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Screening for retinopathy of prematurity in North China
Li Li1, Yanlin Gao1, Wei Chen1
1Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Vision Science, Nankai University Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, 4, Gansu Road, Heping District, Tianjin, 300020, People's Republic of China.
Insights
Retinopathy of prematurity (ROP) affects 17.9% of premature infants in North China, with gestational age and birth weight being key risk factors. Modified screening criteria show improved effectiveness for ROP detection.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early detection and treatment are crucial to prevent severe visual outcomes.
Purpose of the Study:
- To determine the incidence and severity of ROP in North China.
- To evaluate the efficacy of various ROP screening criteria.
Main Methods:
- Retrospective analysis of ROP screening data from 2016-2021.
- ROP grading followed the International Classification of Retinopathy of Prematurity (2005).
- Evaluation of gestational age and birth weight as risk factors and comparison of different screening guidelines.
Main Results:
- ROP was diagnosed in 17.9% of 4069 screened infants; 1.9% required treatment.
- Lower gestational age and birth weight were significantly associated with ROP.
- Current China, USA, and UK guidelines would miss 7.69%, 25.82%, and 14.29% of ROP cases, respectively.
Conclusions:
- Gestational age and birth weight are primary risk factors for ROP.
- Modified screening criteria (GA ≤ 33 weeks and/or BW ≤ 2100 g) significantly improved detection rates, missing only one case.
- The incidence and treatment rates in Tianjin are comparable to other Chinese regions, suggesting localized screening modifications are beneficial.
Purpose:
To analyze the incidence and severity of retinopathy of prematurity (ROP) in north China, and to evaluate the effectiveness of different ROP screening criteria.
Patients And Methods:
The screening data of premature infants were collected from 2016 to 2021. The severity of ROP was graded according to the International Classification of Retinopathy of Prematurity (2005). And the treatment for ROP followed the Early Treatment for Retinopathy of Prematurity Cooperative Group. The effects of gestational age (GA) and birth weight (BW) on the incidence and severity of ROP were evaluated. The screening data were also analyzed using different ROP screening guidelines.
Results:
A total of 4069 infants underwent ROP screening, and 728 infants (17.9%) were diagnosed with ROP. Of those, 78 infants (1.9%) received treatments. Gestational age and BW showed significant differences between infants with and without ROP (29.1 ± 2.1w vs. 32.9 ± 2.6w, p < 0.001; 1362.7 ± 427.3 g vs. 1751.9 ± 509.4 g, p < 0.001; respectively). Fifty-six infants (7.69%), 188 infants (25.82%), and 104 infants (14.29%) in all infants with ROP would have been missed according to the China, USA, and UK screening guidelines respectively. If GA ≤ 33 weeks and/or BW ≤ 2100 g were considered as screening criteria, only one infant (0.14%) with critical systemic illness was missed diagnosed with severe ROP.
Conclusion:
Gestational age and BW are major risk factors for the incidence and severity of ROP. And the incidence and treatment rate of ROP in Tianjin is similar to that reported in the other regions of China. Modified ROP screening criteria were considered to be more effective in Tianjin.
