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A. L. Levison, A. M. Berrocal, MD, W. Shi, R. Johnson, RN, D. Hess, T. Murray, MD; Rate of Partial or Complete Retinal Detachment From Retinopathy of Prematurity Over a Six-Year Period in a Large County Hospital. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3145.
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With advancements in the neonatal care of premature infants as well as the modifications of screening and treatment guidelines after the completion of the CRYOROP and ETROP studies, the incidence of retinal detachment from retinopathy of prematurity has progressively decreased. Few studies exist that evaluate rates of retinal detachment from ROP despite current methods of screening and treatment. At Jackson Memorial Hospital (JMH) in Miami, FL all ROP exams and treatment are performed by one ophthalmologist from Bascom Palmer Eye Institute. All ROP screening and treatment guidelines from the American Academy of Pediatrics are followed, including the changes implemented in 2006, however all newborns are examined between 31 and 32 weeks corrected gestational age. The incidence of retinal detachment due to retinopathy of prematurity for newborns born at Jackson Memorial Hospital is extremely low.
A retrospective chart review was performed using records of infants born at JMH from January 2002 to March 2008. The data collected included infant’s gestational age at birth, birth weight, and exam results including zone, stage, clock hours, and presence or absence of plus disease. All lasers performed were documented as well as any progression despite treatment that resulted in partial or complete retinal detachment requiring surgery. All screening data of newborns transferred to JMH for retinopathy of prematurity was also collected including documentation of whether or not the newborn required surgical intervention.
Of those infants born at JMH 2522 eyes were examined over the six-year period. 1049/2522 = 42% of eyes developed some form of ROP. 226/ 2522 = 9% of eyes required laser treatment and 6/2522 = .24% of eyes progressed despite treatment and developed either stage 4a, 4b, or stage 5 ROP. The average birth weight and gestational age at birth of the infants that detached were 559g and 25 weeks, respectively. Over the same time period 204 infants were transferred to Jackson Memorial Hospital for ROP screening and treatment. 26/204= 12.7% newborns required surgery.
Partial or complete retinal detachments should be a rare occurrence if premature infants are systematically screened using a team approach, are screened and treated according to consistent guidelines, are treated in a timely fashion, and are followed closely in the post-treatment period.
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