Document Detail

Racial variation in retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group.
MedLine Citation:
PMID:  9152127     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine and compare the incidence of severe, vision-threatening retinopathy of prematurity (ROP) in black and white low-birth-weight infants. DESIGN: Prospective cohort study. SETTING: Seventy neonatal intensive care units in 23 US participating centers in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity. PATIENTS: A total of 4099 premature infants weighing less than 1251 g at birth were enrolled to evaluate the natural history of ROP. This 'Natural History' cohort included 2158 white infants and 1584 black infants who were followed up prospectively according to a Natural History protocol. MAIN OUTCOME MEASURES: Incidence and severity of acute ROP. RESULTS: While ROP occurred with similar frequency in all racial subgroups, severe ROP was less common in black infants. One hundred sixty (7.4%) of 2158 white infants reached threshold ROP (defined as at least 5 contiguous or 8 cumulative clock-hours of stage 3 retinopathy in zone 1 or zone 2 in the presence of "plus disease" [dilation and tortuosity of the posterior pole blood vessels]), but only 51 (3.2%) of 1584 black infants progressed to threshold ROP. Using multiple logistic regression analysis, race emerged as a highly significant factor (P < .001) in the development of threshold disease, even when birth weight, gestational age status at delivery, sex, multiple births, and transport status were considered. CONCLUSIONS: Severe, vision-threatening ROP occurs with greater frequency in low-birth-weight white infants than in low-birth-weight black infants who are seemingly at equivalent risk. The reason for this disparity is unknown. We speculate that differences in retinal pigmentation may confer relative protection against free radical-mediated phototoxic injury in black infants.
R A Saunders; M L Donahue; L M Christmann; A V Pakalnis; B Tung; R J Hardy; D L Phelps
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of ophthalmology     Volume:  115     ISSN:  0003-9950     ISO Abbreviation:  Arch. Ophthalmol.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-05-23     Completed Date:  1997-05-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  604-8     Citation Subset:  AIM; IM    
N. Edgar Miles Center for Pediatric Ophthalmology, Department of Ophthalmology, Medical University of South Carolina, Charleston, USA.
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MeSH Terms
African Continental Ancestry Group*
Birth Weight
Cohort Studies
European Continental Ancestry Group*
Gestational Age
Infant, Newborn
Prospective Studies
Retinopathy of Prematurity / ethnology*,  etiology,  surgery
Severity of Illness Index
United States / epidemiology
Grant Support
5-U01-EY05874/EY/NEI NIH HHS

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