Delayed resolution of retinopathy of prematurity

J AAPOS. 2019 Apr;23(2):90.e1-90.e6. doi: 10.1016/j.jaapos.2018.10.012. Epub 2019 Feb 14.


Purpose: To compare the characteristics of infants whose retinopathy of prematurity (ROP) resolves in <50 weeks with those of infants whose ROP resolves in >50 weeks' postmenstrual age (PMA) in order to identify which infants are at risk for delayed resolution and to evaluate whether severe ROP developed after 50 weeks' PMA.

Methods: The medical records of infants screened for ROP from January 2008 to December 2016 at a tertiary care facility were reviewed retrospectively. Infants without follow-up prior to ROP resolution or complete retinal vascularization and those with retinal detachment were excluded. Delayed resolution of ROP was defined as presence of immature retinal vasculature at ≥50 weeks' PMA. The birth characteristics, neonatal complications, and ROP characteristics of infants with and without delayed resolution were compared.

Results: A total of 996 infants were included, of whom 136 (13.6%) showed delayed resolution. Increasing severity of ROP (higher stage, lower zone, plus/pre-plus disease) and type 2 ROP was associated with delayed resolution (P < 0.05). Other variables associated with delayed resolution included <28 weeks gestational age, ≤3rd percentile birth weight, positive blood culture sepsis, necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia (P < 0.05). No infants developed type 1 after 50 weeks' PMA. After a prolonged follow-up course consistent with AAP guidelines, a single patient in our study cohort was treated at 81 weeks' PMA for persistent type 2 ROP.

Conclusions: In our cohort, delayed resolution of ROP was more likely in infants with more severe ROP or a complex neonatal course. No patient with delayed resolution developed type 1 ROP after 50 weeks' PMA, supporting AAP guidelines.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Physical Examination
  • Remission, Spontaneous
  • Retinopathy of Prematurity / complications
  • Retinopathy of Prematurity / physiopathology*
  • Retrospective Studies
  • Risk Factors
  • Time Factors