High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born

Objective Prematurity is a major risk factor for retinopathy of prematurity (ROP). We aimed to elucidate ROP prevalence, treatment and retreatment in infants born before 24 gestational age (GA) weeks in a Swedish cohort.Methods and analysis Infants with completed ROP screening, born at <24 GA...

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Main Authors: Ann Hellström, Lotta Gränse, Marie Saric, Birgitta Sunnqvist, Agneta Wallin, Kristina Tornqvist, Eva Larsson, Eva Morsing, Gerd E Holmström, Pia Lundgren, Anna-Lena Hård, Lena Jacobson, Abbas Al-Hawasi, Lois LE Smith
Format: Article
Language:English
Published: BMJ Publishing Group 2021-09-01
Series:BMJ Open Ophthalmology
Online Access:https://bmjophth.bmj.com/content/6/1/e000695.full
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author Ann Hellström
Lotta Gränse
Marie Saric
Birgitta Sunnqvist
Agneta Wallin
Kristina Tornqvist
Eva Larsson
Eva Morsing
Gerd E Holmström
Pia Lundgren
Anna-Lena Hård
Lena Jacobson
Abbas Al-Hawasi
Lois LE Smith
author_facet Ann Hellström
Lotta Gränse
Marie Saric
Birgitta Sunnqvist
Agneta Wallin
Kristina Tornqvist
Eva Larsson
Eva Morsing
Gerd E Holmström
Pia Lundgren
Anna-Lena Hård
Lena Jacobson
Abbas Al-Hawasi
Lois LE Smith
author_sort Ann Hellström
collection DOAJ
description Objective Prematurity is a major risk factor for retinopathy of prematurity (ROP). We aimed to elucidate ROP prevalence, treatment and retreatment in infants born before 24 gestational age (GA) weeks in a Swedish cohort.Methods and analysis Infants with completed ROP screening, born at <24 GA weeks, 2007–2018 in Sweden were included. Data of GA, birth weight (BW), sex, neonatal morbidities, maximal ROP stage, aggressive posterior ROP (APROP), ROP treatments, treatment modality and treatment centre were retrieved.Results In total, 399 infants, with a mean GA of 23.2 weeks (range 21.9–23.9) and a mean BW of 567 g (range 340–874), were included. ROP was detected in 365 (91.5%) infants, 173 (43.4%) were treated for ROP and 68 of 173 (39.3%) were treated more than once. As the first treatment, 142 (82.0%) received laser and 29 (16.1%) received intravitreal injection of antivascular endothelial growth factor (anti-VEGF). Retreatment was performed after first laser in 46 of 142 (32.4%) and in 20 of 29 (69.0%) after first anti-VEGF treatment. Retreatment rate was not associated with GA, BW or sex but with APROP, treatment method (anti-VEGF) and treatment centre where the laser was performed (p<0.001). Twenty eyes progressed to retinal detachment, and two infants developed unilateral endophthalmitis after anti-VEGF treatment.Conclusion Infants, born at <24 weeks’ GA, had high rates of treatment-warranting ROP and retreatments. Treatment centre highly influenced the retreatment rate after laser indicating that laser treatment could be improved in some settings.
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spelling doaj-art-79ffb1e2e2b54c7c91c94ec9f75eb2f42025-08-20T02:11:34ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692021-09-016110.1136/bmjophth-2020-000695High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants bornAnn Hellström0Lotta Gränse1Marie Saric2Birgitta Sunnqvist3Agneta Wallin4Kristina Tornqvist5Eva Larsson6Eva Morsing7Gerd E Holmström8Pia Lundgren9Anna-Lena Hård10Lena Jacobson11Abbas Al-Hawasi12Lois LE Smith13The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden3 Ophthalmology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenDepartment of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden5 Department of Ophthalmology, Länssjukhuset Ryhov, Jönköping, Sweden4 St Erik Eye Hospital, Stockholm, Sweden3 Ophthalmology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenDepartment of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden7 Department of Paediatrics, Lund University, Lund, SwedenInstitution of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden2 The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden7 Department of biomedical and clinical science, Linköping University, Linkoping, SwedenDepartment of Ophthalmology, Boston Children`s Hospital, Harvard Medical School, Boston, Massachusetts, USAObjective Prematurity is a major risk factor for retinopathy of prematurity (ROP). We aimed to elucidate ROP prevalence, treatment and retreatment in infants born before 24 gestational age (GA) weeks in a Swedish cohort.Methods and analysis Infants with completed ROP screening, born at <24 GA weeks, 2007–2018 in Sweden were included. Data of GA, birth weight (BW), sex, neonatal morbidities, maximal ROP stage, aggressive posterior ROP (APROP), ROP treatments, treatment modality and treatment centre were retrieved.Results In total, 399 infants, with a mean GA of 23.2 weeks (range 21.9–23.9) and a mean BW of 567 g (range 340–874), were included. ROP was detected in 365 (91.5%) infants, 173 (43.4%) were treated for ROP and 68 of 173 (39.3%) were treated more than once. As the first treatment, 142 (82.0%) received laser and 29 (16.1%) received intravitreal injection of antivascular endothelial growth factor (anti-VEGF). Retreatment was performed after first laser in 46 of 142 (32.4%) and in 20 of 29 (69.0%) after first anti-VEGF treatment. Retreatment rate was not associated with GA, BW or sex but with APROP, treatment method (anti-VEGF) and treatment centre where the laser was performed (p<0.001). Twenty eyes progressed to retinal detachment, and two infants developed unilateral endophthalmitis after anti-VEGF treatment.Conclusion Infants, born at <24 weeks’ GA, had high rates of treatment-warranting ROP and retreatments. Treatment centre highly influenced the retreatment rate after laser indicating that laser treatment could be improved in some settings.https://bmjophth.bmj.com/content/6/1/e000695.full
spellingShingle Ann Hellström
Lotta Gränse
Marie Saric
Birgitta Sunnqvist
Agneta Wallin
Kristina Tornqvist
Eva Larsson
Eva Morsing
Gerd E Holmström
Pia Lundgren
Anna-Lena Hård
Lena Jacobson
Abbas Al-Hawasi
Lois LE Smith
High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
BMJ Open Ophthalmology
title High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
title_full High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
title_fullStr High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
title_full_unstemmed High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
title_short High rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
title_sort high rate and large intercentre variability in retreatment of retinopathy of prematurity in infants born
url https://bmjophth.bmj.com/content/6/1/e000695.full
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