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Infants with retinopathy of prematurity (ROP) in Germany and Türkiye-a comparison based on data from the EU-ROP
Johanna M Pfeil1, Sophie C Schnorr1, Emely Meinheit1
1Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany.
Insights
Retinopathy of prematurity (ROP) treatment patterns and patient demographics significantly differ between Germany and Türkiye. However, retreatment rates for ROP appear comparable across both nations, suggesting varied approaches to persistent avascular retina may explain this similarity.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Limited data exists on regional variations in demographics and treatment strategies for retinopathy of prematurity (ROP).
- Understanding these differences is crucial for optimizing ROP care globally.
- The European ROP registry (EU-ROP) was established to facilitate comparative studies on ROP.
Purpose of the Study:
- To analyze and compare demographic data and treatment patterns for ROP between Germany and Türkiye, two countries with high patient numbers in the EU-ROP registry.
- To investigate differences in ROP severity, treatment modalities, and retreatment rates between the two cohorts.
Main Methods:
- A non-interventional, multicenter study using data from the EU-ROP registry (established 2021).
- Inclusion of 267 treated children (516 eyes) from Germany and 198 treated children (378 eyes) from Türkiye.
- Comparison of cohorts based on demographics, ROP treatment parameters, and retreatment rates.
Main Results:
- German infants had significantly lower gestational age (GA) and postmenstrual age (PMA) at treatment compared to Turkish infants.
- Treatment indications varied, with stage 3 ROP in zone II with plus disease (II 3+) predominant in Germany, while Türkiye showed a mix of ROP II 3+, aggressive ROP (A-ROP), and ROP II 3-.
- Treatment modalities differed, with ranibizumab dominating in Germany, while Türkiye utilized laser coagulation and intravitreal bevacizumab more frequently.
- Retreatment rates were comparable (approx. 28%) but depended on initial treatment, with indications for retreatment differing significantly.
Conclusions:
- Significant differences exist in ROP demographics, severity, and treatment patterns between Germany and Türkiye.
- Comparable retreatment rates between the two countries may be attributed to differing management strategies for persistent avascular retina (PAR).
- Further research is needed to elucidate the long-term outcomes associated with these varied treatment approaches.
Purpose:
Data on regional differences in demographics and treatment patterns for treatment-warranted retinopathy of prematurity (ROP) is limited. In this study, data from the two countries with the highest patient numbers in the EU-ROP registry, Germany and Türkiye, are analyzed.
Methods:
The non-interventional, multicenter European ROP registry (EU-ROP) was established in 2021 to compare various parameters related to ROP. In this evaluation, 267 treated children (516 eyes) from Germany and 198 treated children (378 eyes) from Türkiye were included. The two cohorts were compared with regard to demographics, ROP treatment parameters and retreatment rates.
Results:
Infants in the German cohort had significantly lower gestational age (GA) as well as postmenstrual age (PMA) at initial treatment and (where applicable) at the time of retreatment. In the German cohort, the majority of eyes (56.1%) were treated due to stage 3 ROP in zone II with plus disease (II 3+). In the Turkish cohort, ROP II 3+ (22.0%), aggressive ROP (A-ROP) (17.9%), and ROP II 3- (17.3%) were the most common treatment indications. While ranibizumab was the predominant treatment modality in the German cohort (91.3%), about half of the eyes in the Turkish cohort were treated with laser coagulation (48.2%) while about 40% received intravitreal bevacizumab. Retreatment rates seemed to be comparable between Germany and Türkiye (28.1% vs. 27.3% of eyes) and were depending on the initial treatment method (30.5% after ranibizumab, 36.9% after bevacizumab, 14.2% after laser coagulation), although the retreatment indications [persistent avascular retina (PAR) vs. active ROP] appear to differ significantly between the two cohorts.
Conclusion:
In the investigated cohorts, ROP demographics, severity and treatment patterns differed significantly between Germany and Türkiye while the retreatment rate seems comparable. Different approaches to treatment of PAR may have contributed to the comparable retreatment rates despite the differences in initial treatment.
