Risk factors for the development and progression of retinopathy of prematurity and the optimization of its screening

Abstract

Objective. To study risk factors for the development and progression of retinopathy of prematurity (ROP) and to develop practical recommendations for the timely detection of severe forms of the disease.

Material and methods. A data analysis of 7022 preterm infants (gestational age less than 33 weeks, birth weight less than 2000 g) was performed, including univariate and multivariate assessment of the influence of perinatal factors. Based on the obtained data, a risk scoring scale (Neo-ROP-8) adapted for clinical use was created.

Results. It was established that key risk factors are sepsis (OR = 22.5), prolonged oxygen therapy (more than 28 days, OR = 12.3), intraventricular hemorrhage (OR = 6.9), and blood transfusion (OR = 5.7). Gestational age and birth weight have a protective effect: each additional week of gestation reduces the risk of ROP by 28 %, and each 100 g increase in birth weight reduces it by 15 %. The Neo-ROP-8 scale with a threshold of 7 points or more allows for the detection of 85 % of ROP cases with 90 % accuracy. Infants with severe retinal immaturity (vessels in zone 1) have a 97.5 % risk of progression to terminal stages.

Conclusion. Risk factors for the development and progression of ROP coincide. The use of the Neo-ROP-8 scale in combination with the assessment of retinal maturity allows for the optimization of screening timing without loss of diagnostic quality.