Incidence of retinopathy of prematurity in Germany: evaluation of current screening criteria

2020 ◽  
pp. fetalneonatal-2020-319767
Author(s):  
Petra P Larsen ◽  
Andreas Müller ◽  
Wolf A Lagrèze ◽  
Frank G Holz ◽  
Andreas Stahl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinopathy Of Prematurity ◽  
Screening Programme ◽  
University Hospitals ◽  
Quality Assurance Procedure ◽  
Screening Criteria ◽  
Additional Risk ◽  
Postmenstrual Age ◽  
Current Screening ◽  
Rop Screening

ObjectiveTo evaluate current screening criteria for retinopathy of prematurity (ROP) by investigating the incidence of ROP requiring treatment in infants with gestational age (GA) ≥30 weeks or postmenstrual age (PMA) <32 weeks in Germany.MethodsThree patient databases were analysed, that is, the German Quality Assurance Procedure in Neonatology (years 2011–2017; n=52 461 infants screened for ROP, 1505 infants treated for ROP), the German Retina.net ROP Registry (years 2011–2018; n=281 treated infants) and the ROP screening programme of two German university hospitals (years 2012–2016; n=837 screened infants).ResultsIn the analysed cohorts, infants with GA ≥30 weeks represented 33.1%–38.5% of the screening populations but only 1.40%–1.42% of the cases requiring ROP treatment. In a cohort of 281 infants treated for ROP, all 4 infants with GA ≥30 weeks had additional risk factors for ROP including prolonged oxygen supplementation and/or significant comorbidities. Five infants (1.8%) were treated at 32 weeks PMA and none at PMA <32 weeks.ConclusionsIn the investigated cohorts, preterm infants with GA ≥30 weeks carried a very low or no risk for developing treatment-requiring ROP unless additional risk factors were present, and no treatment was performed earlier than 32 weeks PMA. These findings are of relevance for the ongoing re-evaluation of ROP screening criteria.

scholarly journals Retinopathy of prematurity in a tertiary facility: an initial report of a screening programme

2020 ◽  
Vol 47 (2) ◽  
pp. 55-60
Author(s):  
B.A. Olusanya ◽  
T.S. Oluleye ◽  
O.O. Tongo ◽  
M.O. Ugalahi ◽  
Y.O. Babalola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Screening Criteria ◽  
Screening Programs ◽  
Significant Difference ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Rop Screening

Background: Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the  development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening  program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks.  Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those  without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening  programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards  developing country-specific screening guidelines. Keywords: Retinopathy; Prematurity; Preterm; Neonates; Nigeria; Africa

Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

2020 ◽  
pp. bjophthalmol-2020-316401
Author(s):  
Qian Yang ◽  
Xiaohong Zhou ◽  
Yingqin Ni ◽  
Haidong Shan ◽  
Wenjing Shi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Predictive Performance ◽  
Screening Guideline ◽  
Postmenstrual Age ◽  
The Mean ◽  
Type 1 Rop ◽  
Rop Screening

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.ResultsOf the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.ConclusionsThe incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

scholarly journals Comparative cohorts of retinopathy of prematurity outcomes of differing oxygen saturation: real-world outcomes

2021 ◽  
Vol 6 (1) ◽  
pp. e000626
Author(s):  
May May Choo ◽  
John Grigg ◽  
Elizabeth H Barnes ◽  
Nurliza Khaliddin ◽  
Tengku Ain Kamalden ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Real World ◽  
Retinopathy Of Prematurity ◽  
Screening Programme ◽  
Intraventricular Haemorrhage ◽  
Developing Nations ◽  
Retrospective Comparative Study ◽  
Treatment Mortality ◽  
Fundoscopic Examination ◽  
Rop Screening

ObjectiveAn ongoing third epidemic of retinopathy of prematurity (ROP) is contributed largely by developing nations. We describe a cohort of infants in a single neonatal unit where two limits of oxygen saturation were administered, to show real-world outcomes from trend in neonatology for higher oxygen to improve survival.Methods and analysisThis retrospective, comparative study of prospectively collected data in an ROP screening programme included infants indicated by gestational age ≤32 weeks, birth weight <1501 g, ventilation for 7 days or requiring oxygen >1 month, who underwent dilated fundoscopic examination from age 4 weeks, every 2 weeks until full retinal vascularisation. Infants with ROP were examined weekly and treated where indicated. Data were divided into two epochs. Epoch 1 oxygen saturation targets were [88–92%], epoch 2 targets [90–95% (99%)] with allowance of increase to 20% for several hours after procedures. Outcome measures included development of ROP, treatment, mortality, sepsis and intraventricular haemorrhage.ResultsA total of 651 infants underwent examination between 2003 and 2016. The incidence of ROP in epoch 1 was 29.1% and epoch 2 was 29.3% (p=0.24). ROP progression doubled in epoch 2 (5 vs 11%, p=0.006), proportion of cases treated halved (14% vs 6%, p=0.0005), sepsis was halved (78.5% vs 41.2%, p<0.0001) and intraventricular haemorrhage doubled (20.2% vs 43.8%, p=0.0001) in epoch 2. Mortality was 4% and 0% in epochs 1 and 2, respectively.ConclusionIncidence of ROP did not differ, although ROP cases that worsened doubled with higher oxygen targets. ROP cases requiring treatment decreased, as did sepsis and mortality. Intraventricular haemorrhage cases doubled.

scholarly journals Risk Factors for Retinopathy of Prematurity in the Netherlands: A Comparison of Two Cohorts

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Kasia Trzcionkowska ◽  
Floris Groenendaal ◽  
Peter Andriessen ◽  
Peter H. Dijk ◽  
Frank A.M. van den Dungen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
The Netherlands ◽  
Retinopathy Of Prematurity ◽  
Screening Guideline ◽  
Potential Risk Factors ◽  
Second Period ◽  
Perinatal Database ◽  
Rop Screening

<b><i>Introduction:</i></b> Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP. <b><i>Methods:</i></b> Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians. Ophthalmologists provided data of screened infants, which were combined with risk factors from the national perinatal database (Perined). Clinical data and potential risk factors were compared to the first national ROP inventory (NEDROP-1, 2009). During the second period, more strict risk factor-based screening inclusion criteria were applied. <b><i>Results:</i></b> Of 1,287 eligible infants, 933 (72.5%) were screened for ROP and matched with the Perined data. Any ROP was found in 264 infants (28.3% of screened population, 2009: 21.9%) and severe ROP (sROP) (stage ≥3) in 41 infants (4.4%, 2009: 2.1%). The risk for any ROP is decreased with a higher GA (odds ratio [OR] 0.59 and 95% confidence interval [CI] 0.54–0.66) and increased for small for GA (SGA) (1.73, 1.11–2.62), mechanical ventilation &#x3e;7 days (2.13, 1.35–3.37) and postnatal corticosteroids (2.57, 1.44–4.66). For sROP, significant factors were GA (OR 0.37 and CI 0.27–0.50), SGA (OR 5.65 and CI 2.17–14.92), postnatal corticosteroids (OR 3.81 and CI 1.72–8.40), and perforated necrotizing enterocolitis (OR 7.55 and CI 2.29–24.48). <b><i>Conclusion:</i></b> In the Netherlands, sROP was diagnosed more frequently since 2009. No new risk factors for ROP were determined in the present study, apart from those already included in the current screening guideline.

A worldwide survey of retinopathy of prematurity screening

2017 ◽  
Vol 102 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Justin S Mora ◽  
Christopher Waite ◽  
Clare E Gilbert ◽  
Brenda Breidenstein ◽  
John J Sloper
Keyword(s):  
Low Income ◽  
Retinopathy Of Prematurity ◽  
Online Survey ◽  
Low Income Countries ◽  
Screening Criteria ◽  
Middle Income ◽  
Premature Babies ◽  
Inadequate Knowledge ◽  
The World ◽  
Rop Screening

BackgroundTo ascertain which countries in the world have retinopathy of prematurity (ROP) screening programmes and guidelines and how these were developed.MethodsAn email database was created and requests were sent to ophthalmologists in 141 nations to complete an online survey on ROP screening in their country.ResultsRepresentatives from 92/141 (65%) countries responded. 78/92 (85%) have existing ROP screening programmes, and 68/78 (88%) have defined screening criteria. Some countries have limited screening and those areas which have no screening or for which there is inadequate knowledge are mainly Southeast Asia, Africa and some former Soviet states.DiscussionWith the increasing survival of premature babies in lower-middle-income and low-income countries, it is important to ensure that adequate ROP screening and treatment is in place. This information will help organisations focus their resources on those areas most in need.

scholarly journals Retinopathy of Prematurity in A Tertiary Care Hospital in Eastern Nepal

2008 ◽  
Vol 47 (169) ◽  
Author(s):  
Srijana Adhikari ◽  
B P Badhu ◽  
N K Bhatta ◽  
R S Rajbhandari ◽  
B K Kalakheti
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Screening Criteria

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening

scholarly journals Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units

2018 ◽  
Vol 102 (12) ◽  
pp. 1711-1716 ◽  
Author(s):  
Ahmet Yagmur Bas ◽  
Nihal Demirel ◽  
Esin Koc ◽  
Dilek Ulubas Isik ◽  
İbrahim Murat Hirfanoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Relative Weight ◽  
Neonatal Intensive Care Units ◽  
Screening Criteria ◽  
Prospective Multicentre Study

BackgroundTo evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition.MethodsA prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses.ResultsThe TR-ROP study included 6115 infants: 4964 (81%) with a GA≤32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW≤1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW≤1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment.ConclusionsScreening of infants with a GA≤34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs.Trial registration numberNCT02814929, Results.

scholarly journals Analysis of Current Status and Strategies of Retinopathy of Prematurity Screening during 6 Years in Local Regions of China: Implication and Caution

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Lu Chen ◽  
Ming Su ◽  
Sheng-gang Ren ◽  
Hui-lan Hua ◽  
Jian-cang Wang ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
North China ◽  
Local Region ◽  
Hebei Province ◽  
Current Status ◽  
Fundus Examination ◽  
Ocular Diseases ◽  
Initial Screening ◽  
Screening Criteria ◽  
Rop Screening

Purpose. To understand the current status of retinopathy of prematurity (ROP) screening in a province of North China.Methods. We retrospectively analyzed 5651 cases with ROP screening in the Provincial Screening Center of Hebei Province from January 2008 to December 2013.Results. 14.98% of all ROP patients and 1.56% of severe ROP patients required treatment. All the severe ROP patients met the criteria of screening. Severe ROP patients were detected at recommended initial screening time (4–6 weeks after birth). The frequency of other ocular diseases was 8.03%, in which the main disease was fundus hemorrhage. In 2665 more mature and unqualified infants, only 2 retinoblastoma and 2 familial exudative vitreoretinopathy were detected, which indicates the advantage of early diagnosis and treatment based on fundus examination.Conclusions. It is suggested that the standard of GA < 32 weeks and/or BW < 1800 g could be served as the screening criteria in the local region for ROP screening. 4 weeks after birth is the most appropriate time for initial screening.

scholarly journals Retinopathy of prematurity in the period 2015-2019 in a tertiary referral centre in Slovenia

2021 ◽  
pp. 1-8
Author(s):  
Manca Tekavčič Pompe ◽  
Špela Markelj ◽  
Liljana Kornhauser Cerar
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Screening Criteria ◽  
Number Of Children ◽  
Extremely Preterm ◽  
Gestational Week ◽  
Rop Screening

Background: Retinopathy of prematurity (ROP) is the leading cause of blindness among prematurely born children. The incidence of any stage of ROP in children born before the 31st gestational week in Europe and the USA is between 10-45%. The purpose of this study was to show characteristics of ROP between 2015 and 2019 at the Neonatal Intensive Care Unit of the University Medical Centre Ljubljana (NICU-Lj), which is the larger of the two tertiary referral centres in Slovenia and in which more than two thirds of Slovenian very low birth weight children are treated. Methods: All prematurely born children screened for ROP at NICU-Lj between 2015 and 2019 were included in the study. The following parameters were recorded: number of children screened, total number of exams, number of exams per child, number of children with ROP, ROP stages, number of children who needed ROP treatment and number of treatments per child treated. Results: Between 2015 and 2019, 82-130 prematurely born children fulfilled ROP screening criteria each year. A total of 1,412 exams were performed over the period of five years (range: 239-386 per year). Every child had one or more ROP screening exams (range: 1-10). Extremely preterm children born before the 27th week of gestation had more exams (average: 5 exams/child) compared to other prematurely born children (average: 1.5 exams/child). The number of prematurely born children with any stage of ROP ranged from 17 to 30 per year. ROP of any stage was present in 18.75% (2015), in 17.7% (2016), in 23% (2017), in 29.3% (2018), and in 24.1% (2019). More than 70% of all babies with ROP were born before the 27th gestational week. The most mature baby with ROP was born with 29 6/7 weeks of gestational age. Every year, 15-35% of babies with ROP received laser treatment. Conclusions: ROP is an important disease in prematurely born children. During the period 2015-2019, the incidence of any stage of ROP and of serious ROP requiring treatment was comparable. The screening and treatment of ROP requires intense cooperation between paediatric ophthalmologists and neonatologists in order to prevent blindness in prematurely born children.

Sign in / Sign up

Export Citation Format

Share Document