Association Between Neighborhood Opportunity Levels and Requiring Retinopathy of Prematurity Treatment

Purpose: To determine the relationship between neighborhood-level socioeconomic status and requiring retinopathy of prematurity (ROP) treatment, using the Child Opportunity Index (COI). Methods: Electronic medical records for all patients who received ROP treatment from January 2010 to March 2024 at a tertiary care center were retrospectively reviewed. Controls were obtained by matching pediatric ophthalmology patients with the closest clinic visit date and no history of retinopathy of prematurity. Demographic and clinical information were collected. The patient's 5-digit ZIP code was used to determine the COI score and level. Results: This study included 245 study patients and 735 matched controls, of which 110 (44.9%) and 329 (44.8%) were female, respectively. The study group had a significantly lower mean COI score (48 ± 29) compared to controls (56 ± 31, P < .001). Additionally, the study group had a higher percentage of Hispanic/Latino patients compared to the control group (51.8% vs 41.9%, respectively, P = .01). When stratified into type 1 (n = 195) and type 2 (n = 50) ROP, patients in the ROP groups continued to have lower mean COI scores (50 ± 29 and 44 ± 28, respectively) than the control group (56 ± 31; P = .01 and P = .006, respectively). The type 1 ROP group had a greater number of patients with Medi-Cal insurance compared to the control group (50.8% vs 46.4%, respectively, P = .04). Conclusions: Neighborhood socioeconomic status may play a critical role in the management of ROP. It is important to understand the synergistic relationship between social determinants of health when addressing health disparities and developing community-level interventions.