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One-Year Review of Retinopathy of Prematurity in Cyprus: Risk Factors and Screening Effectiveness
Vivi Choleva1, Stylianos Christodoulou1, Fedonas Herodotou2
1The Ophthalmology Department, Archbishop Makarios III Hospital, School of Medicine, Nicosia, Cyprus.
Insights
Retinopathy of prematurity (ROP) affects 18% of preterm infants in Cyprus, with severe prematurity being the main risk factor. UK screening criteria are effective for identifying ROP in this population.
Area of Science:
- Neonatal Ophthalmology
- Public Health
- Epidemiology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Effective screening protocols are crucial for early detection and intervention.
- Cyprus lacked specific epidemiological data on ROP incidence and risk factors.
Purpose of the Study:
- To determine the incidence and risk factors of ROP in Cyprus.
- To evaluate the applicability of United Kingdom (UK)-based ROP screening criteria.
- To optimize ROP screening guidelines for improved neonatal care in Cyprus.
Main Methods:
- Retrospective study of 183 infants screened for ROP.
- Data collected from January to December 2023 at Cyprus's sole tertiary neonatal intensive care unit.
- Analysis of gestational age, birth weight, and other neonatal factors in relation to ROP development.
Main Results:
- ROP incidence was 18% (33/183 infants), with 11 cases of vision-threatening ROP.
- Gestational age (born 24-32 weeks), birth weight, sepsis, and prolonged oxygen use were strongly associated with ROP.
- Infants born between 24-28 weeks gestation had the highest risk of vision-threatening ROP.
Conclusions:
- The 2008 UK ROP screening criteria are valid and appropriate for the Cypriot population, as no cases requiring treatment were missed.
- Severity of prematurity is the primary determinant of ROP risk.
- This study provides the first national assessment of ROP incidence and screening effectiveness in Cyprus.
Purpose:
To assess the incidence and risk factors of retinopathy of prematurity (ROP) in Cyprus and evaluate the validity of United Kingdom-based screening criteria on the population. The findings aimed to optimize ROP screening guidelines for improved neonatal care.
Methods:
This was a retrospective study of 183 children undergoing ROP screening from January to December 2023 in the only tertiary neonatal intensive care unit in Cyprus.
Results:
A total of 33 infants developed ROP (18%) and 11 of these had vision-threatening ROP. Nine infants received treatment and two died prior to treatment. The youngest infant with ROP was born at 24 weeks of gestation and the oldest was born at 32 weeks. Gestational age, birth weight, sepsis, and long oxygen duration have a strong association with ROP, whereas race, multiple births, blood transfusion, and other operations in the neonatal age are not associated with ROP. Every week of increase in gestational age is correlated with reduction in ROP incidence. The severe prematurity group born at 24 to 28 weeks had the highest risk of vision-threatening disease.
Conclusions:
Based on the analysis of a cohort of 183 preterm infants who underwent ROP screening over 1 year in the only tertiary-level neonatal intensive care unit in Cyprus, the authors concluded that the 2008 United Kingdom ROP screening criteria are appropriate and valid for this population because no cases of treatment-requiring ROP were missed. The findings indicate that the severity of prematurity is the primary determinant of ROP risk, whereas other independent risk factors appear to have a comparatively lesser impact on the development of ROP. Importantly, this represents the first epidemiological study of ROP in Cyprus, providing a nationally representative assessment of ROP incidence and screening effectiveness.
