Surveillance for retinopathy of prematurity in a Danish county. Epidemiological experience over 20 years

• Published in: Acta ophthalmologica Scandinavica Vol. 82; no. 1; pp. 38 - 41
• Main Authors: Fledelius, Hans C., Kjer, Birgit
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.02.2004
• Subjects: birthweight; epidemiology of ROP; gestational age; retinopathy of prematurity (ROP); trends over two decades
• ISSN: 1395-3907; 1600-0420
• DOI: 10.1046/j.1600-0420.2003.00199.x

. Purpose:  An updated analysis of the trends in a Danish county regarding retinopathy of prematurity (ROP), outlining its natural history over the years 1982–2001. Methods:  Epidemiological data are given of the 132 infants in the county with birth years 1998–2001 prospectively under surveillance for ROP. The customary national screening limits of gestational age (GA) and birthweight (BW) of 32 weeks/1750 g were generally adhered to. The findings are compared to five previous consecutive reports of a similar set‐up, now making a total of 1123 who have been under surveillance. Results:  With focus on the 20 years' newborns at a higher risk for ROP in the county (GA/BW both under the above limits; n = 591) the continuous improvement up to 1998 − as reflected by ROP frequency, its severity, and risk levels according to GA/BW − appears to have been interrupted. Compared to the previous 4‐year period, the percentage acquiring ROP in 1998–2001 increased from 10 to 31%, and four recent cases qualified for retinal ablation therapy, compared with zero in the previous 4‐year period. However, there were no advanced stages (of at least ROP 3) in infants above 30 weeks/1500 g at delivery. Conclusions:  (a) Using the ROP also as a neonatal treatment quality parameter, the present trend (progress stopped) should be followed attentively. So far, we have no clues regarding therapy‐related or other causality. (b) Despite the suggested worsening, a lowering of the ophthalmic GA and BW screening limits now seems justifiable. With a view also to the high‐risk Copenhagen data and the national childhood visual impairment register, a reduction of the values to 31 weeks/1500 g should be considered.