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Published on: February 23, 2024
[Changes in neonatal care : Implications for ophthalmological care]
Eva Mildenberger1, Dirk Wackernagel2, Alexander K Schuster3
1Sektion Neonatologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland. eva.mildenberger@unimedizin-mainz.de.
Insights
The incidence of retinopathy of prematurity (ROP) has not increased in Germany, but preterm infants require specialized ophthalmological and neurological care. Approximately 70,000 check-ups are estimated annually for these children.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Context:
- Increasing survival rates of extremely preterm infants (<28 weeks) in Germany present unique challenges.
- Preterm infants face risks of vision impairment and retinopathy of prematurity (ROP).
- High-income countries observe a growing population of preterm survivors into adulthood.
Purpose:
- To assess the impact of increased preterm infant survival on ophthalmological care provision in Germany.
- To analyze trends in retinopathy of prematurity (ROP) and other visual impairments in preterm infants.
- To estimate the demand for specialized outpatient care for preterm infants.
Summary:
- Approximately 60,000 preterm infants are born annually in Germany, with ~3600 extremely preterm (<28 weeks) infants receiving intensive care.
- Survival rates for extremely preterm infants approach 80%, with no observed increase in severe retinopathy of prematurity (ROP) incidence.
- Visual impairment rates in preterm infants vary (3-25%), necessitating specialized ophthalmological and neurological expertise.
Impact:
- Ophthalmological care must adapt to the specific visual system needs of preterm individuals.
- An estimated 70,000 annual outpatient check-ups are required for preterm infants and toddlers needing combined ophthalmological and developmental neurological expertise.
- Proactive management and specialized care are crucial for optimizing long-term visual health outcomes in preterm populations.
Background:
Preterm infants are at risk of characteristic, sometimes life-threatening diseases and development of deficits related to immaturity. In the field of ophthalmology, retinopathy of prematurity (ROP) and vision impairment reflect structural and functional disturbances in this large group of patients. In high income countries, more and more very immature preterm infants survive into adolescence and adulthood.
Objective:
To characterize the impact of an increasing number of surviving individuals born preterm on the provision of ophthalmological care in Germany.
Material And Methods:
A literature search and analysis of key figures and quality indicators published in national health registers were carried out.
Results:
Currently, about 60,000 preterm infants are born in Germany every year. Of these, approximately 3600 extremely immature preterm infants with a gestational age < 28 weeks are treated with a curative approach on neonatal units. The survival rate is around 80%. A rise in the proportion of infants suffering from severe ROP has not been observed in recent years in Germany. The incidences of other structural and functional visual impairments vary between 3% and 25% in high income countries.
Conclusion:
The incidence of ROP apparently has not increased in Germany. However, specific peculiarities of the structure and function of the visual system of individuals born preterm have to be taken into account. Approximately 70,000 outpatient check-ups of infants and toddlers, who require both, ophthalmological and developmental neurological expertise, are estimated for Germany each year.
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