Clinical characteristics and treatment response of treatment requiring retinopathy of prematurity (ROP) in Big Premature Infants in Turkiye: BIG-ROP Study Group Report No 2 (BIG-ROP STUDY)

Clinical characteristics and treatment response of treatment requiring retinopathy of prematurity (ROP) in Big Premature Infants in Turkiye: BIG-ROP Study Group Report No 2 (BIG-ROP STUDY)

Objective This study evaluated the clinical characteristics and treatment outcomes of bigger premature infants treated for retinopathy of prematurity (ROP).Methods A retrospective, multicentre study analysed data from 33 ROP centres in Türkiye. Infants with gestational ages (GA) of 32–37 weeks and b...

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Main Authors: Sengul Ozdek, Zafer Cebeci, Ayşegül Çömez, Nihat Sayın, Merih Çetinkaya, Ozlem Şahin, Ahmet Yagmur Bas, Esin Koc, İbrahim Murat Hirfanoglu, Guner Karatekin, Kadir Serafettin Tekgunduz, Servet Ozkiraz, Hilal Ozkan, Mustafa Kurthan Mert, Serdar Comert, Sadık Yurttutan, Funda Tuzun, Caner Kara, Gokhan Celik, Ayse Yesim Oral, Sadullah Keles, Burak Bilgin, Nihan Aksu Ceylan, Emrah Utku Kabatas, Ikbal Seza Petricli, Hande Celiker, Ayse Ipek Akyuz Unsal, Ozgul Salihoglu, Ramazan Ozdemir, Sinan Albayrak, Zuhal Ozen Tunay, Huseyin Baran Ozdemir, Aslı Vural, Meral Yıldız, Handan Bezirganoglu, Tugba Göncü, Sadik Etka Bayramoglu, Emine Alyamac Sukgen, Nur Kır, Dilbade Yıldız Ekinci, Osman Kızılay, Semra Tiryaki Demir, Taylan Öztürk, Sinan Bekmez, Erdem Eriş, Hüseyin Mayalı, Günhal Şatırtav, Tülin Öğreden, İsmail Umut Onur, Duygu Yalınbaş Yeter, Suzan Tayfun Tanıdır, Müberra Akdoğan, Pelin Çelemler, Emrullah Beyazyıldız, Özlem Beyazyıldız, Özdemir Özdemir, Damla Ergintürk Acar, Esra Kızıldağ Özbay, Yasin Özcan, Özlem Eşki Yücel, Mustafa Yıldırım, Seyhan Dikci, Aslıhan Uzun, Ayça Sarı, Özge Begüm Seferoğlu Comba, Bilge Araz Erşan, Zeynep Seymen, Alp Alaluf, Nilüfer Zorlutuna Kaymak, Hürkan Kerimoğlu, Cüneyt Tayman, Sinan Uslu, Tülin Gökmen Yıldırım, Nurdan Fettah Dinlen, Hüseyin Altınhan, Gaffari Tunç, Deniz Güven Karakurt, Özlem Bozkurt Demiroğlu, Canan Aygün, Mahir Ceylan, Umut Zübahiroğlu, Abdullah Barış Akcan
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open Ophthalmology
Online Access:https://bmjophth.bmj.com/content/10/1/e002081.full
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Summary:Objective This study evaluated the clinical characteristics and treatment outcomes of bigger premature infants treated for retinopathy of prematurity (ROP).Methods A retrospective, multicentre study analysed data from 33 ROP centres in Türkiye. Infants with gestational ages (GA) of 32–37 weeks and birth weights (BW) >1500 g who required ROP treatment were included. Patient demographics, clinical details, treatments, responses and complications were recorded. Descriptive statistics were calculated after excluding cases with missing or erroneous data.Results The study included 365 eyes of 365 infants. The average GA at birth was 33±1 weeks, with a mean BW of 1896±316 g. Of these, 83.6% had type 1 ROP, and 16.4% had aggressive ROP (A-ROP). Treatment-requiring ROP (TR-ROP) occurred at an average postmenstrual age of 39.0±4.6 weeks. Among 170 infants with TR-ROP at their first exam, 81.2% were screened at 4 weeks postpartum. Reactivation of ROP was observed in 5.4% of the primary laser photocoagulation (LPC) group and 23.9% of the primary anti-vascular endothelial growth factor (VEGF) group (p<0.001). Reactivation and progression to stage 4–5 were more frequent in A-ROP cases (p=0.012; p=0.008). The need for additional treatment was significantly higher in cases of A-ROP, zone 1 disease or stage 4–5 disease (p<0.001). Anti-VEGF therapy demonstrated superior single-treatment success rates in A-ROP eyes compared with laser LPC (85.7% vs 60%, p=0.03). Infants requiring additional treatments also had higher rates of respiratory distress syndrome (RDS), maternal premature rupture of membranes (PROM) and non-ophthalmological surgical interventions (p<0.05).Conclusion Bigger premature infants in low and middle-income countries should be screened earlier than 4 weeks after birth. A-ROP, zone 1 disease and stage 4–5 disease have higher reactivation risks. Primary anti-VEGF therapy was associated with a greater need for retreatment. Maternal PROM, RDS and surgical interventions also increase retreatment risk. Limitations include retrospective design and lack of smaller preterm comparisons, potentially limiting generalisability.
ISSN:2397-3269

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