In the United States, the rates of retinopathy of prematurity (ROP) among ROP candidates has increased from 4.4% in 2003 to 8.1% in 2019, according to research presented at the American Society of Retina Specialists 40th Annual Meeting, held in New York, July 13-16, 2022. Presenters say that the increase in incidence “may be driven by better screening and advances in neonatal care.”

Researchers utilized a nationwide inpatient care database to explore the variability of ROP across populations, locations, and time in the United States. Newborn patients with International Classification of Diseases (ICD)-9 codes (ICD-10 for 2016) for premature birth week or low birth weight (lighter than 1500 g) were regarded as potential ROP candidates. The team used chi-square tests of independence to determine whether incidences changed by year or differed across subpopulations. 

Researchers found that the incidence of ROP among ROP candidates increased from 4.4% in 2003 to 8.1% in 2019 (P <.001). Compared with White, Native American, or Asian infants, ROP incidence increased the most in Black and Hispanic infants (P <.001).  

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The incidence of ROP was higher in lower-income populations (P <.001). When stratified by region, the South and the Midwest had persistently higher incidences of ROP than the Northeast and the West (P <.001). 

Premature boy and girl infants had similar relative increases in ROP diagnosis (4.47% to 8.27% vs 4.76% to 8.86%, respectively).

“Regardless of region, the burden of ROP seems to have partially shifted from rural hospitals to urban ones,” according to the researchers. “These trends indicate ROP is a growing problem in the United States and one that may be disproportionately affecting certain subpopulations.”

This study may have been limited by better screening and advances in neonatal care, which may have increased incidences of ROP.  


Bhatnagar A, Skrehot H, Bhatt A, Herce H, Weng CY. Epidemiology of retinopathy of prematurity in the United States from 2003 to 2019. Poster presented at: The 40th annual meeting of the American Society of Retina Specialists; June 13-16, 2022; New York. Poster 601.