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Epidemiology of retinopathy of prematurity
Y K Ng1, A R Fielder, D E Shaw
1Department of Ophthalmology, Leicester University Medical School.
Insights
Retinopathy of prematurity (ROP) affects nearly half of premature infants, with severity linked to low birth weight. Most cases resolve, but severe ROP can lead to lasting vision issues.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of vision impairment in premature infants.
- Understanding ROP incidence and severity in specific populations is crucial for targeted interventions.
Purpose of the Study:
- To prospectively investigate the incidence and severity of ROP in a defined geographical area.
- To identify risk factors associated with ROP development and severity.
- To assess ethnic variations in ROP incidence and outcomes.
Main Methods:
- Prospective study of 505 infants weighing ≤1700g born in the East Midlands over 23 months.
- Data collection on birth weight, gestation, ROP stage, and ethnic background.
- Community-based incidence calculation for acute and cicatricial ROP.
Main Results:
- 49.1% of infants developed acute ROP, with severity associated with short gestation and low birth weight.
- Most acute ROP resolved; 23.8% of stage 3/4 ROP cases resulted in cicatricial sequelae.
- Black infants had lower ROP rates despite shorter gestations; Asian infants had higher severe ROP rates, linked to better survival.
Conclusions:
- ROP incidence is high in preterm infants, with significant risk factors identified.
- Ethnic differences in ROP incidence and severity exist, influenced by survival rates.
- Community-based studies are essential for accurate ROP incidence assessment, avoiding biases from hospital-based data.
Abstract:
The incidence and severity of retinopathy of prematurity (ROP) were studied prospectively in a geographically defined area of the East Midlands. Over 23 months, 505 infants weighing 1700 g or less at birth to mothers resident in this area were studied. Acute ROP developed in 248 (49.1%) and there was a significant association between short gestation and low birthweight and greater severity. Most acute ROP underwent complete resolution; only stage 3/4 disease did not and cicatricial sequelae subsequently developed in 5 infants, 23.8% of this group. No infant was blind because of ROP. Black infants had shorter gestations yet were less likely to have any stage of ROP. Although Asians were not smaller than their caucasian counterparts, severe (stage 3/4) ROP was more likely (14.1% vs 2.7% for caucasians); this difference was largely due to their better survival. Since 505 of the available 547 infants in this geographically defined area were examined, it was possible to calculate the incidence of acute and cicatricial ROP on a community population basis. There are dangers in attempting to deduce the incidence of acute ROP from infrequent eye examinations, and in comparing community and hospital-based reports.