Yuan Melissa, Altamirano Francisco, Hu Daniel, Hoyek Sandra, Chaaya Celine, Abidi Muhammad, De Bruyn Hanna, Fulton Anne, Mantagos Iason S, Wu Carolyn, Gonzalez Efren, VanderVeen Deborah K, Gise Ryan, Patel Nimesh A
Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Ophthalmol Retina. 2025 May 23. doi: 10.1016/j.oret.2025.05.026.
We aimed to determine the timing of retinopathy of prematurity (ROP) diagnosis and treatment in a cohort of infants meeting criteria for micro- and/or nano-prematurity with the goal of informing screening protocols in this high-risk group.
Retrospective consecutive study.
We included all screened infants who met the criteria for micro-prematurity (24-26 weeks gestational age [GA] and/or birth weight [BW] 600-799 grams) or nano-prematurity (<24 weeks GA and/or BW <600 grams).
Data collected from 2013 to 2023 included GA at birth, BW, postmenstrual age (PMA) at ROP diagnosis, PMA at type 1 ROP diagnosis, and number of inpatient examinations.
Rates of ROP and treatment-warranted ROP, timing to first ROP diagnosis and treatment-warranted ROP, and the number of examinations.
3239 infants were screened during this time period for ROP, and 650 infants met inclusion criteria. The median GA at birth and BW were 25.3 weeks and 682.5 g, respectively. Four hundred fifty-six infants (70.2%) were micro-premature and 194 (29.8%) were nano-premature. Retinopathy of prematurity was detected in 524 patients (80.6%). The median PMA at first ROP diagnosis was 33.7 weeks. The median interval from birth to first ROP diagnosis was 8.4 weeks. The median examination number at first ROP diagnosis was the second examination. The median number of inpatient examinations was 9. Of ROP patients, 180 (34.4%) had ROP diagnosis at their first examination. A total of 126 (19.4% of all infants and 24.0% of those with ROP) infants met type 1 treatment criteria. The median PMA at type 1 ROP diagnosis was 37 weeks. The median interval from birth to type 1 ROP was 12 weeks. The median examination number at type 1 diagnosis was the fifth examination.
In this modern cohort of high-risk extremely premature infants, 9 patients (1.4%) were diagnosed with type 1 ROP on the first or second inpatient exams. These infants had generally good outcomes after treatment, with only 2 eyes of 1 patient progressing to stage 4 disease. Our findings support maintaining current screening guidelines for high-risk extremely premature infants, while suggesting opportunities for optimizing screening approaches through risk stratification.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
我们旨在确定符合微早产和/或超早产标准的一组婴儿中早产儿视网膜病变（ROP）的诊断和治疗时机，以便为这一高危群体的筛查方案提供参考。
回顾性连续研究。
我们纳入了所有符合微早产标准（胎龄24 - 26周[GA]和/或出生体重[BW]600 - 799克）或超早产标准（GA < 24周和/或BW < 600克）的接受筛查的婴儿。
收集2013年至2023年的数据，包括出生时的GA、BW、ROP诊断时的孕龄（PMA）、1型ROP诊断时的PMA以及住院检查次数。
ROP和需要治疗的ROP的发生率、首次ROP诊断和需要治疗的ROP的时间、检查次数。
在此期间，3239名婴儿接受了ROP筛查，650名婴儿符合纳入标准。出生时的GA中位数和BW中位数分别为25.3周和682.5克。456名婴儿（70.2%）为微早产，194名婴儿（29.8%）为超早产。524名患者（80.6%）检测出早产儿视网膜病变。首次ROP诊断时的PMA中位数为33.7周。从出生到首次ROP诊断的间隔中位数为8.4周。首次ROP诊断时的检查次数中位数为第二次检查。住院检查次数中位数为9次。在ROP患者中，180名（34.4%）在首次检查时被诊断为ROP。共有126名婴儿（占所有婴儿的19.4%，占ROP婴儿的24.0%）符合1型治疗标准。1型ROP诊断时的PMA中位数为37周。从出生到1型ROP的间隔中位数为12周。1型诊断时的检查次数中位数为第五次检查。
在这个现代的高危极早产儿队列中，9名患者（1.4%）在首次或第二次住院检查时被诊断为1型ROP。这些婴儿治疗后总体预后良好，只有1名患者的2只眼睛进展到4期疾病。我们的研究结果支持维持当前对高危极早产儿的筛查指南，同时表明通过风险分层优化筛查方法的机会。
专有或商业披露信息可在本文末尾的脚注和披露部分找到。
