Abstract
Introduction: The aim of the study was to analyse the clinical and demographic features of infants with gestational age (GA) of 32–37 weeks and birth weight (BW) of >1,500 g who developed treatment requiring retinopathy of prematurity (ROP). Methods: Data on the infants with a GA of 32–37 weeks and BW >1,500 g who developed treatment requiring ROP (TR-ROP) were collected retrospectively from the 33 ROP centres in Turkiye. GA, BW, type of hospital, neonatal intensive care units (NICUs) level, presence of an ophthalmologist and neonatologist in the same hospital, length of stay in NICU, duration of oxygen therapy, comorbidities, type of ROP, and timing for TR-ROP development were analysed. Results: A total of366 infants were included in the study. Mean GA and BW were 33 ± 1 weeks and 1,896 ± 316 g, respectively. Duration of hospitalization was 3–4 weeks in 46.8% of them. The first ROP examination was performed at postnatal 4–5 weeks in 80.3% of infants, which was significantly later in level 2 and lower NICUs and non-university clinics. At the first ROP examination, any stage of ROP was detected in 90.9% and TR-ROP was detected in 15.3% of the infants. The mean postnatal week of TR-ROP development was 6.16 ± 2.04. Conclusion: Routine ROP screening thresholds need to be expanded in hospitals with suboptimal NICU conditions considering the development of TR-ROP in more mature and heavier preterm infants. The first ROP examination should be earlier than the fourth postnatal week.
Plain Language Summary
Retinopathy of prematurity (ROP) is a serious eye condition that affects premature babies, sometimes leading to blindness. Babies born at more than 32 weeks of pregnancy or weighing over 1,500 g are generally considered less at risk. However, in low- and middle-income countries where neonatal intensive care is not optimal, these bigger and more mature babies can still develop severe ROP requiring treatment (TR-ROP). This study is the first of its kind to examine how having both an eye specialist (ophthalmologist) and a baby care specialist (neonatologist) in the same hospital affects the development of TR-ROP in different regions across Turkiye. The study found that bigger babies often show signs of ROP at their first eye exam and that the condition can worsen quickly. This aggressive form of ROP, similar to a severe type called A-ROP, progresses rapidly. The findings suggest that these bigger babies need to be screened earlier than 4 weeks after birth. The study recommends expanding ROP screening programs to include larger infants, especially in developing areas of Turkiye. These recommendations could also apply to other developing countries facing similar challenges.
