July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Screening for retinopathy of prematurity in very preterm infants: Epipage 2 cohort study
Author Affiliations & Notes
  • thibaut Chapron
    Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, INSERM UMR 1153, Paris, France
    Ophthalmopediatry, Fondation Rothschild, Paris, France
  • Georges Caputo
    Ophthalmopediatry, Fondation Rothschild, Paris, France
  • Jean-Christophe Rozé
    Service de Néonatologie , Nantes University Hospital, Nantes, France
    CIC 004, INSERM, Nantes, France
  • Elsa Kermorvant-Duchemin
    Paris Descartes University, Paris , France
    Department of Neonatal medicine, Necker Hospital, Paris, France
  • Amandine Barjol
    Ophthalmopediatry, Fondation Rothschild, Paris, France
  • Mélanie Durox
    Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, INSERM UMR 1153, Paris, France
  • Pierre-Yves Ancel
    Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, INSERM UMR 1153, Paris, France
    Paris Descartes University, Paris , France
  • Héloïse Torchin
    Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, INSERM UMR 1153, Paris, France
    Service de Médecine et Réanimation néonatales de Port-Royal, AP-HP, Hôpital Cochin, Paris, France
  • Footnotes
    Commercial Relationships   thibaut Chapron, None; Georges Caputo, None; Jean-Christophe Rozé, None; Elsa Kermorvant-Duchemin, None; Amandine Barjol, None; Mélanie Durox, None; Pierre-Yves Ancel, None; Héloïse Torchin, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2788. doi:
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      thibaut Chapron, Georges Caputo, Jean-Christophe Rozé, Elsa Kermorvant-Duchemin, Amandine Barjol, Mélanie Durox, Pierre-Yves Ancel, Héloïse Torchin; Screening for retinopathy of prematurity in very preterm infants: Epipage 2 cohort study
      . Invest. Ophthalmol. Vis. Sci. 2018;59(9):2788.

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

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Abstract

Purpose : Retinopathy of prematurity (ROP) is a severe blinding disease whose screening is recommended but the put into practice of these recommendations is rarely evaluated. The objective was to study the prevalence of fundus in very preterm infants as well as the individual factors and characteristics of the centers associated with the screening.

Methods : Our data was extracted from the Epipage-2 cohort, a national prospective population based study of births occurring between 22 and 34 completed weeks’ gestation (WG) in 2011. Children <32 WG without severe malformation alive at the recommended age for ROP screening were included. We performed two separate analyzes using nested mixed models; we studied 1) the achievement of the fundus and 2) its achievement on time according to the French recommendations in force in 2011.

Results : At the end, 70.5% (2169/3077) of children eligible for screening received a fundus examination. This rate decreased with WG from 96.4% at 24 WG to 49.9% at 31 WG. The infant characteristics associated with fundus examination were a small gestational age (p <0.001), low birth weight (p <0.001), presence of severe bronchodyspasia (p <0.01) or severe neurological lesions (p <0.01) as well as a transfer of the child during the screening period (p <0.001). Children hospitalized in units using wide angle imaging were better screened (OR 2.65 [1.17-6.01] p <0.001). The other characteristics of the centers (level, administrative status, volume of activity) were not significant.
Of the children screened, 75.7% (1641/2169) were on time. Factors associated with a fundus examination performed on time were a high gestational age (p <0.001), the use of wide angle imaging (OR 2.20 [1.06-4.58], p <0.01); while a low birth weight (p <0.001), presence of severe bronchodysplasia (p <0.001) or a necrotizing enterocolitis (p <0.001) were associated with a delay in the examination.

Conclusions : Children the most at risk of ROP were the best screened but the latest. A better compliance of the units using wide angle imaging system supports the benefit of its deployment and the setting of a sharing process between neonatal units regarding its cost.

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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