Background Retinopathy of prematurity (ROP) is a severe complication of preterm birth and can lead to severe visual impairment or even blindness if untreated. The incidence of ROP requiring treatment is increasing in some developed countries in conjunction with higher survival rates at the lower end of gestational age (GA).
Material and methods The incidence of ROP and severe ROP (sROP) requiring treatment in Switzerland was analysed using the SwissNeoNet registry. We conducted a retrospective cohort analysis of very preterm infants with a GA below 32 weeks who were born between 2006 and 2015 in Switzerland. Patient characteristics were stratified according to GA.
Results 9.3% and 1.8% of very preterm infants in Switzerland developed ROP of any stage and sROP, respectively. The incidence of ROP treatment was 1.2%. Patients with 24 and 25 weeks GA had the highest proportion of ROP treatment at 14.5% and 7.3%, respectively, whereas the proportion of treated infants at or above a GA of 29 weeks was 0.06%. Similarly, the risk of sROP declined strongly with increasing GA. During the observation period of 10 years, the incidence of ROP treatment ranged between 0.8% and 2.0%. Incidences of sROP or ROP treatment did not increase over time.
Conclusion The incidence of ROP treatment in Switzerland is low and was stable over the analysed period. The low incidence of sROP in patients with a GA of 29 weeks or more leaves room for a redefinition of ROP screening criteria.
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Contributors RG was responsible for study design, supervised data collection and analyses. He also wrote the first and subsequent versions of the manuscript. VB was responsible for data collection, validation of existing data and completion of missing data. DB, BL, REP, MN and BM were involved in the design of the study and contributed to data collection at neonatal centres as well as editing of the final manuscript. CG-K was involved in the assessment of ROP stages, gave valuable input in interpretation of ophthalmological data and reviewed the manuscript critically. MA was responsible for data collection and validation of the SwissNeoNet. He also performed statistical analyses, was responsible for interpretation of data quality and edited the final manuscript. All authors revised the results and their interpretation carefully, approved the final version of the manuscript and are accountable for all aspects of the work.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Ethics approval Swiss Federal Commission for Privacy Protection in Medical Research and the Swiss ethical review boards (KEK-ZH-Nr. 2014-0551 and KEK-ZH-Nr. 2014-0552)
Provenance and peer review Not commissioned; externally peer reviewed.
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