The decreasing incidence and severity of retinopathy of prematurity

Purpose: We sought to determine whether the incidence of retinopathy of pre maturity (ROP) at our institution has changed since the Cryo-ROP recruitmen t period 10 years ago. Methods: We determined the incidences of threshold R OP, prethreshold ROP, less-than-prethreshold ROP, and no disease for each o f 3 birth weight classes (<750 g, 750 to 999 g, and 1000 to 1250 g) of infa nts born between July 1, 1995, and June 30, 1996, and cared for in the Vand erbilt Neonatal Intensive Care Unit. We then compared these with the rates from our institution during the Cryo-ROP study recruitment period (January 1, 1986, to November 30, 1987). Results: The current incidence and severity of ROP have decreased substantially overall and for each weight group comp ared with the 1986-87 incidence (P < .001, Cochran-Mantel-Haenszel test). T he incidence of "any ROP" decreased by 27% for infants with birth weights l ess than 750 g, by 51% for infants 750 to 999 g, and by 71% for infants 100 0 to 1250 g. The incidence of "prethreshold or greater ROP" decreased by 70 % for the 750 to 999 g and 77% for the 1000 to 1250 g weight groups. Althou gh the de crease in "prethreshold or greater ROP" was not as dramatic (25%) for the inf ants less than 750 g, only 1 infant (10%) progressed to thresh old disease in this group, whereas 7 (47%) did in 1986-87. The incidence of threshold ROP decreased by 84% for infants less than 750 g and by 66% for infants 750 to 999 g. No infant with birthweight greater than 999 g progres sed to threshold ROP. Conclusions: The incidence of all levels of ROP has d ecreased substantially for all infants with birth weights less than 1251 g at Vanderbilt University Medical Center du ring the past dec ade. Putative factors responsible for this decrease may inc rude surfactant use, continuo us pulse oximetry, aggressive use of antenatal steroids, and improved neona tal nutritional support.