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Incidence and treatment of retinopathy of prematurity in England between 1990 and 2011: database study
Sally L Painter1, Andrew R Wilkinson2, Parul Desai3
1Oxford Eye Hospital, John Radcliffe Hospital, Oxford, UK.
Insights
The incidence of retinopathy of prematurity (ROP) in England rose tenfold between 1990 and 2011, with laser treatment becoming the preferred method. This increase reflects improved neonatal survival and ROP screening awareness.
Area of Science:
- Ophthalmology
- Neonatal care
- Public health
Background:
- Retinopathy of prematurity (ROP) is a potentially blinding condition affecting premature infants.
- Effective screening and treatment protocols are crucial for preventing vision loss in at-risk newborns.
- Understanding trends in ROP incidence and treatment is vital for optimizing neonatal care.
Purpose of the Study:
- To analyze the incidence and treatment patterns of retinopathy of prematurity (ROP) in England.
- To examine changes in ROP diagnosis and management from 1990 to 2011.
- To correlate ROP trends with advancements in neonatal care and screening guidelines.
Main Methods:
- Utilized English national Hospital Episode Statistics for inpatient admissions.
- Calculated annual rates of ROP diagnosis and treatment per 1000 low birthweight (LBW) infants (<1500g).
- Analyzed treatment modalities, comparing cryotherapy and laser ablation rates over time.
Main Results:
- Recorded ROP incidence increased significantly, from 12.8 to 125.5 per 1000 LBW babies (1990-2011).
- Treatment rates for ROP rose from 1.7 to 14.8 per 1000 LBW babies during the study period.
- Laser treatment for ROP increased from 1.8% (1999) to 11.7% (2011), largely replacing cryotherapy (13.3% to 0.1%).
Conclusions:
- The rise in recorded ROP incidence is attributed to increased neonatal survival and improved screening awareness.
- Dissemination of ROP screening and treatment guidelines has likely contributed to observed trends.
- Laser treatment has become the predominant method for retinal ablation in ROP management.
Aims:
To study the incidence and treatment of retinopathy of prematurity (ROP) in England, 1990-2011.
Methods:
English national Hospital Episode Statistics were analysed, for babies born in hospital and for inpatient admissions, to obtain annual rates of diagnosis of, and treatment for, babies with ROP. National data on low birthweight (LBW) babies, born <1500 g and therefore eligible for ROP screening, were used as denominators in calculating rates of ROP per 1000 babies at risk.
Results:
The recorded incidence of ROP increased tenfold, from 12.8 per 1000 LBW babies in 1990 to 125.5 per 1000 LBW babies in 2011. Tretment rates for ROP by cryotherapy or laser rose from 1.7 to 14.8 per 1000 LBW babies between 1990 and 2011. In 1990, 13.3% of babies with ROP were treated with cryotherapy, which fell to 0.1% in 2011. Rates for laser treatment rose from 1.8% of babies with ROP in 1999 to 11.7% in 2011.
Conclusions:
Increased neonatal survival, improved awareness of ROP and dissemination of guidance on screening and treatment of ROP will all have contributed to the substantial rise in recorded incidence of ROP between 1990 and 2011. Retinal ablation is now almost always performed using laser treatment rather than cryotherapy.
