June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
The State of Retinopathy of Prematurity Screening and Treatment in North Carolina
Author Affiliations & Notes
  • Tika Zbornik Thompson
    The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States
  • Michelle Go
    Ophthalmology, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States
  • Grace Prakalapakorn
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Footnotes
    Commercial Relationships   Tika Zbornik Thompson None; Michelle Go None; Grace Prakalapakorn None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1419. doi:
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      Tika Zbornik Thompson, Michelle Go, Grace Prakalapakorn; The State of Retinopathy of Prematurity Screening and Treatment in North Carolina. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1419.

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

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Purpose : There is a worldwide shortage of ophthalmologists trained and willing to screen for and treat retinopathy of prematurity (ROP). The purpose of this survey is to determine how many ophthalmologists screen for ROP, how long they plan to continue, if they treat ROP, and if there is an unmet need for ROP services in North Carolina (NC).

Methods : We compiled a list of ophthalmologists and neonatal intensive care units (NICUs) in NC known to be involved in ROP screening. An electronic survey was developed and emailed to assess the training background, where each ophthalmologist performs ROP screening, when they plan to stop screening and factors contributing to that decision, if and where they treat ROP, and ROP services offered across NICUs.

Results : In NC, there are 28 ophthalmologists and 27 NICUs involved in ROP screening. Twenty-two (79%) ophthalmologists completed the survey, representing 24 (89%) NICUs. By training, 13 (59%) are pediatric ophthalmologists, 6 (27%) retina specialists, 1 (5%) pediatric/neuro-ophthalmologist, and 2 (9%) comprehensive ophthalmologists. Nine ophthalmologists (32%) plan to stop screening for ROP within 5 years, 3 (11%) in 6-10 years, and 10 (36%) in >10 years. Seventeen (77%) cited retirement as the reason for stopping. Ten NICUs (37%) offer ROP treatment. Fourteen (52%) NICUs do not offer ROP treatment and must transfer infants needing treatment to another NICU a mean of 64 (range: 5-222) miles away. Fifteen (54%) ophthalmologists reported being comfortable performing both anti-vascular endothelial growth factor (VEGF) injections and indirect laser, 3 (11%) anti-VEGF injections only, 2 (7%) indirect laser only, and 2 (7%) neither. Eleven of 14 (79%) NICUs not offering treatment have ROP screeners who are comfortable treating ROP. At 5 of 27 NICUs (19%), all current ROP screeners plan to stop screening in <5 years.

Conclusions : Within 5 years, at least 32% of ROP screeners in NC plan to stop screening, and 19% of NICUs will lose all current ROP screeners. Over half of NICUs do not offer ROP treatment despite at least 65% of them having ophthalmologists capable of treating ROP, resulting in infants being transferred long distances when needing treatment. This survey indicates a statewide mismatch between ophthalmologists capable of treating ROP and NICUs offering treatment. Similar trends likely exist across the United States and plans to address this imminent crisis are needed.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.


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