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Visual impairment due to retinopathy of prematurity and concomitant disabilities in the Netherlands
Kasia Trzcionkowska1, Jacqueline U M Termote2, Maria M van Genderen3
1Leiden University Medical Center, Leiden, Netherlands.
Insights
Visual impairment from retinopathy of prematurity (ROP) did not increase between 2009-2018, even with earlier births. Strict screening criteria ensured no infants were missed for ROP detection.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature infants.
- Changes in neonatal care, including lower gestational age limits and higher oxygen saturation targets, may impact ROP incidence and severity.
- Updated screening criteria for ROP were implemented in 2013.
Purpose of the Study:
- To determine the incidence of visual impairment due to ROP and associated disabilities in the Netherlands from 2009 to 2018.
- To compare current ROP incidence with historical data.
- To monitor the effectiveness of ROP screening following the adoption of stricter criteria.
Main Methods:
- Retrospective analysis of anonymous data from 53 infants diagnosed with ROP.
- Data collected included visual acuity, ROP treatment, and a range of concomitant disabilities.
- Study period coincided with implementation of lower age limits for neonatal support (2010) and higher oxygen saturation targets (2014).
Main Results:
- Visual impairment incidence due to ROP was 2.02 per 100,000 live births.
- A significant decrease in ROP-related visual impairment was observed compared to earlier periods (1975-2000).
- Concomitant disabilities remained stable, while mean gestational age decreased to 26.6 weeks.
Conclusions:
- The incidence of visual impairment from ROP and associated disabilities has not increased between 2009 and 2018.
- Despite changes in neonatal care (lower GA, higher O2 saturation), ROP screening effectiveness was maintained.
- No infants were missed for ROP screening after the implementation of more restrictive inclusion criteria.
Aim:
Determine incidence of visual impairment due to retinopathy of prematurity (ROP) and concomitant disabilities between 2009 and 2018 in the Netherlands and compare data to four former similar studies. Secondly, monitor if infants were missed for ROP-screening since the adoption of stricter, risk factor guided criteria (2013).
Methods:
Retrospective inventory on anonymous data of infants diagnosed with ROP from Dutch visual impairment-institutes. Data including: best corrected visual acuity, ROP-treatment and concomitant disabilities: bronchopulmonary dysplasia, behavioral abnormalities, epilepsy, hearing deficit, developmental delay, cerebral palsy and cerebral visual impairment. During the study period, lower age limit for neonatal life support (2010) and higher oxygen saturation targets (2014) were implemented.
Results:
Records of 53 infants were analyzed. Visual impairment incidence due to ROP was 2.02 per 100.000 live births (2000-2009: 1.84, p = 0.643). Compared to earlier periods (1975-2000), a significant decrease was observed. The incidence of concomitant disabilities remained stable. Mean gestational age (GA) continued to decrease to 26.6 ± 1.9 weeks (2000-2009: 27.4 ± 2.0 weeks, p = 0.047). All patients met the screening inclusion criteria.
Conclusion:
The incidence of visual impairment due to ROP and concomitant disabilities between 2009 and 2018 has not increased, despite lower GA and higher oxygen saturation targets. None of the infants were missed for ROP screening following introduction of more restricted screening inclusion criteria.
