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J. P. Handler, G. S. Ford; Analysis of Comorbidities in Advanced-stage ROP Progressing to Threshold Disease. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3158.
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To evaluate comorbid conditions in patients with advanced-stage ROP as potential risk factors for the progression to threshold disease.
A retrospective chart review was conducted on patients in the neonatal intensive care unit diagnosed with stage 3 ROP between March 1, 2006 and December 31, 2007. Patients were identified using institutional screening and treatment records. Data extracted included birth gestational age (GA), gestational birth weight (BW), stage of ROP at diagnosis, highest stage of ROP reached prior to progression to threshold disease requiring laser photocoagulation, and incidence of necrotizing enterocolitis (NEC), idiopathic ilieal perforation (IIP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and sepsis.
One hundred twenty-three patients with ROP were identified. Of these, 50 patients (40.7%) met inclusion criteria for advanced-stage ROP (stage 3). Twenty-seven of those 50 (54%) progressed to threshold disease requiring laser photocoagulation. The difference in average BW for those patients who progressed to threshold (695.4g) and those who did not (746.9g) was 51.5g (P=0.11). The average GA for the threshold group was 25.3 weeks vs. 25.0 weeks for those who did not progress, a difference that was not statistically significant (P=0.37). The incidence of other comorbid conditions was not statistically different between patients with advanced ROP who did and did not progress to threshold: NEC (n=8 for threshold group, n=6 for non-threshold; P=0.78), IIP (4/2; P=0.50), IVH (11/12; P=0.42), IVH (11/12; P=0.95), PVL (3/1;P=0.38), and sepsis (12/10; P=0.95).
ROP is a complex disease with many contributing variables that are not yet fully understood. Our data suggests that a significant percentage of patients with advanced-stage ROP progress further to threshold disease for which gestational birth weight appears most stongly related.
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