A population based, prospective study of the development of ROP in prematurely born children in the Stockholm area of Sweden.

Holmström, Gerd; Azazi, M el; Jacobson, Lena; Lennerstrand, Gunnar

doi:10.1136/bjo.77.7.417

Cited by 88 publications

(86 citation statements)

References 30 publications

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“…Some have found that there is a narrower range of CA 15 and others a narrower range of PMA 3,16 for the onset of the maximum stage of ROP. In our study, PMA gave a narrower range than CA (6 weeks cf 11 weeks).…”

Section: Age At Onset Of Maximum Ropmentioning

confidence: 99%

“…As previous studies have shown a geographical variation in the incidence of threshold ROP in babies born at similar gestational ages, [2][3][4] it is important to continue to analyse screening data from different regions in order to inform the debate. It is likely that screening criteria will have to be specifically defined for particular populations.…”

Section: Introductionmentioning

confidence: 99%

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Retinopathy of prematurity in practice. I: screening for threshold disease

Brennan

Gnanaraj

Cottrell

2003

Eye

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Aims To review an 11-year period of screening for retinopathy of prematurity (ROP) in the north of England by a single ophthalmologist. To identify the gestational ages and birth weights of babies reaching different stages of ROP. To investigate the workload involved in screening to detect threshold ROP, and that the practical outcomes had narrower inclusion criteria for screening. To identify babies treated for threshold disease. Methods During the period August 1987-October 1998, babies were screened according to the national guidelines and the results were prospectively entered onto a computerised database. These data were then systematically reviewed. Results Data were available for 484 babies: 203 (41.9%) developed any ROP, 46 (9.5%) reached stage 3 ROP, and 25 (5.2%) reached threshold and were treated. Data on 425 babies showed them to require an average of 2.3 screening examinations per baby. It took an average of 39 screening examinations to detect one case of threshold ROP. The more premature and lighter birth weight babies required the most examinations. Therefore, restricting the inclusion criteria for screening would only have reduced the total number of screenings modestly and could have allowed us to miss two of our threshold cases who were both of 30 weeks gestational age and 41400 g birth weight.Conclusions Screening is time consuming but worthwhile in view of the benefits of treatment. As applied to babies in the north of England, the current national screening criteria are satisfactory. The results of treatment of the babies identified in this study are presented in the accompanying paper.

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Section: Age At Onset Of Maximum Ropmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retinopathy of prematurity in practice. I: screening for threshold disease

Brennan

Gnanaraj

Cottrell

2003

Eye

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“…The present study of neonatal risk factors for ROP is based on a population-based, prospective study of the epidemiology of ROP in a well defined geographic area (Holmströ m et al 1993). Two hundred and sixty infants with a birth weight of 1500 grams or less and with a survival of at least 8 weeks, were included in that study.…”

Section: Methodsmentioning

confidence: 99%

“…A prospective, population-based study of the epidemiology and natural history of retinopathy of prematurity (ROP) was performed in our area during 1988to 1990(Holmströ m et al 1993. Risk factors for ROP were also studied and a detailed analysis of maternal data from antenatal centres and labour rooms was recently published (Holmströ m et al 1996).…”

mentioning

confidence: 99%

Neonatal risk factors for retinopathy of prematurity ‐ a population‐based study

Holmström

Broberger

Thomassen

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: The aim of the study was to evaluate possible neonatal risk factors for retinopathy of prematurity (ROP) in a population-based group of preterm, very low birth weight, infants. Method: The main study group included 202 single-born infants with a birth weight of 1500 grams or less. A group of 57 twins were also described. Selected risk factors were extracted from the neonatal records. Results: Univariate analysis revealed an association between ROP and respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), septicaemia, intraventricular bleeding, and the use of ventilator as well as continuous positive airway pressure. In a stepwise logistic regression analysis, however, only gestational age at birth, birth weight and BPD were significantly associated with ROP. Conclusion: Prematurity per se remains the strongest risk factor for ROP.Key words: retinopathy of prematurity -risk factors -gestational age -birth weight -bronchopulmonary dysplasia.

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“…Numerous studies have reported an increased risk of ROP in prematurely born infants, 1,2,3 but only a few have been long-term and strictly populationbased. 4,5 The 1995 Royal College of Ophthalmologists (RCO) guidelines for screening for ROP includes babies under 1500 g and gestational age Ͻ32 weeks and provides an effective and efficient means of detecting treatable ROP. These criteria present a considerable workload to the ophthalmologist and various authors have suggested it may be possible to lower the criteria and reduce the screened population of babies.…”

Section: Introductionmentioning

confidence: 99%

Retinopathy of prematurity: are we screening too many babies?

Mathew

Fern

Hill

2002

Eye

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Purpose With advancement in neonatal care units, early detection of retinopathy of prematurity (ROP) in premature and verylow-birth-weight infants is important. Numerous studies have reported an increased risk of ROP in prematurely born infants, but only few have been long-term and strictly population-based. The aim of the present study was to find out whether birthweight Ͻ1251 grams and gestational age Ͻ30 weeks could provide a safe and efficient means of detecting treatable ROP. We have retrospectively tried to ascertain the incidence and associated risk factors that may contribute to the management of babies with ROP. Methods Infants either with a birth weight below 1500 g or a gestational age of less than 32 weeks were screened for ROP during an 8-year period by a single examiner. Results An incidence of 64/205 (31.2%) ROP was noted. The mean age at detection was 5.5 ؎ 2 weeks of life. The maximum stage reached was stage 1 in 27 (13.2%), stage 2 in 24 (11.7%) and stage 3 in 10 (4.8%) babies. Threshold ROP was present in three (1.5%) babies. Significantly fewer (150/205 = 73%) babies would have been examined had a birth weight of Ͻ1251 grams and a gestational age Ͻ30 weeks been applied. There were five (8%) babies with birth weight Ͼ1250 grams and eight (12%) babies with gestational age Ͼ30 weeks amongst babies with ROP but all were stage 1 or stage 2. All the stage 3 ROP and the threshold ROP cases were babies with birth weight Ͻ1000 grams and gestational age below 28 weeks. Conclusion Ophthalmic examination may be safely and efficiently concentrated in babies with birth weight Ͻ1251 grams and gestational age below 30 weeks. Birth weight (P Ͻ 0.005) and gestational age (P Ͻ 0.01) were the only significant risk factors. During this 8-year period there was no significant decrease in the number of babies screened for ROP and the overall incidence of all stages of the disease has remained constant. In the present series a lower incidence of severe ROP was noted compared to most previous studies. Our experience from this study suggests the need for further refinement of screening guidelines in order to focus screening on the vision-threatening stages of ROP.

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A population based, prospective study of the development of ROP in prematurely born children in the Stockholm area of Sweden.

Cited by 88 publications

References 30 publications

Retinopathy of prematurity in practice. I: screening for threshold disease

Retinopathy of prematurity in practice. I: screening for threshold disease

Neonatal risk factors for retinopathy of prematurity ‐ a population‐based study

Retinopathy of prematurity: are we screening too many babies?

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