Article Text

Download PDFPDF
Original article
No advanced retinopathy of prematurity stages 4 or 5 in a large high-risk German cohort
  1. Philipp S Muether1,
  2. Angela Kribs2,
  3. Moritz Hahn3,
  4. Jasmin Schumacher1,
  5. Frank Eifinger2,
  6. Bernd Kirchhof1,
  7. Bernhard Roth2,
  8. Sascha Fauser1
  1. 1Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany
  2. 2Children's Hospital, Department of Neonatology, University of Cologne, Cologne, Germany
  3. 3Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
  1. Correspondence to Dr Philipp S Muether, Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924 Cologne, Germany; philmuether{at}


Background Retinopathy of prematurity (ROP) remains a major cause of juvenile blindness. As screening recommendations are refined, decreasing gestational age (GA) and birth weight (BW) constitute an increasing risk for ROP. This retrospective case series reviews the screening results of a very immature cohort in Germany.

Methods We conducted ROP screening according to the German guidelines of 1999: all preterm infants with a GA of <32 weeks and/or a BW of <1501 g, or with GA ≥32 weeks and postnatal oxygen treatment for >3 days, were assigned for screening. Dense laser coagulation was performed according to the current treatment criteria.

Results All 767 consecutive inborn (patients born at the Department of Neonatology, University Hospital of Cologne, Germany) preterm infants of a tertiary medical centre of maximum care underwent complete screening from 2001 to 2009. The treatment incidence was 7.0%. No preterm infant developed stage 4/5 ROP. Mean GA and BW of untreated/treated preterm infants were 28.4/24.6 weeks and 1109/635 g, respectively. Increasing treatment incidence was associated with lower GA, but not with lower BW in logistic regression analysis.

Conclusion In this very immature high-risk cohort, advanced stages 4 and 5 were avoided throughout 9 years of screening. We suggest three factors that contributed to this outcome: (1) strict adherence to current ROP screening and treatment guidelines; (2) prompt and very dense laser coagulation if necessary; and (3) a specialised neonatal intensive care unit with experience of very immature babies.

  • Retinopathy of prematurity
  • plus disease
  • laser treatment
  • screening
  • gestational age
  • birth weight
  • retina
  • neovascularisation
  • diagnostic tests/investigation
  • treatment lasers
  • child health (paediatrics)

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding Supported by the Koeln Fortune Program/Faculty of Medicine, University of Cologne.

  • Competing interests None to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.