Surveillance for retinopathy of prematurity in a Copenhagen high‐risk sample 1999–2001. Has progress reached a plateau?

Abstract

ABSTRACT.Purpose: As part of current quality control to evaluate ophthalmic findings in the two combined central Copenhagen neonatology centres, for birth years 1999-2001, and to compare the selected sample with data of the national register for childhood visual impairment. Methods: In a prospective design to report on 372 infants mainly under regular surveillance for retinopathy of prematurity (ROP) in the stratified functional unit made up by the neonatal wards of Rigshospitalet (RH) and Hvidovre Hospital (HH). The median neonate under ophthalmic surveillance in the two wards (screening limits usually 32 weeks/1750 g) was given by gestational age (GA) and birthweight (BW) values of 27.3 weeks/907 g and 30.3 weeks/1420 g, respectively. Feedback regarding outcome was secured for those transferred to regional centres. Results: The overall frequency of ROP was 38.5% in the RH (n ¼ 252) and 10.8% in the HH sample (n ¼ 120). From a peak share above 60% in those <26 weeks/ 750 g at delivery, the incidence of ROP showed a regular decrease with decreasing immaturity. The centralized retinal ablation therapy for advanced ROP was given to a total of 29, with birth year 2001 unexpectedly showing a peak of 17 cases. Seven of the 29 children treated are now in the register for visually impaired, mainly due to low vision. Fourteen of the 29 had been very small for gestational age. Conclusions: Supported also by recent regional Danish data, the apparent progress in the fight against ROP over many years seems to have come to a halt. Except for the continued increased survival of extremely preterm babies we have no obvious neonatological indications to explain the suggested 'adverse' trend.

Juvenile eye growth, when completed? An evaluation based on IOL‐Master axial length data, cross‐sectional and longitudinal

“…Much smaller individual differences can be directly assessed than possible with the ultrasonic techniques, which further are operator dependent. In our experience, with a quiet child, the immersion axial ultrasound measurements can be reproducible down to only ±0.15 mm (Fledelius 1976).…”

“…A comparison of ultrasonic cross-sectional axial length oculometry data mean values by age (Larsen 1971;Tane & Kohno 1984, here approximated after pooling) and factual pooled mean values as derived from the respective papers (Fledelius 1976(Fledelius , 1981(Fledelius , 1982Zadnik et al 2004). At bottom, the present IOL-Master-based series.…”

“…The aim of the present investigation, however, was possibly to assess what could be labelled basic eye growth, as considered relevant for the 50-70% of a juvenile western population who -in accord with the established leptocurtosis of the refractive distribution (Steiger 1913;Duke-Elder 1938;Stenstro¨m 1946;Sorsby 1972;Fledelius 1976Fledelius , 1983) -cluster around emmetropia. In particular, we wanted to exclude the influence of significant myopia on results, in the effort to test the validity of Sorsby's suggestion of 13 years as end stage of normal eye growth.…”

“…The empirical adjustment chosen was as follows: for plus values above 0.25 D, an addition to the actual IOL-Master measurement was made, and for corresponding minus values a subtraction, both according to an averaged relationship of a 1 D difference as corresponding to 0.4 mm axial length difference (Fledelius 1976(Fledelius , 2006Jensen 1991).…”

“…The general statement of Sorsby has remained unchallenged, although confronted with (i) the established evidence of axial elongation for myopia as such (Donders 1864;Gernet 1970;Fledelius 1976;Curtin 1985), and (ii) that myopia usually develops and ⁄ or progresses during school age (Duke-Elder 1938;Sorsby 1972;Delmarcelle et al 1976;Fledelius 1983Fledelius , 2006Curtin 1985;Jensen 1991). In case of population-derived adolescent samples, the increasing fraction with juvenile myopia thus should set its mark in cross-sectional investigations as continued axial elongation also after the age of 13.…”