Abstract

Volume.128 Number.5

Original article : Clinical science

Retinopathy of Prematurity in Extremely Low-birth-weight Infants: a Tokyo Multicenter Study (3rd Report)
Takako Tachikawa1, Mariko Kiyota2, Tomoyo Yoshida3, Sachiko Nishina3, Eiichiro Noda4, Eriko Konno5, Toshinari Funaki5, Tadashi Matsumoto6, Kota Yokoyama7, Yuta Saito7, Ai Toride8, Takashi Negishi8, Taku Toyama9
1 Department of Ophthalmology, Tokyo Metropolitan Ohtsuka Hospital
2 Department of Neonatology, Tokyo Metropolitan Bokutoh Hospital
3 Department of Ophthalmology, National Center for Child Health and Development
4 Department of Ophthalmology, Tokyo Metropolitan Children's Medical Center
5 Department of Ophthalmology, Japanese Red Cross Medical Center
6 Department of Ophthalmology (Oomori), Toho University School of Medicine
7 Department of Ophthalmology, Showa University School of Medicine
8 Department of Ophthalmology, Juntendo University Graduate School of Medicine
9 Department of Ophthalmology, The University of Tokyo, Graduate School of Medicine and Faculty of Medicine

Purpose: This study aimed to report the incidence and treatment of retinopathy of prematurity (ROP) in extremely low-birth-weight (ELBW) infants born in Tokyo.
Subjects and methods: We prospectively investigated the incidence and treatment rates and types of ROP in ELBW infants born at 9 perinatal medical centers in Tokyo between 2020 and 2021. The results were compared with those in the Tokyo Multicenter Study (ROP in ELBW infants) Report 1 (born in 2002) and Report 2 (born in 2011). A medical record template of ROP in ELBW infants and a tally sheet were created in the electronic medical record at each facility. Furthermore, the information was retrieved as a CSV file, and the results were tabulated.
Results: This study evaluated 305 eyes of 305 patients. The mean week of gestation was 25.8±2.6, and the mean birth weight was 704.2±176.7 g. ROP was not observed in 68 (22.3%) patients, spontaneously resolved in 153 (50.2%) patients, and treated in 84 (27.5%) patients. The initial treatment was anti-vascular endothelial growth factor (anti-VEGF) vitreous injection in 49/305 (16.1%) and photocoagulation in 35/305 (11.5%) cases. The mean week when treatment was started was 35.7±2.5 (30-41 weeks). Vitrectomy was performed on 1/305 (0.3%) cases. In the Tokyo Multicenter Study (ROP in ELBW infants) Report 1 (born in 2002), Report 2 (born in 2011), and this report (born in 2020-2021), the incidence of ROP tended to decrease (86.1%, 82.7%, and 77.7%, respectively), and the treatment rate also tended to decrease (41.0%, 29.0%, and 27.5%, respectively). The number of ELBW infants who received anti-VEGF treatment was higher in this report that in Report 2 (4/284 patients [1.4%] ).
Conclusions: The incidence and treatment rates of ROP decreased in ELBW infants than previous reports. Anti-VEGF therapy is increasingly used as an initial treatment for ROP instead of photocoagulation.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 401-409, 2024.

Key words
Retinopathy of prematurity (ROP), Extremely low-birth-weight (ELBW) infants, Incidence, Treatment rates, Database
Reprint requests to
Takako Tachikawa, M. D.　Department of Ophthalmology, Tokyo Metropolitan Ohtsuka Hospital. 2-8-1 Minami-Ohtsuka, Toshima-ku, Tokyo 170-8476, Japan
Received: 28 August 2023. Accepted in revised form: 22 November 2023.
Nihon Ganka Gakkai Zasshi 128: 401-409,2024