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Albert Hovhannisyan, Cassandra Fink, Anna Brown, Susan Ostmo, Robison Chan, Tadevos Hovhannisyan, Ruzanna Harutyunyan, Inga Sargsyan, Michael Chiang, Thomas Lee; The Incidence of Retinopathy of Prematurity in Armenia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):595.
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© ARVO (1962-2015); The Authors (2016-present)
Armenia opened their first Neonatal Intensive Care Units (NICUs) in 1995, leading to increased survival in premature infants (1,600 in 2010) and an epidemic of blindness due to Retinopathy of Prematurity (ROP). ROP affects premature and low birth-weight infants, and can lead to permanent blindness. Fortunately, serial screening examinations and timely treatment leads to complete regression of the disease in up to 90% of patients. Throughout the years Armenia had NICUs, no ROP screenings were performed. When the US ophthalmologists initially traveled to Armenia, 1 in 5 infants in one NICU was observed to be at risk of going blind. During a one year period in which Armenian ophthalmologists were trained to screen, diagnose and treat ROP through a telemedicine training program, data from the examinations were recorded. The objective of this study was to assess the incidence of ROP, treatment requiring ROP, and birth weight and gestational age (GA) cut offs for screening criteria in Armenia.
This retrospective study utilized data from screenings between 06/30/2010 and 06/29/2011 in eight NICUs in Armenia. All babies in the NICUs were screened. The screening was performed by an ophthalmologist using indirect ophthalmoscopy and wide-field digital imaging device (RetCam). Interpretations of retinal images and establishment of diagnoses were performed by well trained Armenian ophthalmologists. The decision to treat with laser photocoagulation was based on the Early Treatment Retinopathy of Prematurity (ETROP) guidelines.
The incidence of ROP was 65% (102/157), while 16.6% (26/157) required laser photocoagulation treatment within 72 hours of high risk ROP diagnosis. The mean birth weight for infants without ROP, with ROP and with treatment requiring ROP were 1536grams (±274.1), 1378.9 g (±335.6) and 1240.4g (±293.2), respectively. The mean GA corresponding to these infants were 32 weeks (±1.69), 30 weeks (±2.24) and 28.9 weeks (±2.3), respectively. Study results demonstrate that 2/26 treated infants (7.7%) did not meet the AAO/AAP/AAPOS screening criteria (birth weight ≤1500g or GA ≤30wks).
The incidence of ROP in Armenia is high, and large birth-weight infants are at risk for severe disease. Implementation of AAO/AAP/AAPOS screening guidelines in Armenia would result in a considerable number of infants going blind. These data can serve as the basis for developing new screening guidelines for infants in Armenia.
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