Premature Infant Retinopathy Regression More Prevalent in Females, Minorities

Retinopathy of prematurity (ROP) regression may be more common in female or minority infants, according to a new assessment which observed recently-discharged premature infants.

ROP, an ophthalmic disorder that commonly affects premature infants born before 31 weeks of gestation and could lead to blindness, affects up to 16,000 infants in the US annually and eventually leads to blindness in approximately 3-4% of affected persons.

New data presented at the American Academy of Ophthalmology (AAO) 2020 Virtual Meeting this weekend showed regression of ROP is discriminate of infant gender and race.

A team of US-based investigators, led by Evan Chen, conducted a retrospective longitudinal cohort assessment of infants via the AAO Intelligent Research in Sight (IRIS) Registry, a comprehensive eye disease clinical registry.

Chen and colleague’s analysis included 1054 eyes from 548 patients to have ROP staging. Of such patient eyes, just 92 (8.7%) progressed, 145 (13.8%) regressed, 699 (66.3%) and were reported as stable. The remainder of patients regressed then progressed (2.4%), or progressed then regressed (8.8%).

Investigators observed that female premature infants were far more likely to regress than male infants (odds ratio [OR], 1.50; P = .03). Black infants were 99% more likely to regress than white patients (OR, 1.99; P = .001), while multiracial infants faced a nearly 3-fold increased risk of regression (OR, 3.88; P = .01).

Mean time to ROP progression was 65 days (SD, 256), while mean time to regression was 117 days (SD, 227).

Just 29 patient ROP eyes received outpatient treatment; of them, 1 underwent virectomy, 23 received laser photocoagulation, 3 received anti-vascular endothelial growth factor (anti-VEGF) therapy, and 2 received both laser and anti-VEGF therapy.

Beyond the obvious parameters of premature birth, clinical development and innovation has recently granted ophthalmologists and pediatricians an opportunity to assess for retinopathy in younger patients without greater costs to families.

A new economic evaluation of diabetic retinopathy screening options from September 2020 suggested autonomous artificial intelligence (AI) screening in pediatric patients with diabetes is effective and cost-saving for families when at least 23% of patients adhered to the screening recommendations.

The newest longitudinal cohort assessment presented at AAO provides an even greater interpretation of the most at-risk ROP populations.

“In premature babies who have been discharged from the hospital, there is an increased likelihood of regression of ROP in female, black and multiracial patients,” investigators wrote.

The study, “ROP Progression and Treatment Following Hospital Discharge: Analysis of the IRIS® Registry,” was presented at AAO 2020.