Comparison of Digital Imaging Screening and Indirect Ophthalmoscopy for Retinopathy of Prematurity

Abstract

The aims of this study were to determine the incidence and severity of retinopathy of prematurity (ROP) using digital imaging screening, confirm findings by indirect opthalmoscopy, and document risk factors of ROP in the neonatal intensive care unit (NICU) of a large tertiary hospital in a developing country. This prospective cohort study included infants with gestational age (GA) ≤ 32 wk, birth weight (BW) ≤ 1,500 g, or older and heavier neonates who were critically ill. Two hundred twenty two eyes (111 infants) were screened with digital imaging (Ret-Cam) and indirect ophthalmoscopy until retinal vascularization was complete or the disease regressed. Perinatal risk factors for ROP were analyzed. The overall incidence of ROP was 18.9 %. The incidence of ROP requiring treatment was 5.4 % (12/222) of the total eyes screened. Lower GA and blood transfusion were independent risk factors associated with ROP by multivariate analysis (p = 0.001, OR = 0.562, 95 % CI = 0.395-0.802, and p = 0.027, OR = 6.11, 95 % CI = 1.22-30.44, respectively). Digital imaging facilitated timely screening and detection of ROP, and enabled transfer of images, allowing early intervention for patients who required treatment.

Analysis of a two-year independent screening effort for retinopathy of prematurity in rural Egypt

“…Abdel Hakeem et al [ 15 ] and Nassar [ 17 ] screened for ROP in a single NICU setting within a university hospital in upper Egypt and found the incidence of the condition to be 19.2 and 36.5%, respectively. Ezz El Din et al [ 34 ] and Hadi et al [ 16 ] examined the incidence in the more urban settings of a Cairo university hospital and 3 Alexandrian private hospitals and found it to be 18.9 and 34.4%, respectively. It is imperative to mention that all the aforementioned studies utilized the lower cutoff GA of 32 weeks and BW of 1500 g (except Hadi et al [ 16 ] who used 1250 g as the cutoff) for screening, and none reported on AP-ROP incidence.…”

Effect of red blood cell transfusion on the development of retinopathy of prematurity: A systematic review and meta-analysis

“…In this systematic review and meta-analysis, 13 cohort and 5 case-control studies including 15072 preterm infants and 5620 cases of ROP were included; among these studies, 10 indicated that RBC transfusion was significantly associated with ROP after adjusting for other confounding factors [13][14][15][16][17][18][23][24][25][26], while others did not demonstrate this association [7, 8, 19-22, 27, 28]. Combining all of these studies, we found that RBC transfusion played a driving role in the development of ROP in preterm infants, with a pooled OR of 1.50 (95% CI: 1.27-1.76).…”

Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight, medical conditions and treatment

“…The incidence of ROP in Middle Eastern countries has been reported to range between 23.31% and 56% and two studies from Alexandria, Egypt, reported an incidence of 33.7% and 36.5%, respectively . The relatively high incidence in our study could be due to the fact that we work in a tertiary hospital, which means that we see a large number of preterm deliveries, we provide a screening programme that allows better adherence to follow‐up and we use digital fundus photography to screen and detect ROP .…”