Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units

Ahmet Yagmur Bas, Nihal Demirel, Esin Koc, Dilek Ulubas Isik, İbrahim Murat Hirfanoglu, Turan Tunc, TR-ROP Study Group, Fatma Nur Sari, Guner Karatekin, Esad Koklu, Huseyin Altunhan, Hatice Turgut, Fatma Narter, Nuriye Tarakci, Kadir Serafettin Tekgunduz, Servet Ozkiraz, Cumhur Aydemir, Ahmet Ozdemir, Bilin Cetinkaya, Ebru Kazanci, Ayhan Tastekin, Sebnem Calkavur, Banu Mutlu Ozyurt, Yaşar Demirelli, Huseyin Selim Asker, Birgul Mutlu, Ozgun Uygur, Hilal Ozkan, Didem Armangil, Ferda Ozlu, Mustafa Kurthan Mert, Hacer Ergin, Beyza Ozcan, Evrim Kıray Bas, Emel Okulu, Betul Acunas, Ulker Celik, Sait Ilker Uslu, Mehmet Mutlu, Nihat Demir, Funda Eroglu, Zeynel Gökmen, Serdar Beken, Bilge Tanyeri Bayraktar, Nilay Hakan, Kazım Kucuktascı, Aysen Orman, Serdar Comert, Sabahattin Ertugrul, Nuran Ustun, Ozlem Sahin, Demet Terek, Yusuf Kale, Murat Konak, Sadık Yurttutan, Ozge Aydemir, Ayşegül Zenciroglu, Dilek Sarici, Nilufer Guzoglu, Sahin Hamilcikan, Tugba Gursoy, Funda Tuzun, Rahmi Ors, Selda Arslan, Arzu Akdag, Asli Memisoglu, Beril Yasa, Berna Hekimoglu, Ozden Turan, Hakan Aylanc, Sahin Takci, Tolga Celik, Suzan Sahin, Ilknur Kilic, Caner Kara, Zuhal Ozen Tunay, Gokhan Celik, Ibrahim Gozen, Gunhal Satirtav, Nihat Polat, Ayse Yesim Oral, Mine Tokgoz, Sadullah Keles, Burak Bilgin, Silay Canturk Ugurbas, Cagatay Karaca, Nedime Sahinoglu Keskek, Dilbade Yildiz Ekinci, Ozlem Balci, Emir Volkan Altan, Sevda Bakbak, Nihan Aksu Ceylan, Sabit Kimyon, Gunay Alyamac, Gamze Ture, Meral Yildiz, Feyza Calis, Selcuk Sizmaz, Emine Sukgen, Ebru Nevin Cetin, Muammer Ozcimen, Semra Tiryaki Demir, Huban Atila, Altan Ozal, Gokhan Tufaner, Ozlem Eski Yucel, Mehmet Kola, Erbil Seven, Sengul Ozdek, Ali Hakan Durukan, Ali Kal, Ali Riza Cenk Celebi, Ibrahim Arif Koytak, Goksu Alacamlı, Arif Esme, Onur Catak, Irfan Perente, Alparslan Sahin, Aylin Ardagil Akcakaya, Gulunay Kiray, Serhat Nalcaci, Umit Aksoy, Berker Bakbak, Aysegül Comez, Huseyin Gursoy, Emrah Utku Kabatas, Ikbal Seza Petricli, Mehmet Erhan Yumusak, Ahmet Kirgiz, Gunay Uludag, Aylin Yaman, Zeynep Dadaci, Ali Karatas, Hande Celiker, Zafer Cebeci, Mahmut Cenap Esenulku, Imren Akkoyun, İsmail Ersan, Selim Demir, Sibel Kadayifcilar, Ayse Ipek Akyuz Unsal, Mumin Hocaoglu, Ahmet Yagmur Bas, Nihal Demirel, Esin Koc, Dilek Ulubas Isik, İbrahim Murat Hirfanoglu, Turan Tunc, TR-ROP Study Group, Fatma Nur Sari, Guner Karatekin, Esad Koklu, Huseyin Altunhan, Hatice Turgut, Fatma Narter, Nuriye Tarakci, Kadir Serafettin Tekgunduz, Servet Ozkiraz, Cumhur Aydemir, Ahmet Ozdemir, Bilin Cetinkaya, Ebru Kazanci, Ayhan Tastekin, Sebnem Calkavur, Banu Mutlu Ozyurt, Yaşar Demirelli, Huseyin Selim Asker, Birgul Mutlu, Ozgun Uygur, Hilal Ozkan, Didem Armangil, Ferda Ozlu, Mustafa Kurthan Mert, Hacer Ergin, Beyza Ozcan, Evrim Kıray Bas, Emel Okulu, Betul Acunas, Ulker Celik, Sait Ilker Uslu, Mehmet Mutlu, Nihat Demir, Funda Eroglu, Zeynel Gökmen, Serdar Beken, Bilge Tanyeri Bayraktar, Nilay Hakan, Kazım Kucuktascı, Aysen Orman, Serdar Comert, Sabahattin Ertugrul, Nuran Ustun, Ozlem Sahin, Demet Terek, Yusuf Kale, Murat Konak, Sadık Yurttutan, Ozge Aydemir, Ayşegül Zenciroglu, Dilek Sarici, Nilufer Guzoglu, Sahin Hamilcikan, Tugba Gursoy, Funda Tuzun, Rahmi Ors, Selda Arslan, Arzu Akdag, Asli Memisoglu, Beril Yasa, Berna Hekimoglu, Ozden Turan, Hakan Aylanc, Sahin Takci, Tolga Celik, Suzan Sahin, Ilknur Kilic, Caner Kara, Zuhal Ozen Tunay, Gokhan Celik, Ibrahim Gozen, Gunhal Satirtav, Nihat Polat, Ayse Yesim Oral, Mine Tokgoz, Sadullah Keles, Burak Bilgin, Silay Canturk Ugurbas, Cagatay Karaca, Nedime Sahinoglu Keskek, Dilbade Yildiz Ekinci, Ozlem Balci, Emir Volkan Altan, Sevda Bakbak, Nihan Aksu Ceylan, Sabit Kimyon, Gunay Alyamac, Gamze Ture, Meral Yildiz, Feyza Calis, Selcuk Sizmaz, Emine Sukgen, Ebru Nevin Cetin, Muammer Ozcimen, Semra Tiryaki Demir, Huban Atila, Altan Ozal, Gokhan Tufaner, Ozlem Eski Yucel, Mehmet Kola, Erbil Seven, Sengul Ozdek, Ali Hakan Durukan, Ali Kal, Ali Riza Cenk Celebi, Ibrahim Arif Koytak, Goksu Alacamlı, Arif Esme, Onur Catak, Irfan Perente, Alparslan Sahin, Aylin Ardagil Akcakaya, Gulunay Kiray, Serhat Nalcaci, Umit Aksoy, Berker Bakbak, Aysegül Comez, Huseyin Gursoy, Emrah Utku Kabatas, Ikbal Seza Petricli, Mehmet Erhan Yumusak, Ahmet Kirgiz, Gunay Uludag, Aylin Yaman, Zeynep Dadaci, Ali Karatas, Hande Celiker, Zafer Cebeci, Mahmut Cenap Esenulku, Imren Akkoyun, İsmail Ersan, Selim Demir, Sibel Kadayifcilar, Ayse Ipek Akyuz Unsal, Mumin Hocaoglu

Abstract

Background: To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition.

Methods: A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses.

Results: The TR-ROP study included 6115 infants: 4964 (81%) with a GA≤32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW≤1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW≤1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment.

Conclusions: Screening of infants with a GA≤34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs.

Trial registration number: NCT02814929, Results.

Keywords: Child Health (paediatrics); Neovascularisation; Retina; Treatment Medical.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Plots of BW versus GA for infants treated for ROP in three different types of NICU. (A) University hospitals. (B) State hospitals. (C) Private hospitals. BW, birth weight; GA, gestational age; NICU, neonatal intensive care unit; ROP, retinopathy of prematurity.

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