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Yousef Cruz-Inigo, Raul Perez; Characteristics of Infants with Severe Retinopathy of Prematurity in Puerto Rico and Screening Implications for our Population. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):969.
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© ARVO (1962-2015); The Authors (2016-present)
Retinopathy of Prematurity (ROP) is a major cause of childhood blindness in Latin America. In comparison to infants born in the continental United States (US), those with severe ROP in Latin America are often of more advanced gestational age (GA) and higher birth weight (BW). In this study we estimate the incidence, BW and GA of infants with severe ROP born in Puerto Rico (PR).
Cross-sectional study of all infants born in PR and screened for severe ROP in 2004. Infants were either born at the University of PR Pediatric Hospital (HOPU-inborns) or were transferred to HOPU from any of 19 Neonatal Intensive Care Units (outborns). According to the American Academy of Pediatrics guidelines from 2001, we included only infants that survived to 29 weeks postmenstrual age and had a BW < 1500 grams (g) or a GA ≤ 30 weeks as well as selected infants between 1500 and 2000 g with an unstable clinical course who were believed to be at high risk. We chose this study period as it was one of the most recent years that our local Department of Statistics had data organized by GA and BW. Severe ROP was defined by the Early Treatment for ROP Study (ETROP Type 1): zone 1 any stage ROP with plus disease, zone 1 stage 3 ROP with or without plus disease, or zone 2 stage 2 or stage 3 ROP with plus disease.
In PR, 217 infants were screened for ROP in 2004. Of these, 51 infants (24%) had severe ROP; 30 male and 21 female infants with mean BW 929 ± 181g (± standard deviation; range, 575 - 1335g) and GA 27 ± 1.8 weeks (± standard deviation; range, 24 - 34 weeks). Infants with severe ROP were subdivided according to birth place, mean BW was 996 ± 159 g for inborns versus 924 ± 184 g for outborns, p=0.448; while mean GA was 27.3 ± 2.1 weeks for inborns versus 26.7 ± 1.7 weeks for outborns, p=0.627. Also, 4 (19.1%) of inborn infants versus 47 (24.0%) of outborn infants had severe ROP, p=0.612.
Our findings suggest that larger and more mature infants are developing severe ROP in PR in comparison to published results from the continental US. This could be due to variation in neonatal care and/or a genetic predisposition. Future evidence-based studies will help confirm if neonatal care is the critical issue and if current US screening guidelines are adequate for screening at-risk infants in our population.
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