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

Yang, Qian; Zhou, Xin; Ni, Yingqin; Shan, Hangguan; Shi, Wenjing; Yin, Xingtian; Liu, Jiang-Qin; Huang, Xin

doi:10.1136/bjophthalmol-2020-316401

Cited by 11 publications

(8 citation statements)

References 31 publications

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“…7,11) Advanced training for neonatologists, ophthalmologists, and neonatal nurses is often lacking, oxygen saturation is not monitored, and ROP is seen in the smallest infants if they do survive as well as in more mature preterm infants. 12) These regions include middle-income regions of Latin America, East and South Asia, Eastern Europe, and Central Asia according to Blencowe et al 2) During this third epidemic, the mean BWs of ROP babies needing treatment ranged from 737 to 763 g (range, 440-1785 g) in the UK, Canada, and the USA, while mean gestational age (GA) ranged from 25.3 to 25.6 weeks (range, [22][23][24][25][26][27][28][29][30][31][32]. 12) Meanwhile, babies affected in low-and middle-income countries have a far wider range of BWs and GAs.…”

Section: Three Phases Of Rop "Epidemics"mentioning

confidence: 99%

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Retinopathy of prematurity: a review of epidemiology and current treatment strategies

2022

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Retinopathy of prematurity (ROP) is among the most common causes of childhood blindness. Three phases of ROP epidemics have been observed worldwide since ROP was first described in the 1940s.Despite advances in neonatal care, the occurrence of ROP and associated visual impairment has been increasing somewhere on Earth and remains difficult to control. Conventional treatment options for preventing ROP progression include retinal ablation using cryotherapy or laser therapy. With the emergence of anti-vascular endothelial growth factor (anti-VEGF) treatment for ocular diseases, the efficacy and safety of anti-VEGF therapy for ROP have recently been actively discussed. In the advanced stage of ROP with retinal detachment, surgical treatment including scleral buckling or vitrectomy is needed to maintain or induce retinal attachment. At this stage, the visual outcome is usually poor despite successful anatomical retinal attachment. Therefore, preventing ROP progression by timely screening examinations and treatment remains the most important part of ROP management.

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Section: Three Phases Of Rop "Epidemics"mentioning

confidence: 99%

“…A multicenter study conducted in Shanghai in 2012-2016 showed an ROP incidence of 15.9% (892/5,606) among all infants undergoing ROP screening. 31) In Southwest China, 12.8% (206/1,614) of premature infants with a GA < 37 weeks…”

Section: A C C E P T E Dmentioning

confidence: 99%

Retinopathy of prematurity: a review of epidemiology and current treatment strategies

2022

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“…The incidence of ROP in Shanghai was 17.8%, and the treatment rate was 6.8% in 2013 [ 13 ]. A recent study reported that the incidence of ROP in Shanghai was 15.9%, and the treatment rate was 1.1% in 2021 [ 14 ]. Tianjin Eye Hospital is the only medical institutions to carried out the ROP screening in Tianjin.…”

Section: Discussionmentioning

confidence: 99%

Screening for retinopathy of prematurity in North China

Gao

Chen

et al. 2022

BMC Ophthalmol

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Purpose To analyze the incidence and severity of retinopathy of prematurity (ROP) in north China, and to evaluate the effectiveness of different ROP screening criteria. Patients and methods The screening data of premature infants were collected from 2016 to 2021. The severity of ROP was graded according to the International Classification of Retinopathy of Prematurity (2005). And the treatment for ROP followed the Early Treatment for Retinopathy of Prematurity Cooperative Group. The effects of gestational age (GA) and birth weight (BW) on the incidence and severity of ROP were evaluated. The screening data were also analyzed using different ROP screening guidelines. Results A total of 4069 infants underwent ROP screening, and 728 infants (17.9%) were diagnosed with ROP. Of those, 78 infants (1.9%) received treatments. Gestational age and BW showed significant differences between infants with and without ROP (29.1 ± 2.1w vs. 32.9 ± 2.6w, p < 0.001; 1362.7 ± 427.3 g vs. 1751.9 ± 509.4 g, p < 0.001; respectively). Fifty-six infants (7.69%), 188 infants (25.82%), and 104 infants (14.29%) in all infants with ROP would have been missed according to the China, USA, and UK screening guidelines respectively. If GA ≤ 33 weeks and/or BW ≤ 2100 g were considered as screening criteria, only one infant (0.14%) with critical systemic illness was missed diagnosed with severe ROP. Conclusion Gestational age and BW are major risk factors for the incidence and severity of ROP. And the incidence and treatment rate of ROP in Tianjin is similar to that reported in the other regions of China. Modified ROP screening criteria were considered to be more effective in Tianjin.

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“…Despite numerous reports on the risk factors of ROP (10,(22)(23)(24), little is known about the factors affecting its spontaneous regression. Only two small-scale studies have identified the factors influencing ROP regression.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Spontaneous Regression of Retinopathy of Prematurity in China: A 5-Year Retrospective Case Series

Wang

Zhu

et al. 2021

Front. Med.

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Purpose: The aim of this study is to explore the clinical features of spontaneous regression of retinopathy of prematurity (ROP) in China, including fundus appearance, time course, and affecting factors.Methods: Data of pediatric patients in whom ROP spontaneously regressed without treatment were collected, including general demographics, medical history, zones and stages of ROP, and changes of fundus appearance. The fundus manifestations of spontaneous regression in ROP were systematically summarized. Meanwhile, the time course of spontaneous regression in ROP was further analyzed, including the onset time, completion time, and duration of regression, which were all compared across different ROP zones and stages. The associated factors were analyzed by survival analysis for their correlation with delayed regression for the first time.Results: Two hundred thirty-seven eyes of 237 pediatric patients were included. The fundus manifestations of regression differed across stages. Lesions gradually subsided, and the retinal vessels gradually vascularized completely. However, despite ROP regression, some abnormalities remained. We observed avascular retina in the temporal periphery (19.0%), increased vascular branching (6.8%), retinal pigmentary changes (6.8%), and smaller angle between the upper and lower temporal retinal vessel trunks (3.0%). Acute ROP started to regress at a median 40 weeks of postmenstrual age (PMA) and completely regressed by median 49.0 weeks of PMA. The median duration for regression was 8.5 weeks. The zone II ROP and stage 3 ROP had a later time for onset and completion of regression, and longer duration. Anemia and retinal hemorrhage (RH) were identified as independent risk factors for delayed regression by survival analysis.Conclusions: During spontaneous regression, the fundus appearance is diverse, and the retinal vessels gradually vascularized completely. The time course of regression differs depending on the ROP zone and stage. Anemia and RH are independent risk factors for delayed regression. Further research of the natural course of the regression of ROP is needed to help design effective screening and follow-up plans.

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

Cited by 11 publications

References 31 publications

Retinopathy of prematurity: a review of epidemiology and current treatment strategies

Retinopathy of prematurity: a review of epidemiology and current treatment strategies

Screening for retinopathy of prematurity in North China

Clinical Features of Spontaneous Regression of Retinopathy of Prematurity in China: A 5-Year Retrospective Case Series

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