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Jennifer Patnaik, Jenae Stutzman, Anne M. Lynch, Emily McCourt; Characteristics of babies with unstable clinical course screened for retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4196 – F0256.
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Retinopathy of prematurity (ROP) screening examinations are recommended for infants with a birth weight (BW) of less than 1500 grams and/or a gestational age (GA) of less than 30 weeks and select infants who do not meet these criteria but have an unstable clinical course. We conducted this study to investigate and characterize babies who met the unstable clinical course criteria at one academic institution.
A retrospective chart review was performed on the medical records of infants screened for ROP at our hospitals between January 2006 and December 2020. Unstable clinical course was defined as babies screened for ROP who did not meet the birthweight or gestational age screening criteria. Chi-square tests were used to compare infants with unstable clinical course to other infants screened for ROP.
Among 2,328 infants screened for ROP, 144 (6.2%) were defined as unstable clinical course. Infants with unstable clinical course were similar to babies meeting the BW and GA criteria in terms of gender, race/ethnicity and singleton/multiple birth. Four of the unstable clinical course babies (2.8%) developed low grade ROP and none developed type 1 or type 2 ROP or needed treatment for ROP. Rates of ROP were much higher among babies meeting the BW and GA criteria in which 6.7% developed type 1, 5.9% type 2, and 22.3% low grade (p<0.0001). Two of the four unstable clinical course infants who developed low grade ROP were born at GA 31 weeks (BW 1800 and 2200 grams), and two were born at GA 32 weeks (BW 1510 and 1695 grams).
At our academic institution, infants defined as unstable clinical course and screened for ROP did not develop ROP to the level that required treatment. Further investigations at other institutions are warranted to determine if the unstable clinical course criteria is indeed capturing infants at risk for ROP.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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