Risk Factors for Progression of Type 2 to Type 1 Retinopathy of Prematurity

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ESPR456
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Background: Retinopathy of prematurity (ROP) is a vasoproliferative disease of the developing retina of premature infants. ROP remains a leading cause of childhood blindness worldwide. Type 1 ROP (ROP1) is aggressive and requires treatment. Type 2 ROP (ROP2) is more indolent and less aggressive. Risk factors of ROP include birth weight (BW) <1500 grams, gestational age (GA) <30 wks, anemia, blood transfusions and poor weight gain. Since ROP is predictable with sequential progression, at risk infants receive carefully timed retinal examinations to identify ROP1. Risk factors for progression of ROP2 to ROP1 are not completely known. 


Objective: To explore risk factors for progression of ROP2 to ROP1.


Design/Methods: Retrospective case-control study comparing neonates born at Flushing Hospital Medical Center between October 2012 and October 2020 with ROP. ROP1 and ROP2 were compared. Data extracted from EHR include maternal age and comorbidities, GA, BW, gender, mode of delivery, resuscitation at delivery, Apgar score at 1 and 5 minutes, weight (Wt) gain at 4 wks of life, detailed hematological profile on day of life (DOL) one and 4 weeks of life, transfusion, respiratory distress syndrome (RDS), sepsis, bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), total duration of oxygen therapy, duration of invasive/non-invasive mechanical ventilation. Data were analyzed using student t-test, chi square, and Mann Whitney U, p<0.05 is considered significant.


Results: Of 66 neonates with ROP, 19 (29%) had ROP1.   ROP1 and ROP2 were compared.  Neonates with ROP1 had lower GA, BW, Apgar score at 5 minutes, and average Wt gain at 4 weeks of life, greater total days of oxygen and invasive ventilation (all p <0.05). Associated comorbidities included RDS, sepsis, BPD, and PDA (all p< 0.05). Higher number of transfusions (>3 of packed red blood cells (PRBC), lower hemoglobin at birth (p=0.001), and lower MCV at 4 wks of life (p=0.003) were significantly more common in those with ROP1. Gender and mode of delivery were not significant, Table 1.


Conclusion: In our small sample, neonates with lower GA and BW, co existing RDS, sepsis, BPD, and PDA are more likely to progress to ROP1. Neonates who progressed to ROP1 also have lower hemoglobin at birth and need a higher number of blood transfusions. 

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Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center

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