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Blindness and partial sight due to retinopathy of prematurity in The Netherlands: 1975-1987
Insights
Retinopathy of prematurity (ROP) caused vision loss in 84 Dutch children between 1975-1987. Insufficient screening in hospitals led to delayed treatment, highlighting the need for improved ROP care.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of childhood blindness.
- From 1975-1987, 84 children in the Netherlands developed vision impairment due to ROP.
- A substantial proportion of affected infants were initially treated in lower-level (I and II) hospitals.
Purpose of the Study:
- To analyze the causes and contributing factors of ROP-related vision loss in Dutch children during a specific period.
- To assess the adequacy of ROP screening and treatment protocols in different hospital levels.
- To understand trends in ROP incidence and identify areas for improved management.
Main Methods:
- Retrospective analysis of neonatal data for children diagnosed with ROP.
- Data collection included hospital level, screening practices, and timing of interventions.
- Comparison of screening and treatment adherence with established recommendations.
Main Results:
- Neonatal data were available for 74 of the 84 affected children.
- Over half (54%) of ROP cases originated from infants initially cared for in level I and II hospitals.
- Screening for ROP was insufficient or improperly timed in a majority of cases across all hospital levels (33/40 in I/II, 25/34 in III).
Conclusions:
- Inadequate ROP screening and delayed treatment are critical issues, particularly in lower-level hospitals.
- Despite decreasing birth rates, the incidence of ROP-related vision impairment may be increasing due to changes in the at-risk population.
- Enhancing screening protocols and ensuring timely treatment are essential for preventing vision loss from ROP.
Abstract:
In 1975-1987 at least 84 children developed blindness or impaired vision due to retinopathy of prematurity (ROP) in the Netherlands. Neonatal data were obtained on 74 (86%). Unexpectedly most children (40 i.e. 54%) had been in level I and II hospitals after birth. Screening for ROP had been either insufficient or not timed according to present recommendations in 33 out of 40 children in level I and II hospitals and 25 out of 34 in level III hospitals. As the number of children with ROP has not changed appreciably over the last 40 years, while birth rates in the Netherlands have steadily decreased, the incidence of blindness/impaired vision due to ROP has probably increased. In the current population at risk of ROP which differs considerably from the one during the first epidemic, the disease may not be completely preventable. We conclude that improvements in screening procedures and timely treatment are crucial in order to improve the present situation.