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Zone 1 retinopathy of prematurity in a transitional economy: a cautionary note
Susan M Carden1, Luu Ngoc Lan, Tess Huynh
1Department of Ophthalmology, Royal Children's Hospital, University of Melbourne, Australia. Smcarden@aol.com
Insights
Severe retinopathy of prematurity (ROP) developed in three low-risk infants in Vietnam. This suggests ROP may present unusually in transitional economies, necessitating broader screening guidelines.
Area of Science:
- Ophthalmology
- Neonatology
- Global Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Standard screening guidelines are based on data from developed countries.
Observation:
- A case series involving three premature infants in Vietnam.
- Infants presented with severe ROP, including zone 1 disease and neovascularization of the disk.
- These clinical presentations are atypical for infants considered low-risk in developed nations.
Findings:
- Severe ROP occurred in low-risk infants, contrary to expectations based on developed country data.
- The observed cases exhibited unusual severity and specific disease characteristics.
Implications:
- Transitional economies may experience unique ROP presentations.
- Current ROP screening protocols may need revision to include infants outside established risk criteria.
- Implementing adapted screening programs is crucial for early detection and intervention in diverse economic settings.
Purpose:
To describe three low risk infants in whom severe retinopathy of prematurity developed.
Design:
A prospective, observational case series.
Methods:
setting: National Hospital of Pediatrics, Hanoi, Vietnam. study population: Premature infants in the neonatal ward. observation procedure: Eye examinations.
Results:
Severe retinopathy of prematurity occurred in three infants. All had zone 1 disease and other unusually severe findings, such as neovascularization of the disk. These infants would not be at risk for the development of such severe retinopathy of prematurity in countries with a developed economy.
Conclusions:
Unusual characteristics of retinopathy of prematurity may be occurring in countries with transitional economies. Screening programs should be implemented and should take into consideration the possibility that retinopathy of prematurity may occur in infants who fall outside the screening guidelines that are used in the developed world.
