{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:28:05Z","timestamp":1793975285017,"version":"4.8.0"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate the association between the Notch phenomenon and retinal vascular maturation, the time to complete retinal vascularisation, and progression to severe retinopathy of prematurity (ROP) in treatment\u2010na\u00efve infants with early\u2010stage disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective observational study, 350 preterm infants with Stage 1\u20132 ROP managed conservatively were included. The Notch phenomenon was identified based on ICROP\u20103 criteria. Time to complete retinal vascularisation was assessed using both weeks from birth and postmenstrual age (PMA). Multivariable regression analyses were performed to assess the independent association between the Notch phenomenon and study outcomes after adjustment for gestational age (GA), birth weight (BW), oxygen therapy, and ROP Zone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Notch phenomenon was identified in 45 infants (12.9%). Among 324 infants with spontaneous regression, Notch(+) infants required significantly longer time to achieve complete retinal vascularisation than Notch(\u2212) infants (14.85\u2009\u00b1\u20092.62 vs. 11.11\u2009\u00b1\u20092.45\u2009weeks from birth;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). PMA at the time of complete retinal vascularisation was also significantly higher in the Notch (+) group (45.15\u2009\u00b1\u20092.21 vs. 42.65\u2009\u00b1\u20091.87\u2009weeks;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), a difference confirmed by Kaplan\u2013Meier analysis (median PMA, 45.50 vs. 42.60\u2009weeks; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Progression to severe ROP occurred more frequently in infants with a Notch (17.8% vs. 5.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). After adjustment for GA, BW, oxygen therapy and ROP Zone, the Notch phenomenon remained an independent predictor of progression to severe, treatment\u2010requiring ROP (OR\u2009=\u20095.10, 95% CI 1.95\u201313.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In treatment\u2010na\u00efve infants with early\u2010stage ROP, the Notch phenomenon is associated with delayed retinal vascular maturation and an increased risk of progression to severe disease, supporting its role as a clinically relevant morphologic risk marker in ROP follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ceo.70154","type":"journal-article","created":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T22:50:46Z","timestamp":1786315846000},"page":"1013-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Notch Phenomenon in Retinopathy of Prematurity: A Potential Marker of Delayed Retinal Vascularisation"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3942-448X","authenticated-orcid":false,"given":"Mediha","family":"Tok Cevik","sequence":"first","affiliation":[{"name":"Faculty of Medicine Istinye University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5653-5800","authenticated-orcid":false,"given":"Sadik Gorkem","family":"Cevik","sequence":"additional","affiliation":[{"name":"Beyoglu Eye Training and Research Hospital, Department of Ophthalmology University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4280-5718","authenticated-orcid":false,"given":"Merve","family":"Ozbek","sequence":"additional","affiliation":[{"name":"Beyoglu Eye Training and Research Hospital, Department of Ophthalmology University of Health Sciences  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5348-9829","authenticated-orcid":false,"given":"Metehan","family":"Simsek","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Dogubayazit Dr. Yasar Eryilmaz State Hospital  Agri Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2019.05.001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S519292"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15468"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2023.12.008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.05.031"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000004231"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1203068"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12599"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417\u2010014\u20102716\u20101"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2007.02.012"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3980\/j.issn.2222\u20103959.2013.04.13"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.13\u201013744"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018\u20103810"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417\u2010025\u201006820\u2010x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2018.10.012"},{"issue":"12","key":"e_1_2_8_18_1","first-page":"1963","article-title":"Risk Factors for Severe Retinopathy of Prematurity in Premature Infants: A Single\u2010Center Study","volume":"31","author":"Ke X. y.","year":"2011","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098\u2010011\u20100363\u20107"},{"issue":"2","key":"e_1_2_8_20_1","first-page":"474","article-title":"Localization of VEGF Receptor\u20102 (KDR\/Flk\u20101) and Effects of Blocking It in Oxygen\u2010Induced Retinopathy","volume":"43","author":"McLeod D. 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