Abstract
Purpose :
Retinopathy of Prematurity (ROP) is a sight threatening disease that can affect preterm infants. It is unclear how low gestational age affects ophthalmologic screening and treatment rates. This study evaluates the examination and treatment rates of infants born less than 25 weeks gestational age (GA) compared to those born 25 weeks or greater requiring screening for ROP.
Methods :
This is a retrospective, cross sectional study of infants who met institutional ROP screening criteria and were admitted to two Montefiore Medical Center (Bronx, NY) NICUs from January 2017 to June 2020. Data was collected using EMR (Epic Systems Corporation, Verona, Wisconsin). Patients were excluded if they were transferred to another facility before screening was completed.
Variables analyzed were GA, birth weight, number of ophthalmology exams (inpatient/outpatient), worst stage of ROP, type I disease or APROP in either eye.
Infants were divided into two groups: Group “GA<25” were those with GA less than 25 weeks and group “GA≥25” were infants with GA equal to or greater than 25 weeks. Two tailed student’s T-test and chi square test were used for statistical analysis.
Results :
Table 1 and Table 2 provide demographic and eye examination results respectively for a total of 415 infants of which 7.3% (n=30) had GA<25. As expected, GA<25 infants had significantly lower birth weight compared to GA≥25 (656g vs 1150g, p<0.001) and significantly higher mortality (37% vs 8.11%, p<0.00001). There were no differences in sex or single/multiple births between the two groups. GA<25 infants had a significantly higher number of total examinations than GA≥25 (9.8 vs 4.2, p<0.001) and higher numbers of inpatients exams (7.8 vs 2.5, p<0.001). Outpatient exams were similar (2.1 vs 1.5). GA<25 had worst average stage of ROP at 1.33 compared to 0.224 for GA≥25 (p<0.001). Rates of Type I ROP were significantly higher for GA<25 compared to GA≥25 (20% vs 1.04%, p<0.001).
Conclusions :
Infants with GA<25 required significantly more ophthalmologic exams, developed more severe ROP and had a higher treatment rate. It is important for ROP services, including neonatologists and ophthalmologists, to be aware of this increased clinical burden, especially as the number of such infants starts increasing in their NICUs.
This is a 2021 ARVO Annual Meeting abstract.