Delays and loss to follow-up in outpatient retinopathy of prematurity screening.

PURPOSE: To determine the frequency and determinants of delayed and complete loss to follow-up (LTFU) for the first outpatient retinopathy of prematurity (ROP) examination after discharge at a single tertiary center.

METHODS

A retrospective chart review of neonates at a single institution from 2014 to 2023 who underwent inpatient ROP screening and were intended to have outpatient follow-up there within 1 month was performed. Frequency of LTFU and delayed follow-up (>3 days) were calculated, and univariate logistic regression revealed potential associations with clinical and sociodemographic factors. Qualitative themes were extracted to identify reasons for gaps.

RESULTS

Of the 721 infants who met inclusion criteria, 691 (95.8%) received follow-up, although 12.9% of those receiving follow-up were delayed by a median of 9 days. Zone III ROP or retinal maturity on inpatient screening was associated with complete LTFU (OR = 0.20; 95% CI, 0.09 - 0.45). Postmenstrual age at discharge ≥40 weeks was also associated with LTFU (OR = 0.31; 95% CI, 0.14-0.65), but among those with follow-up, it was more likely to be timely (OR = 1.84; 95% CI, 1.08-3.30). Inpatient ROP treatment was associated with timeliness of follow-up (OR = 5.27; 95% CI, 1.11-94.2); Hispanic or non-White race/ethnicity was associated with delays (OR = 0.44; 95% CI, 0.28-0.69).

CONCLUSIONS

Despite an overall high rate of follow-up, delays remain a challenge that may disproportionately affect Hispanic or non-White patients. ROP severity may be associated with better follow-up. Although these findings are exploratory, they may inform future research and interventions to ensure uninterrupted care for all patients.