Purpose: Retinopathy of prematurity is a leading cause of preventable childhood vision loss, and infants remain at risk of long-term ocular complications even after ROP screening concludes. However, adherence to recommended pediatric ophthalmology follow-up after ROP screening completion is not well characterized. This study aimed to evaluate adherence to pediatric ophthalmology follow-up visits after completion of ROP screening and identify factors associated with loss to follow-up in a tertiary care setting. Patients and Methods: We performed a retrospective chart review of premature infants eligible for ROP screening at a single urban academic center between January 2018 and December 2021. All infants were screened by a single vitreoretinal specialist, with pediatric ophthalmology follow-up recommended at the time of ROP clearance within 4 to 6 months. The primary outcome was a documented follow-up visit with pediatric ophthalmology. Demographic, perinatal, and ROP-related factors were compared between those who did and did not follow up, using univariate and multivariate logistic regression analyses. Results: Of 475 eligible infants, 223 (46.9%) completed at least one pediatric ophthalmology follow-up appointment. In multivariate analysis, outpatient discharge from ROP care (OR 0.66, 95% CI 0.45– 0.97, p = 0.035) and higher gestational age (OR 0.92, 95% CI 0.84– 1.00, p = 0.041) were significantly associated with lower adherence to follow-up. Timing of follow-up (pre-COVID-19 vs COVID-19 era), insurance status, race, ethnicity, number of comorbidities, and distance to the clinic were not significantly associated with follow-up adherence. Conclusion: Fewer than half of infants completed their recommended pediatric ophthalmology follow-up appointments after ROP screening completion. Lower adherence among infants discharged from outpatient ROP care and those born at higher gestational ages highlights a critical care transition from ROP screening to pediatric ophthalmology. Interventions such as scheduling follow-up appointments prior to discharge and improving caregiver education may enhance continuity of care and reduce preventable vision loss in this vulnerable population. Plain Language Summary: Why was this study done? Infants born prematurely (before their due date) often require eye exams to check for retinopathy of prematurity (ROP), a condition that can lead to blindness. Even after ROP screening is completed and acute disease risk decreases, these infants remain at risk for other vision problems related to prematurity and prior ROP, such as strabismus (eye misalignment), amblyopia (lazy eye), and refractive errors needing glasses. Clinical guidelines recommend a pediatric ophthalmology visit within 4 to 6 months after screening, but it is unclear how often families return. What did the researchers do and find? We reviewed the medical records of 475 infants who underwent ROP screening at one academic medical center in New York City between 2018 and 2021. Fewer than half (47%) of infants attended a pediatric ophthalmology visit after screening ended. Two key factors were associated with lower follow-up:Setting: Infants who completed ROP screening as outpatients were less likely to return than those who completed ROP screening while still in the neonatal intensive care unit (NICU).Gestational age: Infants born closer to full term (less premature) were also less likely to return. Other factors, including race, ethnicity, insurance type, number of medical conditions, and whether follow-up was recommended before or during the COVID-19 pandemic, were not significantly linked to follow-up. What do these results mean? Many infants born prematurely do not receive recommended eye care after ROP screening. Simple steps such as scheduling appointments before discharge and providing parents with clear guidance may ensure timely detection of vision problems and reduce preventable vision loss. Keywords: continuity of patient care, infant, premature, visual development, care transitions
Xing et al. (Sun,) studied this question.