Threshold retinopathy at threshold of viability: the EpiBel study

Area of Science:

• Neonatal ophthalmology
• Perinatal medicine
• Public health

Background:

• Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
• Infants born at the limits of viability (gestational age < or = 26 weeks) are at high risk for severe ROP.
• Understanding ROP incidence and risk factors is crucial for improving outcomes in extremely premature neonates.

Purpose of the Study:

• To determine the incidence of threshold ROP in extremely premature infants (GA <= 26 weeks).
• To identify co-morbidity characteristics associated with threshold ROP.
• To investigate risk factors, including novel ones like renal insufficiency, for threshold ROP development.

Main Methods:

• Retrospective analysis of perinatal data from the EpiBel cohort (1999-2000) in Belgium.
• Inclusion of all inborn survivors with gestational age between 22 and 26 weeks.
• Statistical comparison (chi(2), Mann-Whitney U) and logistic regression to identify risk factors.

Main Results:

• The incidence of threshold ROP was 19.8% among survivors.
• Associated morbidities included central nervous system abnormalities (17%) and chronic lung disease (54%).
• Independent risk factors for threshold ROP were days of respiratory support, number of transfusions, and renal insufficiency (creatininaemia > 1.5 mg/dl).

Conclusions:

• The incidence of threshold ROP remains high in infants born at the limits of viability.
• Renal insufficiency is identified as a significant and independent risk factor for threshold ROP.
• Early identification and management of risk factors, including renal function, are vital for preventing severe ROP.