Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong

Hong Kong Med J. 2017 Feb;23(1):41-7. doi: 10.12809/hkmj154811. Epub 2016 Dec 30.

Abstract

Introduction: Studies on the prevalence and severity of retinopathy of prematurity in the local population are scarce. This study aimed to evaluate the prevalence, screening, and treatment outcome of retinopathy of prematurity in a tertiary hospital in Hong Kong.

Methods: This cross-sectional study with internal comparison was conducted at Queen Mary Hospital, Hong Kong. The study evaluated 89 premature infants who were born at the hospital and were screened for retinopathy of prematurity, in accordance with the 2008 British Guidelines, between January 2013 and December 2013. The prevalences of retinopathy of prematurity and severe retinopathy requiring treatment were studied.

Results: The mean (± standard deviation) gestational age at birth was 30+2 weeks ± 16.5 days (range, 24+1 to 35+5 weeks). The mean birth weight was 1285 g ± 328 g (range, 580 g to 2030 g). A total of 15 (16.9%) infants developed retinopathy of prematurity and three (3.4%) required treatment. In a subgroup analysis of extremely-low-birth-weight infants of <1000 g, 70.6% developed retinopathy of prematurity and 17.6% required treatment. Multivariate logistic regression analysis suggested low birth weight and patent ductus arteriosus were significantly associated with development of retinopathy of prematurity (P<0.001 and P=0.035, respectively). Among the three infants who received treatment for severe retinopathy of prematurity, all regressed successfully after one laser treatment.

Conclusions: Retinopathy of prematurity is a significant problem among premature infants in Hong Kong, especially those with extremely low birth weight. Our screening service for retinopathy of prematurity was satisfactory and treatment results were good. Strict adherence to international screening guidelines and vigilance in infants at risk are key to successful management of retinopathy of prematurity.

Keywords: Neonatal screening; Retinopathy of prematurity; Treatment outcome.

MeSH terms

  • Birth Weight
  • Cross-Sectional Studies
  • Ductus Arteriosus, Patent / epidemiology*
  • Female
  • Gestational Age
  • Hong Kong
  • Humans
  • Infant
  • Infant, Extremely Low Birth Weight*
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Lasers, Semiconductor / therapeutic use
  • Logistic Models
  • Male
  • Mass Screening / methods
  • Multivariate Analysis
  • Practice Guidelines as Topic
  • Retinopathy of Prematurity / diagnosis*
  • Retinopathy of Prematurity / epidemiology*
  • Retinopathy of Prematurity / surgery
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Tertiary Care Centers
  • Treatment Outcome