June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Risk factors for retinopathy of prematurity (ROP): insights from “outlier” infants with low or high birth weights
Author Affiliations & Notes
  • Alexander Port
    Weill Cornell Medical College, New York, NY
  • R.V. Paul Chan
    Ophthalmology, Weill Cornell Medical College, New York, NY
  • Susan Ostmo
    Ophthalmology, Oregon Health & Science University, Portland, OR
  • Michael Chiang
    Ophthalmology, Oregon Health & Science University, Portland, OR
    Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR
  • Footnotes
    Commercial Relationships Alexander Port, None; R.V. Paul Chan, None; Susan Ostmo, None; Michael Chiang, Clarity Medical Systems (unpaid member of Scientific Advisory Board) (S)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4947. doi:
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      Alexander Port, R.V. Paul Chan, Susan Ostmo, Michael Chiang; Risk factors for retinopathy of prematurity (ROP): insights from “outlier” infants with low or high birth weights. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4947.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Many risk factors for ROP, such as low birth weight (BW), systemic illness and supplemental oxygen, are known. However, clinicians are often unable to explain “outliers”: large infants with low apparent risk that develop ROP, and small infants with high apparent risk that never develop disease. This project aims to define features of “outlier” infants, with the goal of gaining insight about protective or predisposing factors.

 
Methods
 

We reviewed infants screened at WCMC and CUMC from 2002-2010. ROP exam results were recorded, along with clinical factors including sex, BW, gestational age, multiple gestation, maternal race, IVF status, mechanical ventilation, bronchopulmonary dysplasia, neonatal sepsis, intraventricular hemorrhage, and necrotizing enterocolitis. The cohort was stratified by weight, highest ROP stage, and need for ROP treatment. Descriptive and correlational statistics were performed.

 
Results
 

During the study period, 1377 infants were screened for ROP. For the overall cohort (n=1377), all clinical factors above and Caucasian race were significantly associated with ROP stage and need for laser treatment (p<0.05). Among 258 infants with BW <750g, 78/258 (30%) were “outliers” who developed no ROP. Among 469 infants with BW >1250g, 66/469 (14%) were “outliers” who developed ROP. For “outliers” with BW <750g or >1250g, the only statistically-significant differences between infants with vs. without ROP were in multiple gestation and neonatal sepsis. Among infants with BW < 500g, there were no statistically-significant differences in any clinical risk factors between the 4 (23%) “extreme outliers” without ROP and the 13 (77%) with ROP (Table1). For the 168 with BW >1500g, there were no significant differences in any clinical risk factors between 16 (9%) “extreme outliers” with ROP vs. the 152 (91%) without ROP.

 
Conclusions
 

In this large cohort, known clinical risk factors were predictive of ROP stage and need for laser treatment. However, these risk factors were not significantly associated with ROP at extremes of birth weight. This suggests that other clinical, maternal, or genetic factors may protect from or predispose to ROP pathogenesis.

 
 
Comparison of ROP risk factors in infants with BW <500g and >1500g. Numbers shown are mean values or proportion of infants with risk factor, P-values are for difference between means calculated by two-tailed student’s t-test.
 
Comparison of ROP risk factors in infants with BW <500g and >1500g. Numbers shown are mean values or proportion of infants with risk factor, P-values are for difference between means calculated by two-tailed student’s t-test.
 
Keywords: 706 retinopathy of prematurity • 655 proliferative vitreoretinopathy • 464 clinical (human) or epidemiologic studies: risk factor assessment  
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