Retinopathy of Prematurity among Very-Low-Birth-Weight Infants in Korea: Incidence, Treatment, and Risk Factors

Abstract

This study was conducted to describe the incidence, risk factors, and current treatment status of retinopathy of prematurity (ROP) in very-low-birth-weight (VLBW) infants registered in the Korean Neonatal Network database. Medical records of 2,009 VLBW infants born between January 2013 and June 2014 who underwent examination by an ophthalmologist were reviewed. The total incidence of ROP was 34.1%. Of the patients, 11.6% showed ROP stage ≥ 3 and 11.5% received treatment of VLBW. Among all infants who received treatment of ROP, 63.6% underwent operation only; 16.9%, anti-vascular endothelial growth factor (anti-VEGF) treatment only; and 19.5%, both operation and anti-VEGF treatment. The mean gestational age (GA) and birth weight (BW) were significantly lower and the prevalence rates of respiratory distress syndrome, patent ductus arteriosus (PDA), invasive ventilator duration, and sepsis were significantly higher in the VLBW infants with ROP than in those without ROP. In the multivariable logistic regression analysis, PDA (odd ratio [OR], 2.1; 95% confidence interval [CI], 1.11-3.79) and invasive ventilator duration (OR, 1.0; 95% CI, 1.00-1.02) were significant risk factors of ROP and ROP stage ≥ 3. In conclusion, the high incidence of ROP is associated with low GA and BW, and attempt to reduce the aforementioned risk factors could reduce the incidence of ROP stage ≥ 3 in VLBW infants.

Retinopathy of Prematurity Trends in Taiwan: A 10-Year Nationwide Population Study

“…11 The most commonly reported risk factors were BW and GA. 7,[12][13][14] Although some articles using national datasets have been reported, few studies have been conducted in Asian populations. [15][16][17] Previous ROP studies in Asian populations were also limited by small sample sizes or constrained by specific ranges of BW. [15][16][17] The National Health Insurance Research Database (NHIRD) in Taiwan contains extracted claims data from all ambulatory and in-hospital patients.…”

Pulmonary Outcomes of Early Extubation in Extremely Premature Infants (Gestational Age: 25–26 Weeks) with Synchronized Nasal Intermittent Positive-Pressure Ventilation

“…In the present study, the combined rate of clinical BPD or death was about 40%. The duration of invasive ventilator use was a significant risk factor of ROP according to a latest nationwide survey 36) . The incidence of ROP requiring treatment in the early extubation group was higher than that in the control group, but relatively lower than that in the latest nationwide survey 36) .…”

“…The duration of invasive ventilator use was a significant risk factor of ROP according to a latest nationwide survey 36) . The incidence of ROP requiring treatment in the early extubation group was higher than that in the control group, but relatively lower than that in the latest nationwide survey 36) . However, no clear benefit was demonstrated for the use of synchronized NIPPV in terms of lowering the incidence rates of BPD or ROP.…”

Risk Factors of Retinopathy of Prematurity Associated with Delayed Retinal Vascular Development

“…The first phase begins with delayed retinal vascularization, followed by a second phase of vascular proliferation. In the initial phase of this model, delayed retinal vascular development occurs partly due to a decrease in ATP levels (1).…”

“…The development of retinopathy of prematurity (ROP) involves multiple factors including neonatal immaturity (gestational age, birth weight), hyperoxia, low nutrient supply, intrauterine fetal demise of one twin, apnea and PDA (1)(2)(3)(4)(5)(6).…”