Clinical Course and Treatment Rates of Retinopathy of Prematurity in Extremely Premature Infants
Gurdeep Jhaj; Deborah M. Costakos; Kelly Laurenti; Iris S. Kassem
Medical College of Wisconsin
Introduction: Advances in neonatal care have increased survival of the youngest premature infants. This study aims to better characterize the incidence and natural history of Retinopathy of Prematurity (ROP) in this population.
Methods: A retrospective and prospective chart review of infants born less than 26 weeks gestational age (GA) at birth was performed. 253 infants were identified with the rates of incidence and course of ROP evaluated.
Results: The weight at birth was 563.33±25 grams at 22 to 22 6/7 weeks, 573.29±13.83 grams at 23 to 23 6/7 weeks, 658.71±10.99 grams at 24 to 24 6/7 weeks, and 701.32±15.03 grams at 25 to 25 6/7 weeks. The incidence and age of treatment requiring (Type I) ROP was 50% at 34.2 weeks for 22 week infants, 66.66% at 35.02±0.35 weeks for 23 week infants, 37.61% at 35.57±0.35 weeks for 24 week infants, and 30.93% at 36.33±0.39 weeks for 25 week infants. The GA at initial treatment for each group was: 22 at 34.29 weeks, 23 at 34.31±0.69 weeks, 24 at 35.31±0.51 weeks, 25 at 36 ± 0.41weeks. There was no difference in the weights of infants with Type I ROP at 22-23 GA, but older infants did have lower weight (p<0.01).
Discussion: Younger premature infants had earlier and higher rates of Type I ROP. Gestational weight was only significantly lower for infants with Type I ROP 24 weeks and older.
Conclusion: Infants born at less than 25 weeks GA may require closer follow-up since they develop Type I ROP more frequently and earlier than older infants.
References: 1. Good WV; Early Treatment for Retinopathy of Prematurity Cooperative Group. Final results of the Early Treatment for Retinopathy of Prematurity (ETROP) randomized trial. Trans Am Ophthalmol Soc 2004: 102:233-48; discussion 248-50.
2. Quinn GE, Barr C, Bremer D, Fellows R, Gong A, Hoffman R, Repka MX, Shepard J, Siatkowski RM, Wade K, Ying GS. Ophthalmology;2016:123(7):1595-600.