Temporal Changes in Screen-Detected Retinopathy of Prematurity Among Screened Very-Low-Birth-Weight Infants Born Before 32 Weeks of Gestation: A Single-Center Retrospective Cohort Study

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Background/Objectives: Retinopathy of prematurity (ROP) remains an important cause of preventable childhood visual impairment, yet recent temporal changes among very-low-birth-weight infants in China are not well characterized. This study aimed to evaluate temporal changes in screen-detected ROP among very-low-birth-weight infants born before 32 weeks of gestation. Methods: We conducted a single-center retrospective cohort study of very-low-birth-weight infants who underwent ROP screening at Peking University Third Hospital from 2021 to 2024. Infants were grouped by birth period, and sequential multivariable regression models and sensitivity analyses were used to assess temporal differences in ROP outcomes. Results: Among 614 infants assessed for eligibility, 478 screened infants with available ROP outcomes were included. Any-stage ROP increased from 34.3% in 2021–2022 to 64.6% in 2023–2024 (p < 0.001). The association remained statistically significant in the sequential explanatory Model 6 (OR 2.82, 95% CI 1.73–4.60; p < 0.001). Treatment-requiring ROP showed a nonsignificant numerical increase from 5.1% to 9.3% (p = 0.112). Among infants with ROP, documented pre-plus findings were more frequent in 2023–2024 than in 2021–2022 (15.5% vs. 4.4%), and the overall plus-status distribution differed between periods (p = 0.040); however, maximum ROP stage and treatment-requiring ROP did not differ significantly. Conclusions: Screen-detected any-stage ROP increased substantially in 2023–2024, with more frequent documented pre-plus findings but no statistically significant increase in treatment-requiring ROP or other predefined severe indicators.

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