The Burden of Retinopathy of Prematurity in Albania: A Nationwide Observational Study.

BACKGROUND

Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the developing retina and a leading cause of preventable childhood blindness. While data from high- and middle-income countries are well-documented, Albania has until now lacked national-level information on ROP incidence and severity.

OBJECTIVE

This study aimed to report the first national data on ROP screening outcomes in Albania and to assess the prevalence, severity, and clinical characteristics of ROP in preterm infants. The study also explores perinatal risk factors associated with the severity of ROP.

Methods

A prospective observational study was conducted across neonatal intensive care units (NICUs) in Albania. A total of 173 preterm infants who met the international screening criteria (≤31 weeks gestational age (GA) or ≤1500 g birthweight (BW)) or with comorbidities underwent indirect ophthalmoscopy. Data regarding GA, BW, ROP stage, plus disease, and treatment requirements were collected and analyzed.

RESULTS

Of the 173 infants screened, 88 (50.9%) had no ROP, 65 (37.6%) developed ROP of any stage, and 18 (10.4%) had incomplete data. Among the 65 infants with ROP, 45 (26.0%) had stages 1-2, 12 (6.9%) had stage ≥3, and 3 (1.7%) presented with plus disease. Infants with advanced ROP had a mean GA of 26.9 ± 1.3 weeks and a mean BW of 1313 ± 217 g. Severe ROP was significantly associated with both lower GA (p < 0.001) and BW (p < 0.001). Two infants with severe ROP required mechanical ventilation.

CONCLUSION

This first national study demonstrates that more than one-third of preterm infants in Albania develop ROP, with nearly 7% progressing to advanced stages. The findings highlight the urgent need for a structured national screening program, improved neonatal care, and access to treatment.