Objective: (1) To determine if preterm babies with ROP are missed with the existing Philippine Pediatric SocietyPhilippine Academy of Ophthalmology 2005 screening criteria of ≤32 weeks gestational age (GA) and ≤1,500 grams birth weight (BW), (2) to determine the incidence (missed-out rate) of these babies with ROP (>32 weeks GA, >1,500 grams BW), (3) to describe their profile, and (4) to determine the appropriate upper limit for GA and BW that can provide safe and efficient screening for severe ROP. Methods: This is a multicenter, retrospective cohort, observational study using data on ROP screening from the medical records of preterm babies from 4 institutions. All babies born ≤36 weeks GA, regardless of BW, who previously underwent ROP screening in 2011-2013, were included. Outcome measures were: (1) missed-out rate, (2) profile of missed babies with ROP (GA, BW, and risk factors), and (3) the proposed new criteria. Results Of the 762 babies screened, 105 (13.8%) had ROP. Of these, 13 (12%) had severe ROP, 28 (27%) was born at 33-36 weeks GA, and 32 (30%) with >1,500 grams BW. The oldest and heaviest of these missed babies with type 1 ROP was almost consistently reported at <35 weeks GA and <2,000 grams BW. Associated significant risk factors seen among missed babies were sepsis, respiratory distress syndrome (RDS), oxygen supplementation, and blood transfusion. There were 45 babies (43%) with ROP but with no risk factors. Among these were babies with GA >32 weeks and BW >1500 grams with ROP. The incidences of ROP, with and without risk factors, in the 4 institutions were not statistically significant. Seventeen (16.2%) preterm babies were missed with the existing criteria. Two of these had no risk factors but had type 1 and type 2 ROP. When <35 weeks GA and <2,000 grams BW as the new criteria were applied, the missed-out rate was reduced to 2% and was further reduced to zero with the inclusion of risk factors.
Retinopathy of Prematurity ; Mass Screening

OBJECTIVE

This study compared the demographics, clinical profile, treatment, and outcomes of retinoblastoma patients seen at medical institutions in the Philippines between two time periods: 2010 to 2015 and 2016 to 2020.

METHODS

This was a multicenter, analytical, cohort study using review of medical charts and databases of retinoblastoma patients seen in 11 medical institutions from 2010 to 2020.

RESULTS

There were 636 patients (821 eyes) included in this study: 330 patients were seen in 2010 to 2015 while 306 in 2016 to 2020. More cases per annum were seen in the latter timeline. The number of patients with unilateral disease was not significantly different between the two time periods (p=0.51). Age at onset of symptom, age at initial consultation, and delay in consult were also not significantly different between the two time periods (p > 0.05). Patients had significantly different distributions of intraocular grades (p < 0.0001) and systemic staging (p < 0.0001) between the two time periods. Enucleation was the most common surgical treatment performed in both timelines. There was significant difference in the status of patients based on the need for systemic chemotherapy (p < 0.01). There was significant difference in outcome between the two time periods, including the proportions of living and deceased patients.

CONCLUSION

This study compared the most comprehensive data on retinoblastoma patients in the country. There was no improvement in early health seeking behavior based on similar age at initial consult and delay in consult. Enucleation remained the most common treatment mode as opposed to chemotherapy due to similar percentage of patients with unilateral disease, an indication for enucleation rather than chemotherapy.

Human ; Retinoblastoma ; Philippines ; Epidemiology ; Treatment ; Therapeutics