Integrated ROP screening program essential to neonatal intensive care
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CHICAGO — Timely screening and treatment are key to preventing progression to retinal detachment in retinopathy of prematurity, according to an expert at Retina Subspecialty Day at the American Academy of Ophthalmology meeting.
Audina M. Berrocal, MD, presented 30-year retrospective data from the neonatal intensive care unit at Jackson Memorial Hospital/Bascom Palmer Eye Institute.
“We had a transition, those years, from pediatric ophthalmic screening and treatment to pediatric retina ophthalmic screening and treatment,” Berrocal said.
From Jan. 1, 1990, to June 20, 2019, the hospital had a total of 25,567 ROP examinations. The mean birth weight of the patients was 1,101 g, and the mean birth age was 28.4 weeks.
The incidence of ROP in the review was 29.6%. However, the number of patients with ROP decreased from 32% in 1990 to 1999 to 25% in 2010 to 2019 (P < .001).
Berrocal said the mean birth weight (858 g to 780 g; P < .001) and gestational age (26.7 weeks to 25.8 weeks; P < .001) of the patients have decreased over the last 30 years. Additionally, the presence of plus disease increased over time among micro-premature neonates who weigh less than 750 g at birth (P < .005), and ROP showed a shift to increased severity by posterior location and aggressive ROP.
“Although we are seeing less ROP overall, it is more severe,” Berrocal said.
The addition of anti-VEGF therapy has helped, however. During the anti-VEGF era from 2010 to 2019, no patients progressed to stage 4 or 5 ROP.
Berrocal said there is a rise in micro-premature neonates.
“Fifty-five-percent of micro-preemies were diagnosed with ROP in the last decade compared to 30% among the overall screened NICU cohort,” she said. “Timely screening, diagnosis and treatment prevent progression to retinal detachment. An integrated ROP screening program is essential.”
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Berrocal AM. Three decades of ROP: The Bascom Palmer Eye Institute Jackson Memorial Hospital academic experience. Presented at: American Academy of Ophthalmology meeting; Sept. 30-Oct. 3, 2022; Chicago.
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