Clinical predictors of disease severity in nasal versus temporal retinopathy of prematurity

Abstract

Objective

Recognition of factors associated with a greater need for treatment may be useful in managing retinopathy of prematurity (ROP). We aim to assess the relationship between nasal and temporal ROP on initial presentation and an infant’s eventual need for treatment.

Methods

All patients screened for ROP between January 2018 and December 2020 were retrospectively reviewed. Data were collected on all patients (n = 286) with stage 1 or higher ROP. Eyes were classified as either nasal ROP or temporal-only ROP at initial presentation of ROP. Data from all ROP screening exams until treatment or completion of screening were reviewed. The primary outcome was treatment-required ROP. Additional data collected included birth weight, patient age, and laterality. Outcomes were compared using univariable and multivariable logistic regression analyses.

Results

Five hundred forty-two eyes were included for analysis. Eyes with nasal ROP on initial presentation were more likely to ultimately require treatment (63/197 [32%]) than eyes with temporal-only ROP on initial presentation (13/345 [4%]; odds ratio [OR]: 12.0, 95% CI: 6.40–22.54) using a univariable logistic regression analysis. A separate multivariable regression analysis demonstrated that eyes with nasal ROP remain more likely to require treatment (OR: 3.28, 95% CI: 1.54–6.99), even when also accounting for birth weight (OR: 0.40/100 g, 95% CI: 0.32–0.51), patient sex, and laterality.

Conclusions

Eyes with nasal ROP at initial presentation are more likely to eventually require treatment than those with temporal-only ROP at initial presentation, even when accounting for other risk factors. Nasal ROP at initial presentation should prompt particular attention when monitoring for progression of ROP.