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Jennifer L. Oakley, Nils K. Mungan; Ophthalmic Outcomes in African Americans with Severe ROP. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3132.
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To investigate the long term ophthalmic outcomes of African Americans with severe retinopathy of prematurity (ROP) compared to other races.
A restrospective chart review was conducted for all infants at the University of Mississippi Medical Center requiring laser for severe ROP from January 2001 - December 2009. Gestational age, sex, race, birth weight, length of postoperative follow-up, and the zone and stage of ROP at the time of laser application were analyzed. Additional data was evaluated for the presence of the following postoperative outcomes: refractive error, pathologic myopia, strabismus, amblyopia, nystagmus, optic atrophy, significant CNS disease, cataract, glaucoma, macular drag or fold, and final structural outcome of the treated retina. Results were grouped for analysis and compared outcomes of African Americans (AA) to all other races (O).
Of the 161 eyes meeting inclusion criteria 64.6% were African American and 35.4% represented other races. Each group was similar in its gender distribution and zone involvement at the time of laser treatment. African American infants with severe ROP were found to have significantly lower gestational age and birth weight than the other races (24.52 weeks AA, 25.74 weeks O, p = 0.00002; 689 grams AA, 808 grams O, p = 0.0004.) African American infants were also found to have a more advanced stage of ROP at the time of laser treatment (2.94 AA, 2.72 O, p = 0.0003.) Additionally the African American group was found to have more than twice the rate of strabismus when compared to other races, a significant difference (42% AA, 19% O, p value = 0.003.) No statistical difference was observed between the two groups in relation to the presence of refractive error, pathologic myopia, amblyopia, CNS disease, nystagmus, optic nerve atrophy, cataracts, glaucoma, macular drag/fold, or favorable structural outcome. Favorable structural outcomes were >90% for both groups.
While African American infants with severe ROP demonstrated lower gestational age and birth weight as well as more advanced staging at time of laser treatment than infants of other races, ophthalmic outcomes were very similar between the two groups in all areas studied except for strabismus, which was twice as likely to develop in African Americans. Despite the known reduced relative risk of African Americans progressing to severe ROP compared to other races, our study demonstrated that for African Americans who do develop severe ROP there does not appear to be a similar protective advantage with respect to long-term ophthalmic outcomes.
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