Orozco President of the Mexican Society of Ophthalmology Retinopathy of Prematurity 6 Acknowledgements Working with premature children reinforces the commitment with the country and the world that Physicians have every day in their mission. Watch children weekly, with their struggle to survive and the vascular changes in their retina until reaching the periphery, is the prize for the efforts made and it represents a gratifying feeling that becomes our trigger in life. The difference for those who will require treatment and who will have access to it means that they will not be blind, which is of high importance and marks an invaluable change for their better development and survival. The intervention that we will have carried out timely and efficiently, impels us to go ahead and continue with this arduous but wonderful work. To have in Mexico ophthalmologists committed to this cause creates a strength- ened common front that makes us feel less alone and allows us to take more ef- fective steps. The disinterested and expert collaboration of each and every one of the authors has produced an interesting work, the first book on Retinopathy of Prematurity written by Mexicans. The important participation of the ophthalmological industry, willing to collab- orate in sponsoring and disseminating this book complements the effort and guarantees its commitment to the country and its vision for the future. The goal to achieve is to homogenize the knowledge in every small corner of the country, and get there where a premature child is suffering. Therefore, my deepest thanks to each of the authors, both the fellow ophthalmologists and pediatricians, for the effort made to achieve this goal, for their chapters, for their images and for the time devoted to this project. My sincere appreciation to Engineer Víctor Fregoso for sponsorship this book. With his support and friendship we have managed to complete this task for our Mexican children. I would like to finish this foreword, by remembering a phrase that one of my best teachers of Medicine memorably left in the hippocampus of my brain: “It is astonishing and fearful to see people die. It is worthy of honor, the doctor who never gets used to the spectacle of the end of life, the one who does not suffer lacks bowels and he who does not philosophize, understanding.” Dr. Luis Porfirio Orozco Gómez 7 Grupo ROP México Contents CHAPTER 1 DEFINITION AND NATIONAL REALITY ................................................................... 11 1.1. DEFINITION ................................................................................................. 11 1.2. HISTORY ...................................................................................................... 11 1.3. ROP WORLDWIDE ...................................................................................... 11 1.4. ROP IN MEXICO .......................................................................................... 12 1.5. ROP LEGAL FRAMEWORK IN MEXICO ..................................................... 17 1.6. REFERENCES ............................................................................................. 19 CHAPTER 2 PATHOPHYSIOLOGY ................................................................................................ 21 2.1. INTRODUCTION .......................................................................................... 21 2.2. NORMAL VASCULAR DEVELOPMENT .....................................................