Related Experiment Video
Updated: May 4, 2026
Electroretinogram Recording for Infants and Children under Anesthesia to Achieve Optimal Dark Adaptation and International Standards
Published on: September 3, 2020
Adherence to Pediatric Ophthalmology Follow-Up After Completion of Retinopathy of Prematurity: A Retrospective Review
Samantha X Xing1, Nicholas Hyman2, Dylan K Kim1
1Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Insights
Fewer than half of infants completed recommended pediatric ophthalmology follow-up after retinopathy of prematurity screening. Lower adherence was linked to outpatient discharge and higher gestational age, indicating a critical care gap.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a primary cause of preventable childhood vision loss.
- Long-term ocular complications can occur even after ROP screening concludes.
- Adherence to pediatric ophthalmology follow-up post-ROP screening is not well understood.
Purpose of the Study:
- To evaluate adherence to pediatric ophthalmology follow-up visits after ROP screening completion.
- To identify factors associated with loss to follow-up in a tertiary care setting.
Main Methods:
- Retrospective chart review of premature infants screened for ROP (2018-2021).
- Pediatric ophthalmology follow-up recommended 4-6 months post-ROP clearance.
- Logistic regression analysis to compare follow-up adherence factors.
Main Results:
- Only 46.9% of eligible infants attended recommended follow-up.
- Outpatient discharge from ROP care and higher gestational age were associated with lower adherence.
- No significant association found with timing of follow-up, insurance, race, ethnicity, comorbidities, or distance.
Conclusions:
- Less than half of infants adhere to recommended follow-up after ROP screening.
- Critical care transition issues exist for infants discharged from ROP care.
- Interventions like pre-discharge appointment scheduling and enhanced caregiver education are needed to improve continuity of care and prevent vision loss.
Purpose:
Retinopathy of prematurity is a leading cause of preventable childhood vision loss, and infants remain at risk of long-term ocular complications even after ROP screening concludes. However, adherence to recommended pediatric ophthalmology follow-up after ROP screening completion is not well characterized. This study aimed to evaluate adherence to pediatric ophthalmology follow-up visits after completion of ROP screening and identify factors associated with loss to follow-up in a tertiary care setting.
Patients And Methods:
We performed a retrospective chart review of premature infants eligible for ROP screening at a single urban academic center between January 2018 and December 2021. All infants were screened by a single vitreoretinal specialist, with pediatric ophthalmology follow-up recommended at the time of ROP clearance within 4 to 6 months. The primary outcome was a documented follow-up visit with pediatric ophthalmology. Demographic, perinatal, and ROP-related factors were compared between those who did and did not follow up, using univariate and multivariate logistic regression analyses.
Results:
Of 475 eligible infants, 223 (46.9%) completed at least one pediatric ophthalmology follow-up appointment. In multivariate analysis, outpatient discharge from ROP care (OR 0.66, 95% CI 0.45-0.97, p = 0.035) and higher gestational age (OR 0.92, 95% CI 0.84-1.00, p = 0.041) were significantly associated with lower adherence to follow-up. Timing of follow-up (pre-COVID-19 vs COVID-19 era), insurance status, race, ethnicity, number of comorbidities, and distance to the clinic were not significantly associated with follow-up adherence.
Conclusion:
Fewer than half of infants completed their recommended pediatric ophthalmology follow-up appointments after ROP screening completion. Lower adherence among infants discharged from outpatient ROP care and those born at higher gestational ages highlights a critical care transition from ROP screening to pediatric ophthalmology. Interventions such as scheduling follow-up appointments prior to discharge and improving caregiver education may enhance continuity of care and reduce preventable vision loss in this vulnerable population.
