A Multi-Center Study of Retinopathy of Prematurity Follow-Up Adherence

• Published in: Retina (Philadelphia, Pa.)
• Main Authors: Mahmud, Fahim, Karmouta, Reem, Strawbridge, Jason C, Prasad, Pradeep, Chu, Alison, Khitri, Monica, Tsui, Irena
• Format: Journal Article
• Language: English
• Published: United States 30.06.2023
• ISSN: 1539-2864

Characterize clinical and socioeconomic factors that impact follow-up to complete retinal vascularization and subsequent pediatric ophthalmology follow-up in neonates with retinopathy of prematurity (ROP). Medical records of 402 neonates diagnosed with ROP from neonatal intensive care units (NICUs) at UCLA Mattel Children's Hospital and UCLA Santa Monica Hospital, both academic medical centers (AMC's), and Harbor-UCLA Medical Center, a safety-net county hospital (SNCH), were reviewed. Primary study outcomes were rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was rate of non-retinal ocular comorbidity. In whole cohort analysis, 93.6% of neonates were followed to complete retinal vascularization and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow up (OR 0.66, 95% CI 0.45-0.98, p=0.04). Participants screened at the AMC had lower rates of pediatric ophthalmology follow-up compared to the SNCH (50.7% vs. 63.5%, p=0.034). In subgroup analysis, AMC participants with public insurance were less likely to have pediatric ophthalmology follow-up than SNCH participants with public insurance (36.5% vs. 63.8%, p<0.001) or those with private insurance at the AMC (36.5% vs. 59.2%, p< 0.001). This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and non-retinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study healthcare disparities in ROP infants.