Surveillance for retinopathy of prematurity in a Copenhagen high-risk sample 1999-2001. Has progress reached a plateau?
OBJECTIVE
As part of a current quality control to evaluate ophthalmic findings in two combined central Copenhagen neonatology centers for birth years 1999-2001, and to compare the selected sample with data of the national register for childhood visual impairment.


METHODS
In a prospective design to report on 372 infants mainly under regular surveillance for retinopathy of prematurity (ROP) in the stratified functional unit made up by the neonatal wards of Righospitalet (RH) and Hvidovre Hospital (HH). The median neonate under ophthalmic surveillance in the two wards (screening limits usually 32 weeks/1750 g) was given by gestational age (GA) and birthweight (BW) values of 27.3 weeks/907 g and 30.3 weeks/1420 g. respectively. Feedback regarding outcome was secured for those transferred to regional centres.


RESULTS
The overall frequency of ROP was 38.5% in the RH (n=252) and 10.8% in the HH sample (n=120). From a peak share above 60% in those <26 weeks/750 g at delivery, the incidence of ROP showed a regular decrease with decreasing immaturity. The centralized retinal ablation therapy for advanced ROP was given to a total of 29, with birth year 2001 unexpectedly showing a peak of 17 cases. Seven of the 29 children treated are now in the register for visually impaired, mainly due to low vision. Fourteen of the 29 had been very small for gestational age.


CONCLUSIONS
Supported also by recent regional Danish data, the apparent progress in the fight against ROP over many years seems to have come to a halt. Except for the continued increased survival of extremely preterm babies we have no obvious neonatological indication to explain the suggested 'adverse' trends.
Fledelius
Hans C
HC
Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark. rh03217@rh.dk
Göte
Hanne
H
Greisen
Gorm
G
Jensen
Hanne
H
D001724:Birth Weight; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D017075:Laser Coagulation; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D011786:Quality Control; D012042:Registries / Q000706:statistics & numerical data; D012178:Retinopathy of Prematurity / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D012307:Risk Factors; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology