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Introduction
Since its discovery in the 1950s, retinopathy of prematurity (ROP) has evolved as a disease due to changes in neonatology practices. One reason is that guidelines minimizing oxygen administration have been implemented in order to decrease rates of ROP.1--3 Other modifiable risk factors include weight gain and diet.4,5
The shift in neonatology practices has resulted in ROP presenting differently in developed and developing countries.6,7 For example, developing countries have older and larger premature infants affected with ROP, similar to developed countries decades ago.8 In other words, the presentation in developing countries is similar to the initial presentation of ROP in developed countries, and it is possible that with improved preventive guidelines in developing countries, the incidence of ROP around the world will soon decrease.
It is unknown how much of the difference in ROP presentation around the world is due to racial and genetic heterogeneity and not just environmental factors. The purpose of this study was to examine trends in ROP at a large community hospital in the Bronx, New York, where the patient population is racially diverse.
Patients and Methods
This study was carried out with institutional review board approval, and research adhered to the tenets of the Declaration of Helsinki. A retrospective chart review was performed of infants screened for ROP at the Montefiore Medical Center, Weiler Neonatal Intensive Care Unit (NICU) 9, in the Bronx, New York, over a 5-year period. Patient information was gathered from the birth certificate, paper chart, hospital-wide electronic medical record, and a NICU-specific multi-user data system (NeoData, Lisle, IL).
Infants were screened according to the American Academy of Pediatrics screening guidelines for ROP. Specifically, if they were born at a gestational age of less than 30 weeks before February 2006 or less than 32 weeks after February 2006, if their birth weight was less than 1,500 g, or if they had an unstable clinical course at the discretion of the consulting NICU attending physician. ROP treatment was performed for threshold or type 1 disease within 48 hours. If an infant was being discharged from the hospital with type 2 ROP and follow-up was difficult or impossible, families were offered treatment before discharge to minimize the need for close follow-up.
Self-reported race...