Retinopathy of prematurity: do we still have a problem?: the Charles L. Schepens lecture.

OBJECTIVE To assess the present-day prevalence of retinopathy of prematurity (ROP) worldwide. METHODS A search of the literature was conducted to better define the worldwide experience with ROP. An interview was also conducted with 2 schools for the blind, Overbrook in Philadelphia, Pennsylvania, and Perkins in Watertown, Massachusetts. The study also is based on personal experience with ROP over the last 49 years. RESULTS Worldwide, the prevalence of ROP is on the rise in developing countries, and some of those ROP-affected premature infants are heavier than 1500 g. In western countries, extremely low-birth-weight infants (≤1000 g) are also surviving. Currently, the Overbrook School for the Blind has 11 of 55 children between the ages of 3 and 5 years with ROP (20%). The Perkins School has 34 of 200 children from birth to age 3 years with ROP (17%). During 2009, 47 babies had laser treatment for ROP in the neonatal intensive care unit of Jefferson Medical College by physicians from Wills Eye Hospital. Twenty-four infants had been identified in a screening of 591 patients (4.1%). The other 23 had been referred in for treatment. In 2009, we had 187 outpatient visits related to ROP ranging from 6 months to 67 years of age. CONCLUSIONS Because more and more extreme low-birth-weight infants are surviving in western countries and because of the rising numbers of surviving premature infants in emerging nations, we may be on the verge of an ROP epidemic.