Evaluation of birth weight and gestational age in infants with treatment requiring retinopathy of prematurity in ROPE-SOS trial

Abstract

Purpose : To characterize the patients in the Retinopathy of Prematurity Eradication – Save Our Sight (ROPE-SOS) trial that required treatment and to determine any differences in birth weight (BW) and gestational age (GA) among those with ROP requiring laser vs anti-vascular endothelial growth factor (anti-VEGF) injections.

Methods : A mobile ROP tele-screening team called ROPE-SOS [Retinopathy of Prematurity Eradication – Save Our Sight] performed screening examinations in South India between August 12, 2015 and September 30, 2015. Digital retinal images of the preterm infants were captured using the Retcam Shuttle (Clarity Medical Systems, Pleasonton, CA). These images were transmitted to Aravind Eye hospital in Coimbatore and a remote ROP expert determined acuity of disease and recommended follow up and treatment. Data regarding infant demographics, retinal exam, diagnosis, and treatment were recorded. Difference in BW or GA were determined between infants who were treated with laser vs infants who were treated with anti-VEGF injections. Asymmetric disease was defined as infant with eyes with different categories of ROP in the right eye vs the left eye. Statistical analysis was performed using STATA.

Results : A total of 3620 patients were screened. Average BW of those screened was 1746.83 ± 453.15 grams (g) and GA was 33.73 ± 2.84 weeks. A total of 103 (2.46%) patients were treated. Average BW of those treated was 1303.88 ± 359.94 g and GA was 30.22 ± 2.81 weeks. Of those patients that received treatment, 13.59% had to receive multiple treatments. Of all infants treated, 71.85% received laser, 42.72% received anti-VEGF injections (40.78% bevacizumab, 1.94% ranibizumab), and 0.97% had surgery. Of those treated, 25.40% had asymmetric disease. BW was 1287.54 ± 342.89g in the laser treatment group and 1351.029 ± 55.08 g in the anti-VEGF group (95% confidence interval (CI) -208.67-81.70, p=0.39). GA was 30.33 ± 2.65 weeks in the laser treatment group and 30.15 ± 3.06 weeks in the anti-VEGF injection group (95% CI -1.04-1.40, p=0.77).

Conclusions : The ROPE-SOS program was able to successfully screen and treat infants at risk for ROP through a telemedicine based screening program in rural India. There was no statistically significant difference in birth weight or gestational age in infants that received laser treatment vs anti-VEGF injections. Only 1 patient required vitrectomy.

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