Abstract

Volume.122 Number.2

Original article : Clinical science

Retinopathy of Prematurity in Extremely Low-birth-weight Infants: a Multicenter Study in Tokyo
Takako Tachikawa1, Masato Takei2, Mariko Kiyota3, Yuta Saito4, Noriyuki Azuma5, Sachiko Nishina5, Ichiro Maruko6, Takashi Negishi7, Eiichiro Noda8, Yasuhiro Okuma9, Kei Yoshida10, Takuro Fujimaki7,11, Tadashi Matsumoto12,13, Emiko Watanabe14, Makoto Saito15
1 Department of Ophthalmology, Tokyo Metropolitan Ohtsuka Hospital
2 Department of Ophthalmology, Japanese Red Cross Medical Center
3 Department of Ophthalmology, Tokyo Metropolitan Bokutoh Hospital
4 Department of Ophthalmology, Showa University School of Medicine
5 Department of Ophthalmology, National Center for Child Health and Development
6 Department of Ophthalmology, Tokyo Women's Medical University School of Medicine
7 Department of Ophthalmology, Juntendo University School of Medicine
8 Department of Ophthalmology, Tokyo Metropolitan Children's Medical Center
9 Department of Ophthalmology, the JIKEI University School of Medicine
10 Department of Ophthalmology, Nihon University Itabashi Hospital
11 Department of Ophthalmology, Katsushika Red Cross maternity hospital
12 Department of Ophthalmology, Toho University School of Medicine
13 Department of Ophthalmology, Aiiku Hospital
14 Department of Ophthalmology, Teikyo University School of Medicine
15 Office for Clinical Research Support, Tokyo Metropolitan Komagome Hospital

Purpose: To investigate the medical condition and treatment situation of retinopathy of prematurity (ROP) in extremely low-birth-weight (ELBW) infants in Tokyo and to examine complications and neurological developments in three ROP severity groups.
Subjects and methods: A survey among ophthalmologists was conducted regarding ROP diagnosis, onset, and treatment conditions of 275 ELBW infants who were born at 14 different perinatal medical centers in Tokyo in 2011. The Neonatal Research Network database was also used to investigate survival rates, complications, and developmental test scores [developmental quotient values (DQ values)] at 3 years of age.
Results:The mean gestational age (mean±standard deviation) was 26.0±2.4 weeks, and the mean birth weight was 722.7±163.7 g. The survival rate was 88.7% (244/275 infants); 82.7% of the infants developed ROP and 29.0% required laser treatment. Group 1 included infants with aggressive posterior ROP (AP-ROP) and zoneI retinopathy who underwent laser treatment (20 infants;8.4%), Group 2 included infants with zoneII retinopathy who underwent laser treatment (49 infants;20.6%), and Group 3 included infants with no ROP or who spontaneously healed (169 infants; 71.0%). A multivariate logistic regression model showed a significantly higher incidence of artificial ventilation administered for ≥60 days, chronic lung disease, and intraventricular hemorrhage in the treatment groups (Groups 1 and 2) than in the spontaneous healing group (Group 3). DQ values of <70 at 3 years of age were observed in 71.4%, 27.6%, and 17.5% of infants in Groups 1, 2, and 3, respectively. Therefore, Group 1 had higher rate of DQ values of <70 than Group 2 (p=0.009).
Conclusions: While the survival rate of ELBW infants improved and ROP incidence and treatment rates declined, the incidence of severe ROP remained high and 29.0% of infants who required treatment had AP-ROP and zoneI retinopathy. These infants showed significant neurodevelopmental delay.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 103-113, 2018.

Key words
Retinopathy of prematurity, Extremely low-birth-weight infant, Neonatal Research Network, Developmental quotient value (DQ value)
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: 24 March 2017. Accepted in revised form: 19 September 2017.
Nihon Ganka Gakkai Zasshi 122: 103-113,2018