A study on incidence and associated factors of retinopathy of prematurity in a tertiary care setting in Sri Lanka

Abstract

Introduction: Retinopathy of prematurity (ROP) chiefly affects preterm infants. With the increased survival of extremely preterm infants, the number of infants with severe ROP has also increased.Objective: To assess the incidence, associated factors and outcome of ROP in neonates born at less than 34 weeks of gestation and/or less than 1.5 kg birth weight in Sri Jayawardenepura General Hospital Method: A prospective, descriptive, observational study was conducted in neonates born from 01/01/2014 to 31/12/2014, who were less than 34 weeks of gestation and/or less than 1.5 kg birth weight. Data was collected from patient records. Incidence estimates were given using descriptive statistics. For bivariate analysis (where associated factors were considered), the Chi Square test was applied to assess significant associations. The level of significance was 0.05. Results:Of 126 neonates, 113 were included in study as 11 met exclusion criteria and 2 dropped out during follow up. Twenty eight (24.8%) neonates had ROP of whom 12 (42.9%) needed treatment. Study revealed that, earlier the gestation and lower the birth weight, ROP was more commonly observed. Patent ductus arteriosus (PDA) (p=0.006), sepsis (p=0.024), invasive ventilation for 7 or more days (p=0.0001) and supplementary oxygen for more than 7 days (p=0.0001) were significantly associated with development of ROP. ___________________________________________

Audit of retinopathy of prematurity rate (total and treatment needed) in Teaching Hospital, Kurunegala, Sri Lanka

“…One study done in severely sight impaired children attending schools for the blind in Sri Lanka 9 revealed ROP accounts for major proportion of bilateral avoidable causes of blindness (34.9%) 9 . Another study done in neonatal intensive care unit of Sri Jayawardhanapura General Hospital Sri Lanka from 01.01.2014 to 31.12.2014 revealed institutional incidence of ROP 24.8% (28/113) in neonates screened 34 weeks or less period of gestation and/or 1.5 kg of birth weight while 42.9% of diagnosed ROP (12/28) or 10.7% of total screened (12/113) required ROP treatment 2 . Whereas Abeysekara et al, 2014 reported a higher rate of ROP incidence 37.6% (214 out of all 568 screened neonates in Lady Ridgeway Hospital for Children Sri Lanka) in which 18.7% (106/568) needed ROP treatment 10 .…”

“…Retinopathy of prematurity (ROP) is a retinovascular disease of preterm, low birth weight neonates who were treated with oxygen and exposed to other risk factors as well 1,2 . Since the disease was first described by "Terry" in 1942 its management has greatly evolved to prevent childhood blindness 1,3,4 .…”

“…Consultant Vitreoretinal Surgeon,2,3,4,5 Medical Officers of Eye Unit, Teaching Hospital, Kurunegala, Sri Lanka. DOI: http://doi.org/10.4038/jcosl.v27i2.47…”

A clinical audit on the screening program and outcome of retinopathy of prematurity at a neonatal intensive care unit & special care baby unit at a tertiary care centre in Sri Lanka

“…Several risk factors are involved, including short gestation, low birth weight, phototherapy, blood transfusion, mechanical ventilation, surfactant therapy [5], oxygen therapy, its duration, low Apgar at 1 and 5 minutes, poor postnatal weight gain, intraventricular haemorrhage, sepsis, multiple pregnancy and anaemia [5,6]. A study done at a tertiary referral centre in Sri Lanka showed that there was a significant association of patent ductus arteriosus, sepsis, prolonged invasive ventilation and oxygen therapy for more than seven days with the occurrence of ROP [7].…”