Retinopathy of prematurity blindness worldwide: phenotypes in the third epidemic

Abstract

Blindness due to retinopathy of prematurity (ROP) is an increasing problem worldwide as improved levels of neonatal care are provided in countries with developing neonatal intensive care units. The occurrence of ROP blindness varies dramatically with the socioeconomic development of a country. In regions with high levels of neonatal care and adequate resources, ROP blindness is largely restricted to premature infants with very low birth weight and low gestational age while in middle- and low-income countries with regional variation in technology and capacity, limited health resources may well limit the care of the premature newborn.

Keywords: ROP; blindness; international.

Figure 1

Burden by world region of retinopathy of prematurity related visual impairment among premature infants born in 2010 and surviving the neonatal period. Note: Reproduced from Blencowe H, Lawn JE, Vazquez T, et al. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74(1):35–49.

Figure 2

Birth weight and gestational age of infants with threshold disease or worse from three high income countries (A); and low/middle income countries (B) in 1996–2002. Notes: The horizontal line indicates the boundaries of the United Kingdom screening data. The letters in brackets refer to different regions or cities within a country. Reproduced with permission from Pediatrics, ;115:e518–e525, Copyright © 2005 by the AAP. Gilbert C, Fielder A, Gordillo L, et al. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Abbreviations: GA, gestational age; ROP, retinopathy of prematurity.