Retinopathy of prematurity in infants < 32 weeks' gestation at birth in New South Wales in 1993 and 1994

Objective: To study the incidence and severity of retinopathy of prematurit y (ROP) in infants < 32 weeks' gestation. Design: Review of the records maintained in the New South Wales Neonatal In tensive Care Unit Study (NICUS) database on infants admitted to the neonata l intensive care units (NICU) in NSW from 1 January 1993 to 31 December 199 4. Results: In the more premature infants, 23-26 weeks' gestation, 65% develop ed ROP (102 of 157 examined for ROP). Forty-four infants (28%) developed se vere ROP (Stage greater than or equal to 3 ROP), 19 infants (12.1%) require d cryo/laser therapy and one infant (0.6%) in this group had a retinal deta chment. One hundred and fifty-seven of 159 surviving infants (98.7%) were e xamined far ROP. In the infants 27-28 weeks' gestation, 38.3% developed ROP (103 of 269 examined for ROP). Fifteen infants (5.6%) developed severe ROP , seven infants (2.6%) required cryo/laser therapy for threshold ROP and th ree infants (1.1%) in this group had a retinal detachment. Two hundred and sixty-nine of 299 surviving infants (90%) were examined for ROP. In the inf ants 29-31 weeks' gestation, 10.8% developed ROP (48 of 443 examined for RO P). Six infants (1.4%) developed severe ROP, one infant (0.2%) required cry o/laser therapy for threshold ROP and no infant in this group had a retinal detachment. However, only 443 of 681 surviving infants (65.1%) in this gro up were examined for ROP. Of the four infants with detached retinas, one wa s a 25 week gestation infant weighing 840 g, two were 27 weeks' gestation w eighing 960 and 980 g and one infant was a 28 week gestation infant weighin g 620 g. No infant developed Stage 5 ROP. Conclusion: In the more mature infants 29-31 weeks' gestation, the rate of ROP is low, although severe ROP still occurs. However, only 65.1% of these infants were examined for ROP and we should be diligent in screening for RO P in the sicker infants in this group. The incidence of severe ROP as well as the rate of cryo/laser therapy in premature infants 23-26 weeks' in NSW has not changed since the increases seen in the early 1990s. Retinal detach ment also occurs in the infants 27-28 weeks' gestation and it is important that all these infants are screened for ROP.