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To the Editor—We read with interest the elegant study by Iu et al1 on the prevalence and severity of retinopathy of prematurity (ROP) in a tertiary hospital in Hong Kong. Compared with their data in which the incidence of ROP was 16.9% in 89 premature infants screened over 1 year,1 our analysis of 602 infants screened over 7 years2 and another local study of 513 infants over 5 years3 revealed a ROP prevalence of 28.2 and 18.5%, respectively. We would like to highlight the point that the prevalence rates could be related to the case-mix. We had a larger proportion of high-risk infants. Our youngest mean gestational age was 29+3 weeks compared with 30+2 weeks in Iu et al’s study1 and 30 weeks in Yau et al’s study.3 We also had a higher proportion of extremely low birth weight (ELBW) infants (<1000 g; 24.1%2 vs 19.1%1). This may reflect socio-economic differences and the complexity of cases. Among ELBW infants, however, a comparable percentage (70.6%1 vs 71.7%2) developed ROP and treatment rates among the studies were also very similar (3.4%1, 3.8%2, and 3.7%3). While all three studies adopted the Royal College of Ophthalmologists ROP guidelines,1-3 Iu et al1 identified 11 infants who would not have been screened had the American Academy of Pediatrics’ criteria been applied, and none of whom developed Hong Kong Med J 2017;23:316 DOI: 10.12809/hkmj176306

Re: Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong