Retinopathy of Prematurity: How to prevent retinopathy of prematurity in Indonesia?

Summary Retinopathy of prematurity (ROP) is a serious eye disease seen in preterm infants that can cause blindness. In this thesis, we tried to answer the following questions. 1. Is this disease seen more frequently in patients in Indonesia compared to High-Income Countries (HIC), and are clinical characteristics different? 2. Are risk factors for the development and progression of ROP different between Indonesia and HIC? 3. Is there a genetic background for this disease? 4. Can we design a program that can help to prevent this disease and its progression? We found that ROP is seen more frequently in Indonesia compared to HIC, and it is seen in more mature infants. The incidence seems to have declined between 2005-2015 and 2017-2018 due to a higher awareness of health care workers and the introduction of national health insurance, but it is still higher compared to HIC. Genetics seems not to be involved. Concerted action is needed to further reduce the high ROP incidence. "STOP-R1O2P3" is an acronym that can help implement standard practices in all neonatal intensive care units in LMIC to prevent the development and progression of ROP. Preterm infants should be born in facilities where well-trained personal and apparatus needed for optimal care are available. The use of oxygen must be much more strictly regulated. ROP screening is mandatory in infants born <34 weeks and infants who received supplemental oxygen for a prolonged period. In case of progression of ROP, immediate treatment is required.