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[Multicenter prospective study of retinopathy of prematurity--IV. Comparison with the data from University of Miami]
A Takeuchi1, M Nagata, H Terauchi
1Eye Clinic, Tenri Hospital, Japan.
Insights
Early detection of retinopathy of prematurity (ROP) is crucial. Japanese ROP treatment involving earlier examinations and intervention showed better outcomes than the natural course observed in Miami.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- The natural course of ROP and the impact of early intervention require further investigation.
- Management strategies for severe ROP, including coagulation therapy, have evolved over time.
Purpose of the Study:
- To compare the timing of diagnosis and disease progression in retinopathy of prematurity (ROP) between Japan and the University of Miami.
- To evaluate the implications of early versus delayed fundus examinations for ROP management.
- To assess the effectiveness of early intervention in severe ROP cases.
Main Methods:
- Retrospective analysis of 360 ROP cases from 12 Japanese institutions.
- Comparison with historical data from the University of Miami representing ROP without coagulation therapy.
- Analysis of examination timing, diagnosis, disease severity, and regression occurrence.
Main Results:
- First ROP examinations and diagnoses occurred significantly earlier in Japan (29 weeks postconceptional age) compared to the University of Miami (32 weeks postconceptional age).
- The time of maximal disease severity and regression onset were also later in the University of Miami cohort.
- Japanese institutions treated severe "plus" disease with coagulation therapy.
Conclusions:
- Earlier fundus examinations are essential for timely diagnosis and management of retinopathy of prematurity.
- Prompt intervention, such as photocoagulation or cryotherapy, for severe "plus" disease is critical.
- Timely management can potentially alter the course and severity of ROP.
Abstract:
We investigated the records of 360 cases of retinopathy of prematurity (ROP) in 12 institutions in Japan (we treated the severe progressive "plus" disease by coagulation therapy), and compared them with data from University of Miami (Ophthalmology 94: 620-629, 1987), as representative of the natural course of ROP without coagulation therapy in those days. The timing of the first examination and the first positive diagnosis were later at University of Miami than in Japan. The time of maximal severity of the disease and occurrence of regression were also later the University of Miami than in Japan. In Japan, the first examination was performed at 29 weeks of postconceptional age or at 3 weeks after birth. At the University of Miami, the first examination was performed at 32 weeks of postconceptional age. If the severe progressive "plus" disease is to be properly treated by photo-coagulation or cryotherapy, it is essential to commence fundus examination earlier.