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Retinopathy of prematurity: do we still have a problem?: the Charles L. Schepens lecture
1Department of Ophthalmology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA. wst1@ureach.com
Insights
Retinopathy of prematurity (ROP) is increasing globally, particularly in developing nations and among extremely low-birth-weight infants in Western countries. This trend suggests a potential ROP epidemic is emerging worldwide.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Global survival rates for premature infants, including those with extremely low birth weights, are increasing.
Discussion:
- The prevalence of ROP is rising in developing countries, affecting premature infants even those weighing over 1500g.
- Western countries are seeing increased survival of extremely low-birth-weight infants (≤1000g), who are also at risk for ROP.
- Data from schools for the blind indicate a notable percentage of children have ROP, highlighting the long-term impact.
Key Insights:
- In 2009, 20% of children aged 3-5 at Overbrook School for the Blind had ROP, and 17% of children aged 0-3 at Perkins School for the Blind had ROP.
- During 2009, 4.1% of screened infants (24 out of 591) in a neonatal intensive care unit required ROP treatment, with an additional 23 referred.
- Outpatient visits related to ROP in 2009 ranged from infants to adults up to 67 years old.
Outlook:
- The increasing survival of premature infants globally, coupled with advancements in neonatal care, points towards a potential ROP epidemic.
- Continued monitoring and early intervention strategies are crucial to mitigate the impact of ROP.
- Further research into preventative measures and treatment efficacy is warranted to address the growing ROP burden.
Objective:
To assess the present-day prevalence of retinopathy of prematurity (ROP) worldwide.
Methods:
A search of the literature was conducted to better define the worldwide experience with ROP. An interview was also conducted with 2 schools for the blind, Overbrook in Philadelphia, Pennsylvania, and Perkins in Watertown, Massachusetts. The study also is based on personal experience with ROP over the last 49 years.
Results:
Worldwide, the prevalence of ROP is on the rise in developing countries, and some of those ROP-affected premature infants are heavier than 1500 g. In western countries, extremely low-birth-weight infants (≤1000 g) are also surviving. Currently, the Overbrook School for the Blind has 11 of 55 children between the ages of 3 and 5 years with ROP (20%). The Perkins School has 34 of 200 children from birth to age 3 years with ROP (17%). During 2009, 47 babies had laser treatment for ROP in the neonatal intensive care unit of Jefferson Medical College by physicians from Wills Eye Hospital. Twenty-four infants had been identified in a screening of 591 patients (4.1%). The other 23 had been referred in for treatment. In 2009, we had 187 outpatient visits related to ROP ranging from 6 months to 67 years of age.
Conclusions:
Because more and more extreme low-birth-weight infants are surviving in western countries and because of the rising numbers of surviving premature infants in emerging nations, we may be on the verge of an ROP epidemic.
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