Screening and treatment of retinopathy of prematurity in Markusovszky Teaching Hospital, 1989–2009 (20 years of experiences)

Abstract

The aims of this study was to obtain the frequency and therapy of retinopathy of prematurity (ROP) in Markusovszky Teaching Hospital, Szombathely, Hungary. A population based study on ophthalmological status of preterm infants was performed, between 01.01.1989 and 01.01.2009. During the study period, ophthalmological status was detected in 543 premature infants. Among them, 34 children (6.3%) suffered from retinopathy of prematurity, and all of them were bilateral. ROP occurred in the highest rate (23/78 cases, 29.5%) at the birth weight of lower than 1000 grams, but frequency was only l.2% (2/169 cases) between weight 1250-1500 grams. Spontaneous recovery was observed in 19 eyes of 10 cases. The frequency of spontaneous resolution was 40% and 50% in the group of larger birth weight: between 1251-1500 grams and weight > or = 1500 grams, but on the other hand, complete recovery was only 26% (6/23 cases) below 1000 grams of birth weight. "Threshold retinopathy" (stage 3 plus), that needed therapy was detected in 25 children's 49 eyes. Cryotherapy was performed in both eyes of 16 children (32 eyes), laser photocoagulation was performed in 9 patients (16 eyes). ROP regressed after cryotherapy in 26 eyes, but in 6 eyes symptoms progressed to stage 5. After laser photocoagulation, recovery was observed in 16 eyes; this therapy was not successful in only one case. According to our experiences, stage 5 ROP developed only in two patients' both eyes, and in 1-1 eye of three children, during the 20 years of study. Our ophthalmological screening program proved that providing cryopexia or laser photocoagulation in time, severe visual impairment of retinopathy can be prevented. In spite of the few number of patients, this population based investigation with a long duration (20 years) offers new data in Hungarian ROP epidemiology.