Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk. Issue 3 (21st March 2017)

• Record Type: Journal Article
• Authors: Adams, Gillian G W; Bunce, Catey; Xing, Wen; Butler, Lucilla; Long, Vernon; Reddy, Aravind; Dahlmann-Noor, Annegret H
• Other Names: Joseph Abbott author non-byline.; Wagih Aclimandos author non-byline.; Gill Adams author non-byline.; Ayman Al-Khaier author non-byline.; Louise Allen author non-byline.; Kayvan Arashvan author non-byline.; Jane Ashworth author non-byline.; Faye Barampouti author non-byline.; Jonathan Barnes author non-byline.; Victoria Barrett author non-byline.; Sebastian Barry John author non-byline.; Adam Bates author non-byline.; Tulin Berk author non-byline.; Susmito Biswas author non-byline.; Andrew Blaikie author non-byline.; Rosie Brennan author non-byline.; Howard Bunting author non-byline.; Jeremy Butcher author non-byline.; Tailoi Chan-Ling author non-byline.; Jonathan Chan author non-byline.; Christopher Child author non-byline.; Jessy Choi author non-byline.; David Clark author non-byline.; David Clark author non-byline.; Luke Clifford author non-byline.; Ahmad Dabbagh author non-byline.; Gervase Dawidek author non-byline.; Luna Dhir author non-byline.; Karen Drake author non-byline.; Richard Edwards author non-byline.; Leonard Esakowitz author non-byline.; Julia Escardo-Paton author non-byline.; Anthony Evans author non-byline.; Brian Fleck author non-byline.; Vernon Geh author non-byline.; Nick George author non-byline.; Lawrence Gnanaray author non-byline.; Raina Goyal author non-byline.; Paul Haigh author non-byline.; Joanne Hancox author non-byline.; Richard Haynes author non-byline.; Dominic Heath author non-byline.; Robert Henderson author non-byline.; Roxane Hillier author non-byline.; Melanie Hingorani author non-byline.; Saurabh Jain author non-byline.; Sunila Jain author non-byline.; David Jones author non-byline.; Namir Kafil-Hussain author non-byline.; Simon Kelly author non-byline.; Nihal Kenawy author non-byline.; Tina Kipioti author non-byline.; Archana Kulkarni author non-byline.; Tim Lavy author non-byline.; David Laws author non-byline.; Joanna Lawson author non-byline.; Jane Leitch author non-byline.; Roland Ling author non-byline.; Mary Macrae author non-byline.; Usman Mahmood author non-byline.; Richard Markham author non-byline.; Jane Marr author non-byline.; Kristina May author non-byline.; Eibhlin McLoone author non-byline.; Murad Moosa author non-byline.; Claire Morton author non-byline.; Ali Mount author non-byline.; Wisam Muen author non-byline.; Alan Mulvihill author non-byline.; Vineeta Munshi author non-byline.; Mahi Muqit author non-byline.; Robert Murray author non-byline.; Ranjit Nair author non-byline.; William Newman author non-byline.; Una O'Colmain author non-byline.; Chetan Patel author non-byline.; Himanshu Patel author non-byline.; Amaya Pedraza Luis author non-byline.; Rachel Pilling author non-byline.; Narman Puvanachandra author non-byline.; Anthony Quinn author non-byline.; Dinesh Rathod author non-byline.; Ashwin Reddy author non-byline.; Alison Rowlands author non-byline.; Stephen Scotcher author non-byline.; Christopher Scott author non-byline.; Rajnish Sekhri author non-byline.; Ayad Shafiq author non-byline.; Tamsin Sleep author non-byline.; Katya Tambe author non-byline.; Anamika Tandon author non-byline.; Alison Tappin author non-byline.; Robert Taylor author non-byline.; Maria Theodorou author non-byline.; Shery Thomas author non-byline.; Graham Thompson author non-byline.; Peter Tiffin author non-byline.; Aman Ullah Muhammed author non-byline.; Patrick Watts author non-byline.; Stephanie West author non-byline.; Stephanie West author non-byline.; Iain Whyte author non-byline.; Louisa Wickham author non-byline.; Cathy Williams author non-byline.; Chien Wong author non-byline.; Siobhan Wren author non-byline.; Rahila Zakir author non-byline.;
• Is Part Of: BMJ open. Volume 7:Issue 3(2017)
• Publication Date: 2017-03-21
• Subjects: NEONATOLOGY; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2016-013366
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To estimate the incidence of severe retinopathy of prematurity (ROP) requiring treatment and describe current treatment patterns in the UK. Design: Nationwide population-based case ascertainment study via the British Ophthalmic Surveillance Unit and a national collaborative ROP special interest group. Practitioners completed a standardised case report form (CRF). Setting: All paediatric ophthalmologists providing screening and/or treatment for retinopathy in the UK were invited to take part. Participants: Any baby with ROP treated or referred for treatment between 1 December 2013 and 30 November 2014, treated with laser, cryotherapy, vascular endothelial growth factor (VEGF) inhibitor or vitrectomy/scleral buckling, or a combination. Main outcome measure: Incidence of ROP requiring treatment. Results: We received 370 CRFs; 327 were included. Denominator from epidemiological data: 8112 infants with birth weight of <1500 g. The incidence of ROP requiring treatment was 4% (327/8112, 95% CI 3.6% to 4.5%). Median gestational age was 25 weeks (IQR 24.3–26.1), and median birth weight 706 g (IQR 620–821). Median age at first treatment was 80 days (IQR 71–96). 204 right eyes (62.39%) had type 1 ROP, and 27 (8.26%) had aggressive posterior ROP. Infants were also treated for milder disease: 9 (2.75%) right eyes were treated for type 2 ROP, and 74 (22.63%) for disease milder than type 1 with plus or preplus, which we defined here as 'type 2 plus' disease. First-line treatment was diode laser photoablation of the avascular retina in 90.5% and injection of VEGF inhibitor in 8%. Conclusions: ROP treatment incidence in the UK is 2.5 times higher than previously estimated. 8% of treated infants receive intravitreal VEGF inhibitor, currently unlicensed. Research is needed urgently to establish safety and efficacy of this approach. Earlier treatment and increasing numbers of surviving premature infants require an increase in appropriate eye care facilities and staff. Trial registration number: NCT02484989.