Retinopathy of prematurity in the period 2015-2019 in a tertiary referral centre in Slovenia
DOI:
https://doi.org/10.6016/ZdravVestn.3085Keywords:
retinopathy of prematurity, prematurity, tertiary referral centreAbstract
Background: Retinopathy of prematurity (ROP) is the leading cause of blindness among prematurely born children. The incidence of any stage of ROP in children born before the 31st gestational week in Europe and the USA is between 10-45%. The purpose of this study was to show characteristics of ROP between 2015 and 2019 at the Neonatal Intensive Care Unit of the University Medical Centre Ljubljana (NICU-Lj), which is the larger of the two tertiary referral centres in Slovenia and in which more than two thirds of Slovenian very low birth weight children are treated.
Methods: All prematurely born children screened for ROP at NICU-Lj between 2015 and 2019 were included in the study. The following parameters were recorded: number of children screened, total number of exams, number of exams per child, number of children with ROP, ROP stages, number of children who needed ROP treatment and number of treatments per child treated.
Results: Between 2015 and 2019, 82-130 prematurely born children fulfilled ROP screening criteria each year. A total of 1,412 exams were performed over the period of five years (range: 239-386 per year). Every child had one or more ROP screening exams (range: 1-10). Extremely preterm children born before the 27th week of gestation had more exams (average: 5 exams/child) compared to other prematurely born children (average: 1.5 exams/child). The number of prematurely born children with any stage of ROP ranged from 17 to 30 per year. ROP of any stage was present in 18.75% (2015), in 17.7% (2016), in 23% (2017), in 29.3% (2018), and in 24.1% (2019). More than 70% of all babies with ROP were born before the 27th gestational week. The most mature baby with ROP was born with 29 6/7 weeks of gestational age. Every year, 15-35% of babies with ROP received laser treatment.
Conclusions: ROP is an important disease in prematurely born children. During the period 2015-2019, the incidence of any stage of ROP and of serious ROP requiring treatment was comparable. The screening and treatment of ROP requires intense cooperation between paediatric ophthalmologists and neonatologists in order to prevent blindness in prematurely born children.
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References
1. Michaelson IC. The mode of development of the vascular system of the retina with some observations on its significance for certain retinal disorders. Trans Ophthalmol Soc U K. 1948;68:137-80.
2. Campbell K. Intensive oxygen therapy as a possible cause of retrolental fibroplasia; a clinical approach. Med J Aust. 1951;2(2):48-50.
DOI: 10.5694/j.1326-5377.1951.tb109040.x
PMID: 14874698
3. Lundgren P, Wilde Å, Löfqvist C, Smith LE, Hård AL, Hellström A. Weight at first detection of retinopathy of prematurity predicts disease severity. Br J Ophthalmol. 2014;98(11):1565-9.
DOI: 10.1136/bjophthalmol-2014-304905
PMID: 24963022
4. Gerull R, Brauer V, Bassler D, Laubscher B, Pfister RE, Nelle M, et al.; Swiss Neonatal Network & Follow-up Group. Incidence of retinopathy of prematurity (ROP) and ROP treatment in Switzerland 2006-2015: a population-based analysis. Arch Dis Child Fetal Neonatal Ed. 2018;103(4):F337-42.
DOI: 10.1136/archdischild-2017-313574
PMID: 28916563
5. Bas AY, Demirel N, Koc E, Ulubas Isik D, Hirfanoglu IM, Tunc T; TR-ROP Study Group. Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units. Br J Ophthalmol. 2018;102(12):1711-6.
DOI: 10.1136/bjophthalmol-2017-311789
PMID: 29519879
6. Quinn GE, Ying GS, Bell EF, Donohue PK, Morrison D, Tomlinson LA, et al.; G-ROP Study Group. G-ROP Study Group. Incidence and early course of retinopathy of prematurity: secondary analysis of the postnatal growth and retinopathy of prematurity (G-ROP) study. JAMA Ophthalmol. 2018;136(12):1383-9.
DOI: 10.1001/jamaophthalmol.2018.4290
PMID: 30326046
7. Stirn Kranjc B, Kornhauser Cerar L. Visual outcome in preterm infants. Analysis of preterm infants born in Ljubljana 1990-1999. Zdrav Vestn. 2002;71:105-8.
8. International Committee for the Classification of Retinopathy of PrematurityThe International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123(7):991-9.
DOI: 10.1001/archopht.123.7.991
PMID: 16009843
9. Suelves AM, Shulman JP. Current screening and treatments in retinopathy of prematurity in the US. Eye Brain. 2016;8:37-43.
PMID: 28539800
10. Cryotherapy for Retinopathy of Prematurity Cooperative GroupMulticenter trial of cryotherapy for retinopathy of prematurity. Three-month outcome. Arch Ophthalmol. 1990;108(2):195-204.
DOI: 10.1001/archopht.1990.01070040047029
PMID: 2405827
11. Early Treatment for Retinopathy of Prematurity Cooperative GroupRevised indications for the treatment of retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121(12):1684-94.
DOI: 10.1001/archopht.121.12.1684
PMID: 14662586
12. Isaac M, Mireskandari K, Tehrani N. Treatment of type 1 retinopathy of prematurity with bevacizumab versus laser. J AAPOS. 2015;19(2):140-4.
DOI: 10.1016/j.jaapos.2015.01.009
PMID: 25892041
13. Natarajan G, Shankaran S, Nolen TL, Sridhar A, Kennedy KA, Hintz SR, et al. Neurodevelopmental outcomes of preterm infants with retinopathy of prematurity by treatment. Pediatrics. 2019;144(2):e20183537.
DOI: 10.1542/peds.2018-3537
PMID: 31337693
14. Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Cerified Orthoptist. Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics. 2018;142(6):e20183061.
DOI: 10.1542/peds.2018-3061
PMID: 30478242
15. Tavassoli S, Wach R, Haynes R, Markham R, Williams C. Estimate of incidence of ROP requiring treatment in extreme preterms and impact on service-7 year review in tertiary unit. Eye (Lond). 2019;33(5):845-9.
DOI: 10.1038/s41433-018-0330-x
PMID: 30651593
16. Taner A, Tekle S, Hothorn T, Adams M, Bessler D, Gerth-Kahlert C. Higher incidence of retinopathy of prematurity in extremely preterm infants associated with improved survival rates. Acta Paediatr. 2020;109(10):2033-9.
DOI: 10.1111/apa.15197
PMID: 31991001
17. Isaza G, Arora S. Incidence and severity of retinopathy of prematurity in extremely premature infants. Can J Ophthalmol. 2012;47(3):296-300.
DOI: 10.1016/j.jcjo.2012.03.027
PMID: 22687311
18. Wilkinson AR, Haines L, Head K, Fielder AR; Guideline Development Group of the Royal College of Paediatrics and Child Health; Royal College of Ophthalmologists; British Association of Perinatal Medicine. UK retinopathy of prematurity guideline. Eye (Lond). 2009;23(11):2137-9.
DOI: 10.1038/eye.2008.128
PMID: 18836408
19. Binenbaum G, Tomlinson LA. Postnatal growth and retinopathy of prematurity study: rationale, design and subject characteristics. Ophthalmic Epidemiol. 2017;24(1):36-47.
DOI: 10.1080/09286586.2016.1255765
PMID: 27996334
20. Drenser KA, Trese MT, Capone A. Aggressive posterior retinopathy of prematurity. Retina. 2010;30(4):S37-40.
DOI: 10.1097/IAE.0b013e3181cb6151
PMID: 20224476
21. Axer-Siegel R, Maharshak I, Snir M, Friling R, Ehrlich R, Sherf I, et al. Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes. Retina. 2008;28(6):839-46.
DOI: 10.1097/IAE.0b013e318169faee
PMID: 18536600
22. Pajntar M, Verdenik I. Usefulness of the data collected by the national perinatal information system of Slovenia for quality control in perinatology. Zdrav Vestn. 2009;78:125-9.
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