Treatment for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden.

AIMS: To study various aspects of treatment for retinopathy of prematurity (ROP) in a Swedish population of extremely preterm infants born before 27 weeks of gestation. METHODS: A national, prospective and population-based study was performed in Sweden from 1 April 2004 to 31 March 2007. The criteria for the treatment of ROP accorded with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. RESULTS: Twenty per cent of the infants (99/506) were treated for ROP. The likelihood of reaching treatment criteria nearly doubled for each week of reduction in gestational age at birth. The first treatment was performed at an earlier postmenstrual age in the most immature infants. One third of the infants had more than one session of laser treatment. CONCLUSIONS: A high percentage of these extremely preterm infants required treatment for ROP. The likelihood of reaching treatment criteria increased with a decline in gestational age at birth. Although only a few infants progressed to ROP stages 4 and 5, the findings of this study indicate a potential for improvement in the treatment routines, both regarding the timing and number of laser spots at the first treatment.

Incidence of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden.

OBJECTIVE: To determine the incidence of retinopathy of prematurity (ROP) in extremely preterm infants born before 27 weeks' gestation in Sweden during a 3-year period. METHODS: A national, prospective, population-based study was performed in Sweden from April 1, 2004, to March 31, 2007. The ophthalmologic part of the study was separately organized, and screening for ROP was performed beginning postnatal week 5. The criteria for the treatment of ROP agreed with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. RESULTS: During the study, 506 of 707 live-born infants survived until the first eye examination. Of these, 368 (72.7%) had ROP: 37.9% had mild ROP and 34.8% had severe ROP. Ninety-nine infants (19.6%) were treated. Gestational age at birth was a stronger predictor of ROP than was birth weight. A log-linear relationship between severe ROP and gestational age at birth was found in the present cohort, and the risk of ROP was reduced by 50% for each week of increase in gestational age at birth. CONCLUSIONS: Today, extremely preterm infants are surviving, and this population-based study with ROP as a primary outcome shows a higher incidence of this condition than in previously reported national cohorts.