Retinopathy of prematurity (ROP) is a vasoproliferative disorder that occurs in the developing retina of preterm infants. Because the timely provision of the optimal treatment is essential to prevent visual function disorder caused by ROP progression, factors that can predict treatment-requiring ROP (TR-ROP) at earlier stages after birth are clinically beneficial. The pathogenic core of ROP development is retinal hypoxia, and oxygen level transported to the tissue is regulated by circulatory and respiratory status. Therefore, in this 9-year retrospective study included 418 neonatal infants who were born at ≤32 weeks of gestational age (GA) or with ≤1500 gm of birthweight (BW) at Kyushu University Hospital, we attempted to identify the predictors of TR-ROP among the factors related to circulatory and pulmonary dysfunctions. Among 418 infants, 76 (18.2%) developed TR-ROP, 119 (28.5%) developed ROP that spontaneously regressed without treatment, and 223 (53.3%) did not develop ROP. Multivariate logistic regression analyses revealed a significant association of GA, history of late-onset circulatory collapse (LCC), and long support with continuous positive airway pressure (CPAP) with the TR-ROP incidence rates among all the screened infants and among the infants who developed ROP, suggesting that these three factors serve as predictors of TR-ROP. Additionally, we evaluated the predictability of the TR-ROP-related factors identified in this analysis. When two factors, history of LCC and CPAP, were used in combination with GA and BW, the areas under receiver operating characteristic curves significantly improved. Our results suggest that premature infants with a history of LCC and a long CPAP support have a high incidence of TR-ROP.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 1013-1019, 2019.