Characteristics of severe retinopathy of prematurity patients in China: a repeat of the first epidemic?

Aim: To describe the characteristics of babies treated for severe retinopathy of prematurity (ROP) in a tertiary referral unit in China, to provide information to assist in determining screening criteria. Methods: Information on consecutive babies referred to one eye department for treatment of stage 3 (prethreshold and threshold disease), and stages 4 and 5 ROP between January 2001 and May 2005 were retrieved from medical records. Results: Data from 114 babies were analysed. The number of babies treated increased from nine in 2001 to 52 in 2004. The numbers of infants in each stage of ROP were as follows: stage 3, 40 babies; stage 4, 19 babies, and stage 5, 55 cases. The mean gestational age (GA) was 29.8 (SD 1.9) weeks (range 26-34 weeks) and the mean birth weight (BW) was 1432 (319) g (range 760 - 2500 g). 31 babies had BWs more than 1500 g (27.2%). 10 cases (8.8%) had GAs more than 32 weeks, and 82 (71.9%) had GAs more than 28 weeks. Overall, 18 (16.2%) infants exceeded UK screening criteria, and 34 (30.4%) exceeded the criteria used in the United States. The median age at presentation was 5.5 months (range 1-72 months). Conclusion: Comprehensive screening programmes for ROP are urgently needed in China. Screening criteria recommended by the American Academy of Pediatric Ophthalmology and Strabismus and the Royal College of Ophthalmologists, United Kingdom, may not be suitable for China where bigger, more mature babies are developing severe disease.