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Retinopathy of prematurity. Clinical findings in a Danish County 1982-87
1Department of Ophthalmology, Frederiksborg County Hospital, Hillerød, Denmark.
Insights
Retinopathy of prematurity (ROP) affects premature infants, with higher risks in those with lower birth weights and gestational ages. While most ROP cases regress, some lead to blindness or myopia.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Public health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Infant risk factors for ROP include low birth weight (BW) and early gestational age (GA).
Purpose of the Study:
- To investigate the incidence and outcomes of ROP in a defined population of at-risk infants.
- To identify correlations between BW, GA, and ROP development and severity.
Main Methods:
- Retrospective study of infants born between 1982-1987 in a Danish county.
- Inclusion criteria: infants at risk for ROP (BW ≤ 1750g and/or GA ≤ 34 weeks, or functional immaturity/oxygen treatment).
- Data analysis included ROP onset age, BW, GA, ROP severity, and visual outcomes.
Main Results:
- ROP was diagnosed in 63 out of 411 at-risk infants (15.3%).
- A negative correlation was observed between GA and ROP onset age (r = -0.34).
- ROP incidence was higher in infants with very low BW (50% of those ≤ 1000g) and early GA (60% of those ≤ 28 weeks).
- Severe ROP (Stage 3) occurred in 14 infants, with 6 experiencing bilateral blindness.
- Most ROP cases (57/63) regressed spontaneously, but 8 infants developed myopia.
Conclusions:
- Prematurity, particularly very low BW and GA, remains a primary risk factor for ROP development.
- While spontaneous regression is common, severe ROP can lead to significant visual impairment, including blindness and myopia.
- Early identification and monitoring of at-risk infants are crucial for managing ROP outcomes.
Abstract:
The study includes all infants in a Danish county born 1982-87 considered at risk of acquiring retinopathy of prematurity (n = 411; 178 girls, 233 boys). 325 had birthweight (BW) less than or equal to 1750 g and/or gestational age (GA) less than or equal to 34 weeks. The remaining referrals were on account of functional immaturity/significant oxygen treatment (n = 86). With a median onset age of 6.5 weeks (range 5-9 weeks) ROP was recorded in 63 infants. A negative correlation (r = -0.34) between GA and ROP onset age suggested a later onset in the very immature infant. ROP appeared in 60% of those born at GA less than or equal to 28 weeks (n = 30) and in 50% of survivals with BW less than or equal to 1000 g (n = 20). With BW and GA beyond the limits of 32 weeks and 1750 g only 5 cases of ROP were observed. Out of the 14 infants with at least stage 3 ROP 6 became blind in both eyes after few months (GA at delivery 25-31 weeks/BW 920-1595 g). All considered, 57 of the 63 with ROP showed spontaneous regression, however, leaving myopia of prematurity in 8 subjects.