728 - Identifying Risk Factors for Post-Discharge Treatment of Retinopathy of Prematurity

Publication Number: 2710.728

Noor Abdullah, Indiana University School of Medicine, Fishers, IN, United States; Ateik Almalahi, Indiana University School of Medicine, Fort Wayne, IN, United States; Christian Akotoye, Indiana University School of Medicine, Indianapolis, IN, United States; Lucas W. Rowe, Indiana University School of Medicine, Indianapolis, IN, United States; Charline Boente, Indiana University, Indianapolis, IN, United States; Kathryn Haider, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Erik Parker, Indiana University Bloomington, Bloomington, IN, United States; Kok Lim Kua, Indiana University School of Medicine, Indianapolis, IN, United States

Background: Retinopathy of prematurity (ROP) is the leading cause of childhood blindness in the United States. With increasing survival rates among extremely preterm infants, a growing number of cases now require aggressive treatment after discharge from the Neonatal Intensive Care Unit (NICU). Typically, these infants do not require treatment during their initial NICU stay but later show disease progression during outpatient follow up, needing interventions such as laser photocoagulation or intravitreal injections. To date, there is a gap in understanding the prevalence and risk factors associated with the need for aggressive ROP treatment, particularly among infants who did not require intervention during their NICU hospitalization.

Objective: The goal of this study is to use a retrospective cohort of preterm infants to identify risk factors and clinical predictors for requiring outpatient ROP treatment.

Design/Methods: This is a retrospective chart review of preterm infants who received ophthalmology follow up at Riley Hospital for Children from 2015 to 2025. Demographic variables, NICU clinical history, and weights at follow-up were recorded. Differences between patients who received outpatient treatment (n=48) and controls who did not receive any ROP treatment (n=98) were assessed using Pearson’s Chi-square, Fisher’s exact, and Wilcoxon rank-sum tests. Additionally, multivariate logistic regression was utilized to analyze clinical predictors for requiring outpatient treatment.

Results: Preterm infants who received outpatient ROP treatment had lower gestational age (GA) at birth and birth weight (p < 0.001). These infants also had higher rates of several morbidities, such as surgical necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, and sepsis, and were more likely to be discharged on nasal cannula (p < 0.001). Logistic regression revealed higher GA at birth is associated with lower likelihood of requiring outpatient treatment. (OR=0.28, p=0.001). Additionally, infants that experienced greater positive changes in weight z-score from discharge to follow-up were less likely to require outpatient treatment (OR=0.22, p=0.046).

Conclusion(s): Based on this cohort’s findings, preterm infants should be followed closely outpatient to monitor for potential ROP treatment, especially those who experienced the previously mentioned comorbidities. Low gestational age at birth and slow growth rates can be utilized as clinical predictors of requiring outpatient ROP treatment.