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Retinopathy of prematurity in Germany over 13 years: incidences, treatment preferences and effects of national guideline changes
  1. Tim U Krohne1,
  2. Alexandra T Camp2,
  3. Johanna M Pfeil3,
  4. Andreas Müller4,
  5. Andreas Stahl3,
  6. Wolf A Lagrèze2,
  7. Jeany Q Li1
  8. for the EU-ROP Registry Study Group
    1. 1 Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
    2. 2 Eye Center, Medical Center, Medical Faculty, University of Freiburg, Freiburg im Breisgau, Germany
    3. 3 Department of Ophthalmology, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
    4. 4 Department of Neonatology and Pediatric Intensive Care, University Children’s Hospital Bonn, University of Bonn, Bonn, Germany
    1. Correspondence to Professor Tim U Krohne, Department of Ophthalmology, University Hospital Cologne, D-50937 Cologne, Germany; tim.krohne{at}uk-koeln.de

    Abstract

    Objective Retinopathy of prematurity (ROP) is a leading yet avoidable cause of childhood blindness. Screening for ROP is highly effective in preventing blindness secondary to ROP. We provide epidemiological data on ROP screening and treatment in Germany since 2010 and evaluate the effects of recently adopted as well as potential future screening guideline adaptations.

    Methods Data sets of the German Quality Assurance Procedure in Neonatology, the ROP screening programme of two German university hospitals, and the German section of the EU-ROP Registry were analysed.

    Results Over the 13-year period from 2010 to 2022, 141 550 infants received ROP screening in Germany. Mean annual incidences of ROP were 3.5% (±0.2%) in premature infants and 19.6% (±2.3%) in screened infants. Of screened infants, 2.0% (±0.3%) received treatment for ROP. Treatment preferences shifted from laser coagulation (46.2% in 2015) to anti-vascular endothelial growth factor therapy (83.7% in 2022). A revision of national screening criteria in 2020 with a reduction of the gestational age limit from <32 to <31 weeks resulted in a decrease of the annual number of infants requiring screening by 25.8% (p<0.001). Infants with a birth weight ≥1500 g accounted for 35.2% of the screening population but only for 0.4% of ROP stage 3–5 cases.

    Conclusions Collection of epidemiological data on ROP in national and international registries enables the continuous surveillance and adaptation of ROP screening and treatment criteria. In Germany, infants with a birth weight ≥1500 g have a very low risk of developing treatment-requiring ROP, supporting an upper birth weight limit for ROP screening.

    • neonatology
    • ophthalmology

    Data availability statement

    Data are available upon reasonable request.

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Presented at This study was presented at the Association of Research in Vision and Ophthalmology (ARVO) annual meeting, 6 May 2024, Seattle, WA, USA.

    • Collaborators EU-ROP Registry Study Group: Patrick Schernthaner, Johann Colvin, Stefan Egger, Herbert Reitsamer, Alexander Hugo Oscar, Ognyan Mitkov Mladenov, Vasil Marinov, Yanitsa Kondova-Atanassova, Gergana Svetoslavova, Piret Jüri, Mari Petraudze, Mikk Pauklin, Peter Walter, Emilia Michalewicz, Volker Buck, Helge Breuß, Sabine Aisenbrey, Marian Liegl, Anne-Kathrin Retzlaff, Marlene Saßmannshausen, Louisa Maria Bulirsch, Erik Chankiewitz, Alexandra Klose, Katrin Engelmann, Imke Goldammer, Ulrike Fleischer, Annika Ader, Martin Tiez, Anja Wienigk, Vinodh Kakkassery, Grabiela Krestanova, Pavel Smetana, Tim U. Krohne, Jeany Q. Li, Rainer Guthoff, Ala Khamees, Sema Kaya, Jemina Benga, Stephan Jansen, Wolf A. Lagrèze, Fanni E. Molnár, Nikolai Gross, Lutz Joachimsen, Michael Reich, Tim Bleul, Alexandra T. Camp, Sebastian Küchlin, Navid Farassat, Anne Schwietering, Stephanie Winterhalder, Iva-Ruth Bartmann, Fithri Indraswari, Mohammed Khattab, Sebastian Bemme, Peer Lauermann, Jana Katharina Dieks, Yulia Meyer, Marie-Christine Bründer, Martin Spitzer, Karsten Hufendiek, Bastian Grundel, Milena Grundel, Andreas Stahl, Allam Tayar, Matthias Heckmann, Hagen Bahlmann, Knud Linnemann, Stefanie Gniesmer, Salvatore Grisanti, Michelle Prasuhn, Roya Piria, Christian Schiemenz, Viktorija Belousova, Julius Caspar Rotering, Georg Spital, Henrik Faatz, Barbara Glitz, Ameli Gabel-Pfisterer, Przemyslaw Ilski, Julia Caliman, Martina Möglich, Thomas Pohlenz, Teresa Barth, Matthias Altmann, Benedikt Blüml, Herbert Jägle, Horst Helbig, Sven Wellmann, Annette Keller-Wackerbauer, Holger Michel, Florian Langhammer, Daniela Süsskind, Michael Partsch, Michael Völker, Axel Frank, Ulrike Hagemann, Armin Wolf, Melih Parlak, Agathi Kouri, Anna Mourgela, Margarita Papadopoulou, Angeliki Nika, Theodoros Gkouvas, Tataropoulou Kassandra, Sofia Androudi, Ioanna Grivea, Eleni Papageorgiou, Maria Goudesido, Katerina Kaffe, Tsani Zoi, Asimina Mataftsi, Stella Moutzouri, Maria Lithoxopoulou, Christos Tsakalidis, Nikolaos Ziakas, Anna Gotz-Więckowska, Jan Mazela, Dawid Szpecht, Marta Pawlak, Julia Dezor-Garus, Anna Chmielarz-Czarnocińska, Elżbieta Czapla, Tomasz Szczapa, Jolanta Kaczmarek, Gabriele Thumann, Gunda Kann, Ariane Malcles, Walid Bouthour, Franscisca Barcos Munoz, Martina Kropp, Huban Atilla, Feyza Çalış Karanfil, Pınar Bingöl Kızıltunç, Bensu Sezer, Emel Okulu, Imren Akkoyun, Deniz Anuk Ince, Ayse Ecevit, Gulsah Gokgoz, Puren İsik, Hacer Yapicioglu Yildizdas, Caner Kara, Ayşen Sumru Kavurt, Eşay Yenice, Betül Ortatatlı, Ahmet Yağmur Baş, Şengül Özdek, Esin Koç, İbrahim Murat Hirfanoğlu, Hüseyin Baran Özdemir, Tuğçe Küçükbalcı, Aslihan Uzun, Nilgun Koksal, Hilal Ozkan, Meral Yıldız.

    • Contributors TUK planned the study. ATC, JMP and JQL collected the data. TUK and JQL analysed the data. TUK, AM, AS, WAL and JQL prepared the manuscript. All authors revised and approved the manuscript. TUK is the guarantor of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests The authors disclose the following potential conflicts of interest (F, financial research support; C, consultant, R, recipient of lecture fees or travel reimbursements): TUK: AbbVie (R), Alimera (R, C), Astellas (C), Bayer (F, R, C), Novartis (F, R, C), Roche (R, C), Stada (C); ATC: none; JMP: none; AM: none; AS: AbbVie (R), Alimera (C), Bayer (C, F, R), Novartis (C, F, R), Roche (F, R); WAL: none; JQL: none.

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

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