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Am J Perinatol 2020; 37(02): 196-203
DOI: 10.1055/s-0039-1694983
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Two-Year Outcomes of Infants with Stage 2 or Higher Retinopathy of Prematurity: Results from a Large Multicenter Registry

Veeral N. Tolia
1   Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, Texas
2   Pediatrix Medical Group, Dallas, Texas
3   The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, Florida
,
Kaashif A. Ahmad
2   Pediatrix Medical Group, Dallas, Texas
3   The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, Florida
4   Department of Pediatrics, Baylor College of Medicine, San Antonio, Texas
,
Jack Jacob
5   Providence Alaska Medical Center, Anchorage, Alaska
,
Amy S. Kelleher
3   The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, Florida
,
Nick McLane
6   Greenville Health System, Greenville, South Carolina
,
Robert W. Arnold
5   Providence Alaska Medical Center, Anchorage, Alaska
,
Reese H. Clark
3   The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, Florida
6   Greenville Health System, Greenville, South Carolina
,
for the MEDNAX ROP Registry Investigators › Institutsangaben Funding This study was funded by the Center for Research, Education, Quality, and Safety at MEDNAX, Inc.
Weitere Informationen

Publikationsverlauf

17. April 2019

09. Juli 2019

Publikationsdatum:
03. September 2019 (online)

    Lizenzen und Reprints

Abstract

Objective To define the incidence of ophthalmologic morbidities in the first 2 years of life among infants diagnosed with stage 2 or higher retinopathy of prematurity (ROP).

Study Design We prospectively enrolled premature infants with stage 2 or higher ROP. The infants were followed up for 2 years, and we report on data collected from outpatient ophthalmology and primary care visits.

Results We enrolled 323 infants who met inclusion criteria, of which 112 (35%) received treatment with laser surgery (90) or bevacizumab (22). Two-year follow-up was available for 292 (90%) of the cohort. The most common ophthalmologic conditions at follow-up were hyperopia (35%), astigmatism (30%), strabismus (21.9%), myopia (19.2%), anisometropia (12%), and amblyopia (12%). Severe ophthalmologic morbidities such as retinal detachment and cataracts were rare, but occurred in both treated and untreated infants. Overall, 22.6% of the infants were wearing glasses at 2 years, including 8.5% of the untreated infants.

Conclusion Patients with stage 2 or higher ROP remain at significant risk for ophthalmological morbidity through 2 years of age. Infants with regression of subthreshold ROP who do not require treatment represent an underrecognized population at long-term ophthalmological risk.

ClinicalTrials.gov Identifier NCT01559571.

Keywords

retinopathy of prematurity - outcomes - premature infants - preterm infants

MEDNAX ROP Registry Investigators

William Archer, MD, Texas Health Resources–Presbyterian Hospital Dallas (Dallas, TX); Barbara Carr, MD, St. Luke's Hospital of Kansas City (Kansas City, MO); Bradlee Drabant, MD, Spring Valley Hospital; Summerlin Hospital Medical Center; Valley Hospital Medical Center (Las Vegas, NV); Jay Kothadia, MD, Novant Health Presbyterian Medical Center (Charlotte, NC); Martha Manar, MD, Northside Hospital (Atlanta, GA); Joe Mendiola Jr., MD, McAllen Medical Center (McAllen, TX); Renuka K. Reddy, MD, Texas Health Resources–Presbyterian Hospital Plano (Plano, TX); David Riley, MD, MBA, Cook Children's Medical Center (Fort Worth, TX); Jayesh Shah, MD, Charleston Area Medical Center (Charleston, WV); Mustafa Suterwala, MD, Baylor University Medical Center (Dallas, TX); Vivek Vijayamadhavan, MD, Methodist Children's Hospital (San Antonio, TX); Kelly Von Herbulis, NNP, Memorial Health University Medical Center (Savannah, GA); David Wells, MD, Greenville Memorial Hospital (Greenville, SC); Robert D. White, MD, Memorial Hospital South Bend (South Bend, IN).


Contributors

Janna Benston, RN, MSN, Northside Hospital (Atlanta, GA); Katrina Grier, RNC-NIC, Northside Hospital (Atlanta, GA); Sheryl Hollander, RN, BSN, Novant Health Presbyterian Medical Center (Charlotte, NC); Mashelle Monhaut, MSN, NNP-BC, Memorial Hospital South Bend (South Bend, IN); Denise P. Smith, BSN, RNC-LRN, RRT-NPS, Winnie Palmer Hospital for Women & Babies (Orlando, FL); Vivian Vargas-Brown, Pediatrix Medical Group of Nevada (Las Vegas, NV). Administrative support was provided by: Carole Benson, Jaclyn Cohen, Nalina Fisher, Theresa Katich, Kathy McCarty, Octavia Reed, Vernice Vixamar, and Shannon Weeks.


 

  • References

  • 1 Schmidt B, Roberts RS, Davis PG. , et al; 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) 982-986
    CrossrefPubMedGoogle Scholar
  • 2 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
  • 3 Adams GG, Bunce C, Xing W. , et al. Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk. BMJ Open 2017; 7 (03) e013366
    CrossrefPubMedGoogle Scholar
  • 4 Walz JM, Bemme S, Pielen A. , et al; Retina.net ROP Registry. The German ROP Registry: data from 90 infants treated for retinopathy of prematurity. Acta Ophthalmol 2016; 94 (08) e744-e752
    CrossrefPubMedGoogle Scholar
  • 5 Adams M, Bassler D, Bucher HU. , et al; Swiss Neonatal Network and the Vermont Oxford Network. Variability of very low birth weight infant outcome and practice in Swiss and US neonatal units. Pediatrics 2018; 141 (05) e20173436
    CrossrefPubMedGoogle Scholar
  • 6 Fierson WM. ; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 2013; 131 (01) 189-195
    CrossrefPubMedGoogle Scholar
  • 7 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
  • 8 Solebo AL, Teoh L, Rahi J. Epidemiology of blindness in children. Arch Dis Child 2017; 102 (09) 853-857
    CrossrefPubMedGoogle Scholar
  • 9 Zepeda-Romero LC, Barrera-de-Leon JC, Camacho-Choza C. , et al. Retinopathy of prematurity as a major cause of severe visual impairment and blindness in children in schools for the blind in Guadalajara city, Mexico. Br J Ophthalmol 2011; 95 (11) 1502-1505
    CrossrefPubMedGoogle Scholar
  • 10 Kimyon S, Mete A. Comparison of bevacizumab and ranibizumab in the treatment of type 1 retinopathy of prematurity affecting zone 1. Ophthalmologica 2018; 240 (02) 99-105
    CrossrefPubMedGoogle Scholar
  • 11 Sankar MJ, Sankar J, Chandra P. Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity. Cochrane Database Syst Rev 2018; 1: CD009734
    PubMedGoogle Scholar
  • 12 Hajrasouliha AR, Garcia-Gonzales JM, Shapiro MJ, Yoon H, Blair MP. Reactivation of retinopathy of prematurity three years after treatment with bevacizumab. Ophthalmic Surg Lasers Imaging Retina 2017; 48 (03) 255-259
    CrossrefPubMedGoogle Scholar
  • 13 Wallace DK, Kraker RT, Freedman SF. , et al; Pediatric Eye Disease Investigator Group (PEDIG). Assessment of lower doses of intravitreous bevacizumab for retinopathy of prematurity: a phase 1 dosing study. JAMA Ophthalmol 2017; 135 (06) 654-656
    CrossrefPubMedGoogle Scholar
  • 14 Mintz-Hittner HA, Kuffel Jr RR. Intravitreal injection of bevacizumab (avastin) for treatment of stage 3 retinopathy of prematurity in zone I or posterior zone II. Retina 2008; 28 (06) 831-838
    CrossrefPubMedGoogle Scholar
  • 15 Mintz-Hittner HA, Geloneck MM, Chuang AZ. Clinical management of recurrent retinopathy of prematurity after intravitreal bevacizumab monotherapy. Ophthalmology 2016; 123 (09) 1845-1855
    CrossrefPubMedGoogle Scholar
  • 16 Morin J, Luu TM, Superstein R. , et al; Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network Investigators. Neurodevelopmental outcomes following bevacizumab injections for retinopathy of prematurity. Pediatrics 2016; 137 (04) e20153218
    CrossrefPubMedGoogle Scholar
  • 17 Holmström GE, Källen K, Hellström A. , et al. Ophthalmologic outcome at 30 months' corrected age of a prospective Swedish cohort of children born before 27 weeks of gestation: the extremely preterm infants in Sweden study. JAMA Ophthalmol 2014; 132 (02) 182-189
    CrossrefPubMedGoogle Scholar
  • 18 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
  • 19 Piermarocchi S, Bini S, Martini F. , et al. Predictive algorithms for early detection of retinopathy of prematurity. Acta Ophthalmol 2017; 95 (02) 158-164
    CrossrefPubMedGoogle Scholar
  • 20 Eckert GU, Fortes Filho JB, Maia M, Procianoy RS. A predictive score for retinopathy of prematurity in very low birth weight preterm infants. Eye (Lond) 2012; 26 (03) 400-406
    CrossrefPubMedGoogle Scholar
  • 21 Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol 2018; 63 (05) 618-637
    CrossrefPubMedGoogle Scholar
  • 22 Askie LM, Darlow BA, Finer N. , et al; Neonatal Oxygenation Prospective Meta-analysis (NeOProM) Collaboration. Association between oxygen saturation targeting and death or disability in extremely preterm infants in the neonatal oxygenation prospective meta-analysis collaboration. JAMA 2018; 319 (21) 2190-2201
    CrossrefPubMedGoogle Scholar
  • 23 Freitas AM, Mörschbächer R, Thorell MR, Rhoden EL. Incidence and risk factors for retinopathy of prematurity: a retrospective cohort study. Int J Retina Vitreous 2018; 4: 20
    PubMedGoogle Scholar
  • 24 Ohlsson A, Aher SM. Early erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants. Cochrane Database Syst Rev 2006; (03) CD004863
    PubMedGoogle Scholar
  • 25 Manzoni P, Memo L, Mostert M. , et al. Use of erythropoietin is associated with threshold retinopathy of prematurity (ROP) in preterm ELBW neonates: a retrospective, cohort study from two large tertiary NICUs in Italy. Early Hum Dev 2014; 90 (Suppl. 02) S29-S33
    PubMedGoogle Scholar
  • 26 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
  • 27 Azami M, Jaafari Z, Rahmati S, Farahani AD, Badfar G. Prevalence and risk factors of retinopathy of prematurity in Iran: a systematic review and meta-analysis. BMC Ophthalmol 2018; 18 (01) 83
    CrossrefPubMedGoogle Scholar
  • 28 Campbell JP, Ryan MC, Lore E. , et al; Imaging & Informatics in Retinopathy of Prematurity Research Consortium. Diagnostic discrepancies in retinopathy of prematurity classification. Ophthalmology 2016; 123 (08) 1795-1801
    CrossrefPubMedGoogle Scholar
  • 29 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
  • 30 Ellsbury DL, Clark RH, Ursprung R, Handler DL, Dodd ED, Spitzer AR. A multifaceted approach to improving outcomes in the NICU: the Pediatrix 100 000 Babies Campaign. Pediatrics 2016; 137 (04) pii: e20150389
    CrossrefPubMedGoogle Scholar
  • 31 Horbar JD, Edwards EM, Greenberg LT. , et al. Variation in performance of neonatal intensive care units in the United States. JAMA Pediatr 2017; 171 (03) e164396
    CrossrefPubMedGoogle Scholar
  • 32 Lyu J, Zhang Q, Chen CL. , et al. Recurrence of retinopathy of prematurity after intravitreal ranibizumab monotherapy: timing and risk factors. Invest Ophthalmol Vis Sci 2017; 58 (03) 1719-1725
    CrossrefPubMedGoogle Scholar
  • 33 Barry GP, Tauber K, Emmanuel G, Horgan MJ, Simon JW. The effectiveness of policy changes designed to increase the attendance rate for outpatient retinopathy of prematurity (ROP) screening examinations. J AAPOS 2013; 17 (03) 296-300
    CrossrefPubMedGoogle Scholar
  • 34 Aprahamian AD, Coats DK, Paysse EA, Brady-Mccreery K. Compliance with outpatient follow-up recommendations for infants at risk for retinopathy of prematurity. J AAPOS 2000; 4 (05) 282-286
    CrossrefPubMedGoogle Scholar
  • 35 Attar MA, Gates MR, Iatrow AM, Lang SW, Bratton SL. Barriers to screening infants for retinopathy of prematurity after discharge or transfer from a neonatal intensive care unit. J Perinatol 2005; 25 (01) 36-40
    CrossrefPubMedGoogle Scholar