Abstract
BackgroundSevere retinopathy of prematurity (ROP) with extremely unfavorable prognosis among infants can do great damage to individuals and bring tremendous social-economic burden. The purpose of this study is to describe the demographic and ocular characteristics of infants who presented with stage 5 ROP in order to identify reasons why they have become blind, and to identify contributing factors in order to focus great attention on the current ROP program and to inspire more effort in ROP screening in middle income countries.MethodsA retrospective review of consecutive infants with stage 5 ROP from December 2010 to December 2016 in Department of Ophthalmology, Xijing Hospital. Various parameters retrieved included birthweight, gestational age, age at initial examination, postmenstrual age, screening details, check-up details and reasons for consultation. Ocular findings were recorded and also detected by ultrasonography.ResultsA retrospective review of 20 consecutive infants with stage 5 ROP are included. Mean birthweight was1712.3 ± 512.97 g and mean gestational age at birth was 32.1 ± 2.21 weeks. Median age at first consultancy was 9.7 month. Median postmenstrual age first consultancy was 52 weeks. All infants were never screened for ROP before they came to the referral center. Of twenty stage 5 ROP infants, 13 cases presented with bilateral stage 5 features. Of the 40 eyes of 20 infants, 33 eyes were diagnosed as stage 5. Leukocoric pupil, closed funnel configuration of retinal detachment (RD), posterior synechia, extraretinal fibrovascular proliferation and retinal folds were the most significant indicators of bad prognosis. Ten eyes appeared no fixation to light, while 30 eyes exhibited following to light or following to toys.ConclusionsOur study shows that in relatively less-developed regions of China, more needs to be done to spread awareness about the disease among pediatricians, neonatologists and ophthalmologists as well as parents of premature infants. Thus, a comprehensive control system which is a whole network of propaganda, screening, treatment and follow-up are encouraged especially in less developed areas in China as well as worldwide.
Highlights
Severe retinopathy of prematurity (ROP) with extremely unfavorable prognosis among infants can do great damage to individuals and bring tremendous social-economic burden
The current ROP screening guidelines recommended by the Ministry of Health in 2004 in China were further improved in 2014 [9], which specify that infants who meet the following criteria need to be screened for ROP: Birthweight (BW) of less than 2000 g or gestational age (GA) of less than or equal to 32 weeks [10]
We describe the demographic and ocular characteristics of these stage 5 ROP infants to identify underling reasons of late consultancy, and to identify contributing factors in order to focus great attention on ROP screening program and to inspire more effort in ROP screening in middle income countries
Summary
Severe retinopathy of prematurity (ROP) with extremely unfavorable prognosis among infants can do great damage to individuals and bring tremendous social-economic burden. The purpose of this study is to describe the demographic and ocular characteristics of infants who presented with stage 5 ROP in order to identify reasons why they have become blind, and to identify contributing factors in order to focus great attention on the current ROP program and to inspire more effort in ROP screening in middle income countries. Severe ROP with unfavorable stages leading to serious visual loss could be avoidable in many developed countries, due to strict adherence to ROP screening guidelines, prompt treatment if necessary, and a specialized neonatal intensive care unit with experience of very immature babies [1, 3, 5]. Recent estimates suggest that 20,000 (15,500–27,200) survivors of preterm birth become blind from ROP each year with the largest number being in Asia [7, 8] It has aroused great attention by these countries including Chinese government. The proportion of infants with Stage 4 and Stage 5 ROP and ROP blind decreased statistically significantly over time after screening guidelines for ROP were issued in 2004 [12]
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