PURPOSE. To evaluate the incidence, visual prognosis, and mortality in retinopathy of prematurity (ROP) in Korea. METHODS. We used the National Health Insurance and the Korean Disability Registry database, which covers the entire newborn population in 2006 to 2014 and includes information on all newborns diagnosed with ROP until 2016. Using these databases, we evaluated the incidence, rate of visual impairment (VI), and mortality in patients with ROP according to the birth weight categories and treatment modalities. RESULTS. The ROP incidence per 1000 newborns was 1.99, which broke down into 317.14 in the very low birth weight (VLBW) less than 1500 g population, 25.45 in the 1500 to 2499 g population, and 0.29 in the 2500 g or greater population. When assessed at age 10, the VI rate was 2.2 per 100 person-years, which was highest at 4.5 per 100 person-years in the VLBW population compared with the population in other birth weight categories. Among treated cases, the proportion of VI in patients undergoing laser photocoagulation or cryotherapy was 1.6% (42/2595), which was lower than the 2.9% (2/68) of patients treated with anti-vascular endothelial growth factor injection, and 32.2% (82/255) of patients undergoing vitrectomy or scleral buckling. The mortality rate was 4.8 per 1000 person-years, which was highest in the VLBW population, but similar across treatment modalities. CONCLUSIONS. The ROP incidence in Korea was approximately 1 in 500 among all newborns, and 1 in 3 in the VLBW population. As the first nationwide population-based study of long-term visual prognosis in ROP, we report the higher VI rate in ROP than previously determined in other studies. Differences in visual outcomes and comparable mortality risks between treatment modalities require further verification.
Bibliographical noteFunding Information:
The Korean government operates the KDR program for certain disabilities, including VI. The KDR is a registration program for persons with disabilities, and requires a verification executed by a physician specializing in the related field, thus ensuring diagnostic reliability. Patients in this program become eligible for financial support, including disability pensions, tax benefits, and reduction of public facility fees. The registration for the KDR program for VI is based on the specific criteria of best-corrected VA or visual field status defined by the Korean Ministry of Health and Welfare, which should be confirmed by an ophthalmologist who achieved board certification.12 VI is classified into the following 6 grades12:
Copyright 2020 The Authors.
- Retinopathy of prematurity
- Visual prognosis