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Published on: December 31, 2015
Nationwide inventory on retinopathy of prematurity screening in the Netherlands
Kasia Trzcionkowska1, Jacqueline U Termote2, Stefan Böhringer3
1Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands k.trzcionkowska@lumc.nl.
Insights
The incidence of retinopathy of prematurity (ROP) remained stable, but severe ROP cases nearly doubled. A new guideline reduced screened infants, leading to better treatment outcomes and less retinal detachment.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of vision impairment in preterm infants.
- The Netherlands implemented a new national ROP guideline in 2017, emphasizing stringent screening criteria and Early Treatment for ROP (ETROP) guidelines.
Purpose of the Study:
- To assess the incidence of ROP in the Netherlands following the new national guideline.
- To evaluate the logistics of ROP screening and treatment.
- To determine the influence of the updated guideline on ROP outcomes.
Main Methods:
- A multicenter, prospective, nationwide study included all preterm infants born in the Netherlands in 2017 eligible for ROP screening.
- Anonymized data from ophthalmologists and pediatricians were collected and merged.
- Outcome data were compared with the 2009 national ROP inventory (NEDROP-1).
Main Results:
- In 2017, 1492 infants were born with gestational age <32 weeks; 1287 were eligible for screening, a decrease from 2009.
- Screened infants decreased by 28.4%, indicating successful implementation of new screening criteria.
- ROP incidence was 20.4% (305/1492), with 3.3% (49/1492) having stage ≥3 ROP. Severe ROP nearly doubled compared to 2009.
- Retinal detachment in infants with stage ≥3 ROP decreased from 20.0% in 2009 to 6.1% in 2017.
Conclusions:
- Despite stable overall ROP incidence, severe ROP cases increased.
- The reduction in screened infants demonstrates effective adoption of the new screening criteria.
- Improved treatment outcomes were observed, with a significant decrease in retinal detachment among severe ROP cases.
Purpose:
Provide up-to-date insight in incidence of retinopathy of prematurity (ROP), logistics of screening and treatment in the Netherlands and influence of the new national ROP guideline in which more stringent screening criteria were implemented and the early treatment for ROP criteria (ETROP) were emphasised.
Methods:
Multicentre prospective nationwide study including all preterm infants, born in the Netherlands in 2017, and considered eligible for ROP screening. Anonymised data from ophthalmologists and paediatricians were merged. Outcome data were compared with the first national ROP inventory (NEDROP-1, 2009).
Results:
In 2017, 1492 infants were live born with gestational age (GA) <32 weeks (2009: 1662); 1287 infants were eligible for screening (2009: 2033). Ophthalmologists screened 1085 infants, versus 1688 in 2009, corrected with factor 1.114 for the difference in number of live births, a 28.4% (479/1688) decrease in screened infants was seen. Among surviving infants with GA <32 week, ROP was found in 305/1492 babies, 20.4% (2009: 324/1662, 19.5%) of which 49/1492 stage ≥3, 3.3% (2009: 30/1662, 1.8%). In all infants, report on presence or absence of plus disease was provided, according to the ETROP criteria. Treatment was performed in 39 infants. Of infants with ROP stage ≥3, 3/49 (6.1%) progressed to retinal detachment (2009: 6/30, 20.0%).
Conclusion:
The overall ROP incidence expressed as a percentage, remained stable but the number of infants that developed severe ROP nearly doubled. A near one-third reduction in screened infants shows satisfactory implementation of the new screening criteria. A notable decrease in retinal detachment delineates improved treatment outcome.
