Management of retinopathy of prematurity in a tertiary referral neonatal intensive care unit: Treatment rates and the impact of outsourcing laser therapy
Management of retinopathy of prematurity in a tertiary referral neonatal intensive care unit: Treatment rates and the impact of outsourcing laser therapy

Management of retinopathy of prematurity in a tertiary referral neonatal intensive care unit: Treatment rates and the impact of outsourcing laser therapy

Acta Ophthalmol. 2025 Nov 25. doi: 10.1111/aos.70029. Online ahead of print.

ABSTRACT

PURPOSE: To describe the treatment rate for retinopathy of prematurity (ROP) at a tertiary referral neonatal intensive care unit (NICU) in the south-western region of the Netherlands. In addition, we evaluated the impact of outsourcing laser treatment, implemented in 2018, by comparing treatment characteristics from 3 years prior and 3 years following this organisational change.

METHODS: This retrospective observational cohort study evaluated data of preterm infants born between 2015 and 2020 who were admitted to our NICU and met the eligibility criteria for ROP screening. ROP treatment rate was calculated for infants screened in our NICU. The impact of outsourcing laser treatment was evaluated based on ROP type at treatment decision, time between treatment decision and treatment, and adverse outcomes, including additional treatments and retinal detachment.

RESULTS: A total of 358 infants were screened at our NICU between 2015 and 2020; complete data were available for 343 infants, of whom 15% (51/343) required treatment. Since outsourcing treatment, additional treatment secondary to laser was performed less frequently (25%, 5/20 versus 7%, 2/31). However, the mean number of days between treatment decision and treatment increased since outsourcing treatment (p = 0.014), and 32% (9/28) of cases were treated prior to reaching the criteria of type 1 ROP.

CONCLUSION: The treatment rate among infants screened at our tertiary referral NICU exceeds previous national and hospital-level reports, likely due to early transfer of low-risk cases. Outsourcing ROP treatment might have led to improved primary treatment success; however, possible disadvantages include treatment delays and over-treatment.

PMID:41288949 | DOI:10.1111/aos.70029