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Retinopathy of prematurity-incidence today
1Clinical Research Unit, Fernandes Figueira Institute, Av Rui Barbosa 716, Flamengo, Rio de Janeiro 22250-020, Brazil.
Insights
Retinopathy of prematurity (ROP) is declining in high-income nations but surging in middle-income countries due to premature births and suboptimal care. Urgent improvements in maternal-neonatal care and ROP screening are needed.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) primarily affects premature infants.
- Incidence of ROP has decreased in high-income countries over recent decades.
- Middle-income countries face a 'third epidemic' of ROP.
Purpose of the Study:
- To highlight the contrasting trends of ROP incidence in high-income versus middle-income countries.
- To underscore the impact of premature birth rates and standards of care on ROP epidemics.
- To advocate for targeted interventions to combat ROP in middle-income settings.
Main Methods:
- Review of existing epidemiological data on ROP incidence.
- Analysis of factors contributing to ROP, including birth weight and neonatal care standards.
- Comparative assessment of ROP prevalence across different economic settings.
Main Results:
- ROP predominantly affects extremely low birth weight infants in high-income countries.
- A significant increase in ROP cases is observed in middle-income countries.
- Suboptimal neonatal resuscitation practices are linked to rising ROP rates in middle-income nations.
Conclusions:
- Improved maternal and neonatal care are crucial for preventing ROP.
- Development of ROP screening guidelines tailored for middle-income countries is essential.
- Widespread and timely treatment of ROP is urgently required to control the epidemic.
Abstract:
Retinopathy of prematurity (ROP) in high-income countries now occurs, mostly in extreme low birth weight infants. In those countries, the incidence of ROP seems to have declined incrementally over the last few decades. But in middle-income countries, high rates of premature birth and increasing resuscitation of premature infants, often with suboptimal standards of care, have resulted in a third epidemic of ROP. Improved maternal and neonatal care, ROP screening guidelines appropriate for middle-income countries, and widespread timely treatment are urgently called for to control this third epidemic.
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