Download PDF
Am J Perinatol 2021; 38(06): 581-589
DOI: 10.1055/s-0039-1700855
Original Article

Proportion of Retinopathy of Prematurity That Was Treated across Regions in the United States

Rowena G. Cayabyab
1   Division of Neonatalogy, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, California
,
Ashley Song
2   Fetal and Neonatal Institute, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
3   Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
,
Rangasamy Ramanathan
1   Division of Neonatalogy, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, California
,
Philippe Friedlich
2   Fetal and Neonatal Institute, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
,
Ashwini Lakshmanan
3   Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
4   Leonard D. Schaeffer Center for Health Policy and Economics, School of Pharmacy, Keck School of Medicine, University of Southern California, Los Angeles, California
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objectives Retinopathy of prematurity (ROP) is the leading preventable cause of blindness in children worldwide. Major eye and visual problems are strongly linked to ROP requiring treatment. Objectives of the study are to: (1) evaluate the trends and regional differences in the proportion of treated ROP, (2) describe risk factors, and (3) examine if treated ROP predicts mortality.

Study Design Retrospective data analysis was conducted using the Kids' Inpatient Database from 1997 to 2012. ROP was categorized into treated ROP (requiring laser photocoagulation or surgical intervention) and nontreated ROP. Bivariate and multivariate logistic regression analyses were performed.

Results Out of 21,955,949 infants ≤ 12 months old, we identified 70,541 cases of ROP and 7,167 (10.2%) were treated. Over time, the proportion of treated ROP decreased (p = < 0.001). While extremely low birth weight infants cared for in the Midwest was associated with treated ROP (adjusted odds ratio [aOR] = 29.05; 95% confidence interval [CI]: 10.64–79.34), black race (aOR = 0.57; 95% CI: 0.51–0.64) care for in the birth hospital (aOR = 0.44; 95% CI: 0.41–0.48) was protective. Treated ROP was not associated with mortality.

Conclusion The proportion of ROP that is surgically treated has decreased in the United States; however, there is variability among the different regions. Demographics and clinical practice may have contributed for this variability.

Keywords

retinopathy of prematurity - extremely low birth weight infants - surgical treatment - national database

Supplementary Material



Publication History

Received: 11 April 2019

Accepted: 24 September 2019

Article published online:
18 November 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Kong L, Fry M, Al-Samarraie M, Gilbert C, Steinkuller PG. An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS 2012; 16 (06) 501-507
    CrossrefPubMedGoogle Scholar
  • 2 Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res 2013; 74 (Suppl. 01) 35-49
    CrossrefPubMedGoogle Scholar
  • 3 Chen J, Stahl A, Hellstrom A, Smith LE. Current update on retinopathy of prematurity: screening and treatment. Curr Opin Pediatr 2011; 23 (02) 173-178
    CrossrefPubMedGoogle Scholar
  • 4 Anderson CG, Benitz WE, Madan A. Retinopathy of prematurity and pulse oximetry: a national survey of recent practices. J Perinatol 2004; 24 (03) 164-168
    CrossrefPubMedGoogle Scholar
  • 5 Tin W, Milligan DW, Pennefather P, Hey E. Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation. Arch Dis Child Fetal Neonatal Ed 2001; 84 (02) F106-F110
    CrossrefPubMedGoogle Scholar
  • 6 Chow LC, Wright KW, Sola A. ; CSMC Oxygen Administration Study Group. Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants?. Pediatrics 2003; 111 (02) 339-345
    CrossrefPubMedGoogle Scholar
  • 7 Carlo WA, Finer NN, Walsh MC. et al; SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med 2010; 362 (21) 1959-1969
    CrossrefPubMedGoogle Scholar
  • 8 The BOOST II United Kingdom, Australia, and New Zealand Collaborative Groups. Oxygen saturation and outcomes in preterm infants. N Engl J Med 2013; 368: 2094-2104
    CrossrefPubMedGoogle Scholar
  • 9 Hellgren KM, Tornqvist K, Jakobsson PG. et al. Ophthalmologic outcome of extremely preterm infants at 6.5 years of age: extremely preterm infants in Sweden study (EXPRESS). JAMA Ophthalmol 2016; 134 (05) 555-562
    CrossrefPubMedGoogle Scholar
  • 10 Drost FJ, Keunen K, Moeskops P. et al. Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years. Pediatr Res 2018; 83 (04) 818-824
    CrossrefPubMedGoogle Scholar
  • 11 Ludwig CA, Chen TA, Hernandez-Boussard T, Moshfeghi AA, Moshfeghi DM. The epidemiology of retinopathy of prematurity in the United States. Ophthalmic Surg Lasers Imaging Retina 2017; 48 (07) 553-562
    CrossrefPubMedGoogle Scholar
  • 12 Patel RM, Kandefer S, Walsh MC. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med 2015; 372 (04) 331-340
    CrossrefPubMedGoogle Scholar
  • 13 Gunn DJ, Cartwright DW, Gole GA. Incidence of retinopathy of prematurity in extremely premature infants over an 18-year period. Clin Exp Ophthalmol 2012; 40 (01) 93-99
    CrossrefPubMedGoogle Scholar
  • 14 Stoll BJ, Hansen NI, Bell EF. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in care practices, morbidity, and mortality of extremely preterm neonates 1993–2012. JAMA 2015; 314 (10) 1039-1051
    CrossrefPubMedGoogle Scholar
  • 15 Grisaru-Granovsky S, Reichman B, Lerner-Geva L. et al; Israel Neonatal Network. Population-based trends in mortality and neonatal morbidities among singleton, very preterm, very low birth weight infants over 16 years. Early Hum Dev 2014; 90 (12) 821-827
    CrossrefPubMedGoogle Scholar
  • 16 Good WV. ; on behalf of the Early Treatment for Retinopathy of Prematurity Cooperative Group. Final results of the early treatment for retinopathy of prematurity (ETROP) trial. Trans Am Ophthalmol Soc 2004; 102: 233-250
    PubMedGoogle Scholar
  • 17 Chiang MF, Arons RR, Flynn JT, Starren JB. Incidence of retinopathy of prematurity from 1996 to 2000: analysis of a comprehensive New York state patient database. Ophthalmology 2004; 111 (07) 1317-1325
    CrossrefPubMedGoogle Scholar
  • 18 Lad EM, Hernandez-Boussard T, Morton JM, Moshfeghi DM. Incidence of retinopathy of prematurity in the United States: 1997 through 2005. Am J Ophthalmol 2009; 148 (03) 451-458
    CrossrefPubMedGoogle Scholar
  • 19 Lad EM, Nguyen TC, Morton JM, Moshfeghi DM. Retinopathy of prematurity in the United States. Br J Ophthalmol 2008; 92 (03) 320-325
    CrossrefPubMedGoogle Scholar
  • 20 Isaza G, Arora S, Bal M, Chaudhary V. Incidence of retinopathy of prematurity and risk factors among premature infants at a neonatal intensive care unit in Canada. J Pediatr Ophthalmol Strabismus 2013; 50 (01) 27-32
    Google Scholar
  • 21 Cayabyab R, Ramanathan R. Retinopathy of prematurity: therapeutic strategies based on pathophysiology. Neonatology 2016; 109 (04) 369-376
    CrossrefPubMedGoogle Scholar
  • 22 Gilbert C, Fielder A, Gordillo L. et al; International NO-ROP Group. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics 2005; 115 (05) e518-e525
    CrossrefPubMedGoogle Scholar
  • 23 Saunders RA, Donahue ML, Christmann LM. et al; The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Racial variation in retinopathy of prematurity. Arch Ophthalmol 1997; 115 (05) 604-608
    CrossrefPubMedGoogle Scholar
  • 24 Yang MB, Donovan EF, Wagge JR. Race, gender, and clinical risk index for babies (CRIB) score as predictors of severe retinopathy of prematurity. J AAPOS 2006; 10 (03) 253-261
    CrossrefPubMedGoogle Scholar
  • 25 Aralikatti AK, Mitra A, Denniston AK, Haque MS, Ewer AK, Butler L. Is ethnicity a risk factor for severe retinopathy of prematurity?. Arch Dis Child Fetal Neonatal Ed 2010; 95 (03) F174-F176
    CrossrefPubMedGoogle Scholar
  • 26 Vyas J, Field D, Draper ES. et al. Severe retinopathy of prematurity and its association with different rates of survival in infants of less than 1251 g birth weight. Arch Dis Child Fetal Neonatal Ed 2000; 82 (02) F145-F149
    CrossrefPubMedGoogle Scholar
  • 27 Owen LA, Morrison MA, Hoffman RO, Yoder BA, DeAngelis MM. Retinopathy of prematurity: a comprehensive risk analysis for prevention and prediction of disease. PLoS One 2017; 12 (02) e0171467
    CrossrefPubMedGoogle Scholar
  • 28 Karna P, Muttineni J, Angell L, Karmaus W. Retinopathy of prematurity and risk factors: a prospective cohort study. BMC Pediatr 2005; 5 (01) 18
    CrossrefPubMedGoogle Scholar
  • 29 Youn Y, Moon CJ, Lee JY, Lee C, Sung IK. Timing of surgical ligation and morbidities in very low birth weight infants. Medicine (Baltimore) 2017; 96 (14) e6557
    CrossrefPubMedGoogle Scholar
  • 30 Darlow BA, Elder MJ, Horwood LJ, Donoghue DA, Henderson-Smart DJ. ; Australian and New Zealand Neonatal Network. Does observer bias contribute to variations in the rate of retinopathy of prematurity between centres?. Clin Exp Ophthalmol 2008; 36 (01) 43-46
    CrossrefPubMedGoogle Scholar
  • 31 Darlow BA, Lui K, Kusuda S. et al; International Network for Evaluating Outcomes of Neonates. International variations and trends in the treatment for retinopathy of prematurity. Br J Ophthalmol 2017; 101 (10) 1399-1404
    CrossrefPubMedGoogle Scholar
  • 32 Phelps DL. It's plus disease, isn't it?. Arch Ophthalmol 2007; 125 (07) 963-964
    CrossrefPubMedGoogle Scholar
  • 33 Hossain S, Shah PS, Ye XY, Darlow BA, Lee SK, Lui K. ; Canadian Neonatal Network; Australian and New Zealand Neonatal Network. Outborns or Inborns: where are the differences? A comparison study of very preterm neonatal intensive care unit infants cared for in Australia, New Zealand and Canada. Neonatology 2016; 109 (01) 76-84
    CrossrefPubMedGoogle Scholar
  • 34 Jensen EA, Lorch SA. Effects of a birth hospital's neonatal intensive care unit level and annual volume of very low birth weight infant's deliveries on morbidity and mortality. JAMA Pediatr 2015; 169 (08) e151906
    CrossrefPubMedGoogle Scholar
  • 35 Schmidt B, Roberts RS, Davis PG. et al; Caffeine for Apnea of Prematurity (CAP) Trial Investigators; Caffeine for Apnea of Prematurity CAP Trial Investigators. Prediction of late death or disability at age 5 years using a count of 3 neonatal morbidities in very low birth weight infants. J Pediatr 2015; 167 (05) 982-6.e2
    CrossrefPubMedGoogle Scholar