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A MULTICENTER STUDY OF RETINOPATHY OF PREMATURITY FOLLOW-UP ADHERENCE
Fahim Mahmud1, Reem Karmouta1, Jason C Strawbridge1
1Department of Ophthalmology, David Geffen School of Medicine, Stein Eye Institute and Doheny Eye Institute, University of California, Los Angeles, CA.
Retina (Philadelphia, Pa.)
|July 3, 2023
Summary
High follow-up to complete retinal vascularization was observed in infants with retinopathy of prematurity. However, pediatric ophthalmology follow-up was lower, particularly for those with public insurance at academic centers, highlighting healthcare disparities.
Area of Science:
- Ophthalmology
- Neonatology
- Health Services Research
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Timely follow-up care is crucial for monitoring ROP progression and ensuring adequate treatment to prevent vision loss.
- Socioeconomic factors and healthcare system characteristics may influence the continuity of care for these vulnerable infants.
Purpose of the Study:
- To investigate clinical and socioeconomic factors affecting follow-up to complete retinal vascularization in neonates with ROP.
- To assess the rate of adequate pediatric ophthalmology follow-up in this population.
- To identify disparities in follow-up care based on insurance status and hospital type.
Main Methods:
- A retrospective review of medical records for 402 neonates diagnosed with ROP was conducted.
- Data were collected from neonatal intensive care units at academic medical centers and a safety-net county hospital.
- Primary outcomes included rates of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up; secondary outcome was nonretinal ocular comorbidity.
Main Results:
- Overall, 93.6% of neonates achieved complete retinal vascularization, but only 53.5% had adequate pediatric ophthalmology follow-up.
- Public insurance was linked to significantly lower rates of pediatric ophthalmology follow-up (OR 0.66, P=0.04).
- Infants at academic centers had poorer follow-up rates compared to the safety-net hospital, especially those with public insurance (36.5% vs. 63.8%, P<0.001).
Conclusions:
- While retinal vascularization follow-up is generally high, pediatric ophthalmology follow-up rates are suboptimal.
- Insurance status and hospital type are significant risk factors for loss to follow-up in ROP infants.
- These findings underscore the need for further research into healthcare disparities affecting ROP management.
