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Retinopathy of Prematurity: Incidence, Risk Factors, and Treatment Outcomes in a Tertiary Care Center
Mara Nike Blazon1, Sandra Rezar-Dreindl1, Lorenz Wassermann1
1Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria.
Insights
Retinopathy of prematurity (ROP) affects 40.9% of premature infants, with lower gestational age and birth weight being key risk factors. Laser therapy and anti-VEGF treatments show initial success, aiding early detection and care.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of childhood blindness, affecting 31.9% globally.
- Early detection and risk factor identification are crucial for managing ROP in premature infants.
Purpose of the Study:
- To determine ROP frequency, stages, and treatment methods in premature infants at the Medical University of Vienna.
- To evaluate the effectiveness of current ROP treatment strategies.
Main Methods:
- Retrospective study of 352 infants screened for ROP (gestational age ≤ 32 weeks and/or birth weight ≤ 1500 g) between 2018-2021.
- Analysis of ROP prevalence, severity, risk factors (gestational age, birth weight), and treatment outcomes.
Main Results:
- ROP was diagnosed in 40.9% of infants; 4.8% required treatment.
- Lower gestational age and birth weight were significant risk factors for ROP development (p < 0.001).
- Stage 2 ROP was most common. Laser therapy (64.7%) and anti-VEGF (35.3%) were primary treatments, with 82.4% showing initial regression.
Conclusions:
- Gestational age and birth weight are confirmed predictors for ROP, crucial for early detection.
- Treatment strategies at the university tertiary care center show initial efficacy, with a need for re-treatment in some cases.
- Findings contribute to understanding ROP prevalence and treatment, informing improved patient care and comparative studies.
Abstract:
Retinopathy of prematurity (ROP) remains a major cause of childhood blindness. Its pooled prevalence worldwide is 31.9%, and that of severe ROP is 7.5% among prematurely born babies. Investigating risk factors is essential for improving early detection and treatment outcomes. Purpose: To determine the frequency and stages of ROP cases and evaluate the treatment methods for premature infants at the Medical University of Vienna. Methods: In this retrospective study, 352 children who underwent ROP screening between 2018 and 2021 with a gestational age (GA) ≤ 32 weeks and/or a birth weight (BW) ≤ 1500 g were included. Results: ROP was found in 144 (40.9%) of the 352 screened premature infants, with 17 (4.8%) requiring treatment. Significant risk factors included GA and BW, while sex and pregnancy type were not significant. The mean GA was 27.7 ± 2.5 weeks, and the mean BW was 989.1 ± 359.7 g. Infants with ROP had a lower GA (25.9 ± 1.7 weeks) and BW (778.6 ± 262.4 g) than those without ROP (28.9 ± 2.2 weeks; 1134.9 ± 345.9 g). GA and BW were significantly lower in infants developing ROP (p < 0.001). Stage 2 ROP was the most common severity in 74 children (51.4%). Laser therapy was the most common first-line treatment, used in 11 infants (64.7%), followed by anti-VEGF therapy, used in 6 infants (35.3%). Children were treated within 1.0 ± 0.6 days on average. Of the 17 infants treated, 14 (82.4%) showed initial regression. Three infants (17.6%) required re-treatment: two with initial anti-VEGF therapy and one after laser therapy. Conclusions: The findings provide insights into ROP's prevalence and treatment preferences at a university tertiary care center. GA and BW were confirmed to be significant predictors, aiding in early detection and informing treatment decisions. These insights will enable comparisons with similar studies and contribute to improved patient care.
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