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E. T. Viriya, K. Ortiz, J. Levine, J. Gurland, I. Moradi; Analyzing Retinopathy of Prematurity in an Inner City Population. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5913.
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To compare the severity and incidence of retinopathy of prematurity (ROP) in Hispanic versus African-American (AA) premature neonates in an inner-city neonatal intensive care unit (NICU) under the 2006 American Academy of Pediatrics guidelines for ROP screening. .
A retrospective chart review was conducted on all babies who were eligible for ROP screening based on the 2006 American Academy of Pediatrics guidelines. Patient data was sampled from the Bronx Lebanon Hospital Center’s NICU from August 2008 to October 2009. ROP was diagnosed according to the 2005 International Committee for the Classification of ROP. Racial identity of the baby was based on the mother’s race. Hispanic and AA patients were compared by birth weight (BW), gestational age at birth (GA), and infant mortality. Differences between the racial groups were evaluated for the incidence of ROP and the incidence of prethreshold or worse ROP. The natural course of ROP was followed by determining the postconceptional age (PCA) at the time: (1) ROP was first diagnosed, (2) at the worst stage of ROP, and (3) resolution of ROP.
A total of 88 babies met screening criteria, but 13 babies were excluded because they were not examined or expired before their first eye exam. The remaining patients were 49.3% Hispanic, 36% AA, and 14.7% Other. The screened Hispanic and AA babies were not statistically significantly different in BW (p=0.3286) or infant mortality (p=0.8320), but the Hispanic babies had a lower average GA (28.6 vs. 30.7weeks, p=0.0056). The incidence of ROP was not greater in Hispanic babies(51% vs. 58%, p=0.6492), but they were more likely to develop prethreshold disease or worse (15.8% vs. 0%, p=0. 0.1763). Hispanic babies were first diagnosed with ROP at a lower PCA (31.8weeks vs. 34.3weeks, p=0.007) and they had a more prolonged course of ROP compared to AA babies (10.9 vs. 3.63weeks, p=0.0532). Both groups on average developed their worst stage of ROP at the same PCA (34.8 vs. 35.0weeks, p=0.8836).
In this retrospective study comparing Hispanic to AA babies there was no difference in the incidence of ROP, but Hispanic babies had a higher incidence of severe ROP. This observation may be secondary to the lower gestational ages of Hispanic babies at birth. Interestingly, Hispanic babies also demonstrated a longer duration of ROP. Further studies will be needed to conclude if race alone accounts for the findings observed in our population.
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