Survey of Current Retinopathy of Prematurity Practices in China
Thao Phuong H. Le; Jing Feng; Leona Ding; Rong Hu; Jan Niklas Ulrich; Xiao Bo Lou; Michelle Cabrera
University of Washington
Seattle, Washington, USA
Introduction: Despite being a large public health concern in China, retinopathy of prematurity (ROP) screening practices remain poorly understood. The most commonly utilized anti-vascular endothelial growth factor (VEGF) for ROP in China, Ranibizumab, has been implicated with high rates of ROP recurrence. This study aims to understand screening and treatment preferences, particularly with the use of anti-VEGF vs. laser, throughout China.
Methods: A Chinese language survey was administered anonymously using WebQ (Catalyst, Seattle, WA, USA) among Chinese ROP screeners from December 2016 to January 2017.
Results: Among 70 ophthalmologists contacted, 65 responded (78% female, mean age 40 years, 57% pediatric ophthalmologists and 25% retina specialists). Thirty percent received <3 months supervised ROP training. Most screened infants weighed 2 kg (62%) at birth and were 37 weeks (34%) gestational age. Screening was mostly performed with assistance of RetCam (Clarity, Pleasanton, CA, USA; 72%). Anti-VEGF was preferred over laser for both zone I (65% vs. 20%) and zone II ROP (49% vs. 35%). Retina specialists (p=0.004) and ophthalmologists with >3 months of training (p=0.03) were more likely to use Anti-VEGF over laser for zone I ROP.
Discussion: Chinese ROP screeners favored anti-VEGF injection and RetCam imaging for ROP management. Lack of training with laser or access to anesthesia are potential barriers to laser treatment.
Conclusion: A better understanding of ROP screening and treatment informs future research and education efforts in China.
References: 1. Chen et al. Analysis of changes in Characteristics of severe Retinopathy of prematurity Patients after screening Guidelines were issued in china. RETINA 35:1674-1679, 2015.
2. Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008 Feb;84(2):77-82.
3. Huang et al. Ranibizumab Injection as Primary Treatment in Patients with Retinopathy of Prematurity. Ophthalmology. Online 4/12/2017.