July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Retinopathy of prematurity incidence and outcomes following implementation of a new oxygen protocol in a neonatal intensive care unit
Author Affiliations & Notes
  • Shelley Jelineo
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    UH Rainbow Babies and Children's Hospital, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Shelley Jelineo, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2766. doi:
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      Shelley Jelineo; Retinopathy of prematurity incidence and outcomes following implementation of a new oxygen protocol in a neonatal intensive care unit. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2766.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : After countless studies and years of debate on the optimal oxygen saturation targets for premature babies, the Oxygen with Love protocol (OWL), has been implemented in many neonatal intensive care units (NICUs), including in our NICU at Rainbow Babies and Children’s Hospital, within the last decade. Our study was thus focused on the incidence and short term outcomes of retinopathy of prematurity among premature babies born and cared for in the Rainbow NICU over the past two years.

Methods : A total of 330 babies were screened for retinopathy of prematurity (ROP) between January 2014 and December 2016, based on a gestational age of ≤ 30 weeks, ≤ 1500 grams birth weight, or babies between 1500 and 2000 grams birth weight that were judged by neonatologists to be at risk of developing ROP. The incidence of ROP and the ocular outcomes were then determined. Babies were stratified into ETROP type 1 and type 2 definitions in order to classify the outcomes.

Results : Of the 330 babies screened for ROP, 131 (39.7%) were diagnosed with ROP, with 49 at stage 1 (14.8%), 42 at stage 2 (12.7%), 39 at stage 3 (11.8%), 1 at stage 4 (0.3%) and no patients with stage 5 disease. Patients diagnosed with ROP were then classified into type 1 and type 2 based on the ETROP study classifications, with 19 patients (5.8%) classified as type 1, 25 (7.6%) as type 2 and 87 (26.4%) as neither type 1 nor type 2. Plus disease was present in 4.5% of all babies screened and 11.5% of all babies diagnosed with ROP (n=15). All but two patients classified as type 1 and two patients classified as type 2 were treated with either laser photocoagulation (n=15, 4.5%) or anti-VEGF treatments (n=6, 1.8%), with resolution of all disease without recurrence.

Conclusions : Compared to past studies, including the Postnatal Growth and ROP (GROP) study, our study found a similar percentage of babies that developed severe ROP (13.3% vs 12.5%). The percentage of infants requiring treatment for severe ROP was also similar, at 6.1% vs 6.9%. Thus our study showed a similar incidence and ocular outcomes to the GROP study and represents a snapshot of the retinopathy of prematurity outcomes following implementation of new oxygen saturation protocols in our NICU.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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