Prevalence and Risk Factors of Retinal Detachment from Retinopathy of Prematurity
Lauren A. Tomlinson; Yinxi Yu; Gui-shuang Ying; Gil Binenbaum; on behalf of The G-ROP Study Group
The Children’s Hospital of Philadelphia
Introduction: Retinal detachment (RD) can develop from retinopathy of prematurity (ROP) despite treatment for Type 1 ROP. We sought to determine the prevalence, timing, and risk factors for RD from ROP. |
Methods: Retrospective ‘G-ROP Study’ at 29 North-American hospitals between 2006-2012. Primary outcomes were prevalence of eyes developing RD (stage 4 or 5) and onset post-treatment. Birth weight (BW), gestational-age, postnatal-weight gain, surgical necrotizing enterocolitis (NEC), sepsis, and days of oxygen supplementation were evaluated as risk factors among treated eyes using multivariable regression.
Results: RD developed in 70/14,996 eyes (0.47%, 95% CI 0.37-0.59%) and 46/7,483 infants (0.61%); 37 stage 4, 33 stage 5; 52% had bilateral RD. 6 eyes/3 infants developed RD without Type 1 ROP diagnosis or treatment. 64/867 eyes developed RD following laser (7.4%, 5.8-9.3%): 56/742 Type 1, 8/128 Type 2. RD occurred at median 5.6 weeks (range 0.7-19 weeks) following treatment. 10 (15.6%) RD’s were within 2 weeks of treatment. #Treated within 72 hours of Type 1 diagnoses was similar between RD and non-RD eyes. In multivariable analysis, lower BW (OR 1.03 per-10 gram-decrease (1.01-1.05)) and NEC (OR 3.0, 1.5-5.9) were significant risk factors for RD following treatment. RD rates were, for example, 11.9% for BW<500g without NEC; 16.9% for BW<700g with NEC.
Discussion: Further investigation of infants at increased risk for RD could lead to modifications of treatment criteria or timing for such infants.
Conclusion: 7.4% of eyes progress to RD despite treatment for ROP. Infants with low BW and/or NEC are at increased risk for RD.