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Xihui Lin, Ashish Singh, Kim Le, Yu-Guang He; Retinopathy of Prematurity in an Inner-City Predominantly Hispanic Population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6279. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The survival rate of premature infants has increased significantly over the past 2 decades and consequently, retinopathy of prematurity (ROP) has become a more prevalent problem facing ophthalmologists. The inner city population is of particular interest due to the poor access to healthcare and multiple maternal comorbidities. The aim of this study is to analyze the characteristics and risk factors for ROP in this population in which more than 60% of the population is Hispanic; a cohort that has never been studied before.
All newborns delivered at Parkland Memorial Hospital between 1/2009 to 7/2014 who had a screening eye exam for ROP and met the screening criteria of weight under 1500 grams or age under 32 weeks were included. Factors analyzed included demographics, comorbidities, severity and treatment of ROP. Maternal factors and comorbidities were also reviewed. Chi squared test was used for categorical data and Student t test for quantitative data analysis. Odds ratio was calculated for potential risk factors. This study received IRB approval from University of Texas Southwestern Medical Center.
391 consecutive newborns were analyzed: 69.3% were Hispanic. The average gestational age at birth was 28.3 weeks and weight was 1176.6 grams. 45.3% of the patients developed ROP and of those with ROP, 27.1% were stage 3 or higher. Statistically significant risk factors for the development of ROP included bronchopulmonary dysplasia (OR 3.34), patent ductus arteriosus (OR 3.08), high grade intraventricular hemorrhage (OR 8.97), sepsis (OR 19.70), and major surgeries (OR 7.37). Maternal risk factors included high parity (OR 2.84), advanced maternal age (OR 3.98), and pre-eclampsia (OR 1.88). At the 6 year follow up, those with ROP had a visual acuity of 20/36 with a +0.47 diopter refractive error. Laser treated eyes had worse myopia. 6.25% of the patients developed amblyopia.
The high rate of ROP in an inner-city underserved population was correlated with multiple risk factors including bronchopulmonary dysplasia, patent ductus arteriosus, high grade intraventricular hemorrhage, sepsis, and major surgeries. Maternal factors that increased the development of ROP included high parity, advanced maternal age, and pre-eclampsia. At 6 years, visual acuity was good but the rate of amblyopia was high and myopia rate increased with laser treatment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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