J Korean Med Sci.  2012 Dec;27(12):1556-1562. 10.3346/jkms.2012.27.12.1556.

Retinopathy of Prematurity in Infants Born before 25 Weeks Gestation in a Korean Single Neonatal Intensive Care Unit: Incidence, Natural History and Risk Factors

• Kong M
• Shin DH
• Kim SJ
• Ham DI
• Kang SW
• Chang YS
• Park WS

• KMID: 2157982
• DOI: http://doi.org/10.3346/jkms.2012.27.12.1556

Abstract

As younger preterm infants are able to survive, more extremely preterm infants are at risk of developing retinopathy of prematurity (ROP). To investigate the incidence, progression and risk factors of ROP in extremely preterm infants in Korea, the medical records of infants born before 25 weeks gestation were retrospectively reviewed. The criteria for laser treatment agreed with type 1 ROP as defined by the Early Treatment for Retinopathy of Prematurity study. Of the 121 infants included in the analysis, 119 (98.4%) infants developed any stage ROP, including 78 infants (64.5%) with type 1 ROP. The mean postmenstrual age (PMA) at the onset of any ROP and type 1 ROP were 33.5 and 36.1 weeks, respectively. All but one infant developed type 1 ROP after 31 weeks PMA. Univariate analysis showed that duration of total parenteral nutrition and onset of any ROP (PMA) were associated with the development of type 1 ROP. In conclusion, this study shows high incidence of ROP in extremely preterm infants and suggests that, although current screening protocols are feasible for most preterm infants born before 25 weeks gestation, earlier screening before 31 weeks PMA may be necessary in infants with an unstable clinical course.

Keyword

Retinopathy of Prematurity; Infant, Premature; Infant, Low Birth Weight

MeSH Terms

Asian Continental Ancestry Group
Birth Weight
Female
Gestational Age
Humans
Incidence
Infant, Extremely Premature
Infant, Newborn
Intensive Care Units, Neonatal
Kaplan-Meier Estimate
Logistic Models
Male
Republic of Korea/epidemiology
Retinopathy of Prematurity/*epidemiology/mortality
Retrospective Studies
Risk Factors
Severity of Illness Index

Figure

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  Fig. 1 Flow-chart of the study population. GA, gestational age; NICU, neonatal intensive care unit; ROP, retinopathy of prematurity.

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  Fig. 2 Onset of any retinopathy of prematurity (ROP) (A) and type 1 ROP (B) in worse eyes relative to gestational age (GA) at birth. P = 0.769, 0.511, 0.566, the onset of any ROP between GA of 22 and 23, 22 and 24, and 23 and 24, respectively, P = 0.122, 0.062, 0.654, the onset of type 1 ROP between GA of 22 and 23, 22 and 24, and 23 and 24, respectively, log-rank test. PMA, postmenstrual age.

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