Incidence and result of treatment-demanding retinopathy of prematurity using revised U.S. screening guidelines
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Published on: April 2, 2021
Hsi-Kung Kuo1, Chih-Cheng Chen, Yi-Hao Chen
1Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Insights
The incidence of treatment-requiring retinopathy of prematurity (ROP) was 4.9% in premature infants screened using revised U.S. guidelines. No infants missed timely treatment, and bevacizumab treatment showed a high success rate.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Revised U.S. screening guidelines aim to improve early detection and treatment of ROP.
- Timely intervention is crucial to prevent severe visual outcomes.
Purpose of the Study:
- To determine the incidence of treatment-requiring ROP under revised U.S. screening guidelines.
- To assess the rate of missed treatments and unfavorable anatomic outcomes.
- To evaluate the effectiveness of intravitreal bevacizumab for ROP treatment.
Main Methods:
- Retrospective review of premature infants (GA < 30 weeks or BW < 2000 g) from September 2008 to August 2010.
- Screening followed the 2006 revised U.S. guidelines.
- Treatment indications included threshold disease and type 1 prethreshold ROP.
Main Results:
- The incidence of treatment-demand ROP was 4.9% (19/385 infants).
- No infants missed timely treatment; 21% of treated infants had birth weight >1500 g.
- Primary intravitreal bevacizumab treatment achieved a 91% success rate, with 3 eyes progressing to stage 4/5.
Conclusions:
- The revised U.S. screening guidelines identified a 4.9% incidence of treatment-demand ROP.
- Effective teamwork ensures timely, high-quality ROP care.
- Intravitreal bevacizumab is a successful treatment option for ROP.
Objective:
To study the incidence of treated retinopathy of prematurity (ROP) using the revised U.S. screening guidelines, the rate of missed treatment, and unfavorable anatomic outcomes over a period of 2 years.
Study Design:
We reviewed the admission records of premature patients treated at our hospital from September 2008 to August 2010. Any baby born with a gestational age (GA) of less than 30 weeks or a birth body weight (BW) of less than 2000 g was included in this study. The ROP screening followed the revised U.S. screening guidelines as presented in 2006. The indications of treatment for ROP were threshold disease as defined by the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study and type 1 prethreshold ROP as defined by the Early Treatment for Retinopathy of Prematurity Randomized Trial study.
Results:
There were 385 infants who were examined for ROP screening during this period. Nineteen babies (35 eyes) fit the treatment criteria and received treatment. The incidence of treatment-demand ROP was 4.9% (19/385). Four babies had a birth BW >1500 g (4/19; 21%). Seventeen babies received treatment during their first admission and two babies received treatment during outpatient follow-up. No baby missed timely treatment. Three eyes progressed to stage 4/5 after receiving intravitreal bevacizumab treatment. The success rate after primary bevacizumab was 91% (30/33 eyes).
Conclusion:
The incidence of treatment-demanding ROP using revised U.S. screening criteria was 4.9%. Teamwork and cooperation are very important to ensure that the highest-quality care possible is provided to patients in a timely manner.
