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Retinopathy of prematurity, a decrease in frequency and severity. Trends over 16 years in a Danish county
1Eye Department, Hillerod Sygehus, Copenhagen, Denmark.
Insights
Retinopathy of prematurity (ROP) decreased significantly in premature infants from 1982-97. Improved neonatal care led to fewer severe ROP cases and visual impairment, even in high-risk infants.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Monitoring ROP trends can reflect the quality of neonatal intensive care.
Purpose of the Study:
- To analyze the 16-year trends (1982-1997) in the clinical appearance of retinopathy of prematurity (ROP) in a Danish county.
- To evaluate the impact of evolving neonatal care standards on ROP outcomes.
Main Methods:
- Analysis of ophthalmic surveillance data for ROP in premature infants born between 1993-1997.
- Comparison with data from four preceding 3-year periods (1982-1992), totaling 814 infants.
- Screening criteria included gestational age (GA) ≤32 weeks and/or birthweight (BW) ≤1750 g.
Main Results:
- The number of high-risk infants (GA <32 weeks/BW <1750 g) increased steadily over the study period.
- ROP frequency decreased from 39% to 10% among screened infants.
- Fewer infants experienced severe ROP sequels, and those initially screened 'above limits' avoided ROP.
Conclusions:
- ROP trends indicate improvements in neonatal care quality for immature newborns between 1982-1997.
- Lowered risk thresholds for gestational age and birthweight have reduced ROP incidence.
- A significant decrease in ROP frequency and progression to visual impairment was observed.
Purpose:
To analyse the trends over 16 years (1982-97) in a Danish county regarding the clinical appearance of retinopathy of prematurity (ROP).
Methods:
The data for birth years 1993-97 regarding the regular ophthalmic surveillance for ROP in the region have been analysed. With gestational age (GA) 32 weeks and/or a birthweight (BW) 1750 g as attempted screening limits a total of 177 premature infants were surveyed. Comparison was made with studies of a similar set-up from the preceding four 3-year periods comprising a total of 814 subjects.
Results:
The number of survivors regarded at a higher risk of developing ROP (GA and BW both <32 weeks/1750 g, n=478) showed an even increase over the five investigation periods. The ROP frequency, however, fell from a level of 39% to 10%, there were fewer with severe sequels to ROP, and the children surveyed 'above limits' eventually avoided ROP.
Conclusions:
Using the ROP profile as a yardstick for the quality of the neonatal service given to the most immature newborns over the period 1982-97, the risk limits regarding GA and BW have gone down. More and more of the heavier preterm babies now escape ROP. A significant decrease in frequency of ROP in the more immature groups has been observed, and fewer cases have progressed to visual impairment.