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Incidence of retinopathy of prematurity in Germany: evaluation of current screening criteria
  1. Petra P Larsen1,
  2. Andreas Müller2,
  3. Wolf A Lagrèze3,
  4. Frank G Holz1,
  5. Andreas Stahl4,
  6. Tim U Krohne1,5
  7. for the German ROP Registry Study Group
    1. 1 Department of Ophthalmology, University of Bonn, Bonn, Germany
    2. 2 Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Bonn, University of Bonn, Bonn, Germany
    3. 3 Eye Center, Medical Center, Medical Faculty, University of Freiburg, Freiburg im Breisgau, Germany
    4. 4 Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
    5. 5 Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
    1. Correspondence to Professor Tim U Krohne, Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; tim.krohne{at}


    Objective To evaluate current screening criteria for retinopathy of prematurity (ROP) by investigating the incidence of ROP requiring treatment in infants with gestational age (GA) ≥30 weeks or postmenstrual age (PMA) <32 weeks in Germany.

    Methods Three patient databases were analysed, that is, the German Quality Assurance Procedure in Neonatology (years 2011–2017; n=52 461 infants screened for ROP, 1505 infants treated for ROP), the German ROP Registry (years 2011–2018; n=281 treated infants) and the ROP screening programme of two German university hospitals (years 2012–2016; n=837 screened infants).

    Results In the analysed cohorts, infants with GA ≥30 weeks represented 33.1%–38.5% of the screening populations but only 1.40%–1.42% of the cases requiring ROP treatment. In a cohort of 281 infants treated for ROP, all 4 infants with GA ≥30 weeks had additional risk factors for ROP including prolonged oxygen supplementation and/or significant comorbidities. Five infants (1.8%) were treated at 32 weeks PMA and none at PMA <32 weeks.

    Conclusions In the investigated cohorts, preterm infants with GA ≥30 weeks carried a very low or no risk for developing treatment-requiring ROP unless additional risk factors were present, and no treatment was performed earlier than 32 weeks PMA. These findings are of relevance for the ongoing re-evaluation of ROP screening criteria.

    • ophthalmology
    • neonatology
    • epidemiology

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    • Collaborators Members of the German ROP Registry Study Group (in alphabetical order): Helios Klinikum Berlin-Buch, Berlin, Germany: Helge Breuß, Nadja Rieckehr; Klinikum Chemnitz, Chemnitz, Germany: Katrin Engelmann, Jacqueline Hecker; Klinikum Ernst von Bergmann, Potsdam, Germany: Ameli Gabel-Pfisterer; University of Aachen, Aachen, Germany: Antonios Koutsonas, Peter Walter; University of Bonn, Bonn, Germany: Tim U Krohne, Jeany Q Li, Raffael Liegl; University of Freiburg, Freiburg, Germany: Moritz Daniel, Daniela Goos; University of Gießen, Gießen, Germany: Birgit Lorenz, Christine Mais; University of Göttingen, Göttingen, Germany: Sebastian Bemme, Nicolas Feltgen, Hans Hoerauf; University of Greifswald, Greifswald, Germany: Marie-Christine Bründer, Andreas Stahl; University of Hamburg, Hamburg, Germany: Volker Knospe, Lars Wagenfeld, Christos Skevas, Martin Spitzer; University of Hannover, Hannover, Germany: Amelie Pielen, Nicole Eter, Barbara Glitz, Viktoria C Müller; University of Regensburg, Regensburg, Germany: Teresa Barth; University of Tübingen, Tübingen, Germany: Karl Ulrich Bartz-Schmidt, Daniela Süsskind, Ulrike Hagemann; Vivantes Klinikum Neukölln, Berlin, Germany: Sabine Aisenbrey, Thomas Macher.

    • Contributors All authors contributed to planning, conduct and reporting of the study.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests Financial disclosures (F, financial research support; C, consultant, R, recipient of lecture fees or travel reimbursements): PPL: none; AS: Allergan (R), Bayer (C, R), Novartis (C, F, R), Recordati Rare Diseases (C, R); AM: none; WAL: none; FGH: Acucela (C, F, R), Allergan (F, R), Apellis (C, R), Bayer (C, F, R), Boehringer-Ingelheim (C), Bioeq/Formycon (F, C), CenterVue (F), Ellex (R), Roche/Genentech (C, F, R), Geuder (C), Grayburg Vision (C, R), Heidelberg Engineering (C, F, R), Kanghong (C, F), LinBioscience (C, R), NightStarX (F), Novartis (C, F, R), Optos (F), Pixium Vision (C, F, R), Oxurion (C, R), Stealth BioTherapeutics (C, R), Zeiss (F, R); TUK: Alimera Sciences (C, R), Allergan (R), Bayer (C, F, R), Heidelberg Engineering (R), Novartis (C, F, R), Roche (C, R).

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request.