Program Updates “Center of Excellence for the prevention of Childhood Blindness” 2012 – 2015

photo by Art Simon

Throughout the world the number of infants who survive a premature birth and low birth weight is increasing with advances in neonatal care. However, these newborns face a number of serious health risks including Retinopathy of Prematurity (ROP). ROP is a condition in which abnormal retinal neovascularization occurs at the intersection of mature and premature retina leading to changes in the retina including macular traction and retinal detachment which result in childhood blindness.


Developing countries like Armenia are now seeing this disease that the U.S. first encountered in the early 1950s when an epidemic of ROP left an estimated 7,000 children blind in one year alone. ROP emerged in Armenia in the mid 2000s with practicing neonatologists and ophthalmologists encountering more and more cases. According to some estimates about 500 - 600 children are born annually who belong to the risk group, which is defined as birth weight of less than 1500g or with a gestational age of 30 weeks or less and infants with a birth weight between 1500g and 2000g or gestational age of more than 30 weeks with an unstable clinical course. According to international data, more than 50 percent of newborns having a birth-weight of less than 1250 grams have some degree of ROP. The probability of ROP is inversely proportional to birth-weight; the lower the birth-weight of the child, the higher the probability that he or she will develop ROP.

In 2010, in cooperation with the Ministry of Health, USAID, Children’s Hospital of Los Angeles and other partners the AECP introduced an ROP initiative including screening, early detection and laser treatment. ROP has a very rapid course and infants can go blind in a matter of weeks if not days. If not detected in time treatment will most certainly be less effective if not impossible.

The AECP has equipped ROP screeners with state-of-the-art equipment and has provided continuous professional support including mentors. The program started in all neonatal intensive care units in Yerevan. Through September 2013, 2,052 premature infants have been screened and 70 infants have received laser and anti-VEGF treatment. ROP screening is now provided in Gyumri and will be established in Lori and Kapan shortly.

In 2012, in partnership with USAID, established the Center of Excellence of the Prevention for Childhood Blindness (CEPCB) in Armenia. This enabled the AECP, along with USAID, the Armenian Ministry of Health, Children’s Hospital of Los Angeles and a number of other partners, to expand its ROP program to include a surgical tier. Children who require further treatment may now receive it in Armenia rather than in anther country, which can be prohibitively expensive and time consuming.

The mission of the CEPCB is to establish and develop a specialized ophthalmological capacity to help children from Armenia and abroad to combat childhood blindness and to facilitate the exchange of knowledge among medical professionals in the region. Specialized eye care is made accessible to all children in Armenia and throughout the region to eliminate childhood blindness caused by ROP and other diseases.

The continuing involvement of U.S. physicians — among the finest retina and ROP specialists in the world — along with highly trained AECP Armenian surgeons and modern equipment will elevate the treatment of ROP in Armenia to a level that will qualify it as a regional center. The project is committed to ensuring excellence in treatment and in service. The lack of trained professionals and equipment, as well as the increase in ROP cases in other countries — a majority of which do not have nationwide or systematized programs — make the services of the Center of Excellence very much in demand. The program also works to improve the quality of care for newborns. To accomplish this objective the AECP and Children’s Hospital of Los Angeles have introduced an online training program for neonatologist and neonatal nurses.

With the addition of the surgical tier the full complement of treatment options for ROP is available in Armenia making it possible to provide treatment for all cases of ROP and related eye diseases thereby preventing a lifetime of blindness. The CEPCB has initiated training for Armenian surgeons in the U.S., has secured surgical equipment and is working toward the establishment and implementation of tools for professional cooperation.