Neonatal Intensive Care Unit-based screening program for retinopathy of prematurity and its treatment in an Indian population

Goyal, Anubhav; Anantharaman, Giridhar; Gopalakrishnan, Mahesh; Thachil, Thomas

doi:10.4103/ijo.ijo_201_18

Cited by 12 publications

(17 citation statements)

References 23 publications

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“…Studies from India [20,21] reported an incidence of BPD of 28.7%, 10.7% & 11.2% in infants less than 28 weeks, 29-30 weeks and 31-32 weeks respectively The BPD rates from Indian centre in this study is lower than reported studies from India. Necrotising enterocolitis ≥stage 2 is 11.5% and 12.6% in U.K and Indian cohort, results are comparable to the previous studies [23].Number of babies with severe Retinopathy of Prematurity (ROP) and number of ROP needing treatment with laser or Avastin was signi cantly higher in Indian centre (12.9% vs 7.7%) despite higher gestational age of cohort than the UK centre possibly explained by difference in practices or higher risk factors. EPICure study [4] from the UK has shown an increased incidence of ROP needing treatment (Laser/Avastin) from 13% to 22%, however data from India for babies with ROP needing treatment (laser/Avastin) is between 16.6-20.7% [23,24].…”

Section: Discussionsupporting

confidence: 77%

“…Necrotising enterocolitis ≥stage 2 is 11.5% and 12.6% in U.K and Indian cohort, results are comparable to the previous studies [23].Number of babies with severe Retinopathy of Prematurity (ROP) and number of ROP needing treatment with laser or Avastin was signi cantly higher in Indian centre (12.9% vs 7.7%) despite higher gestational age of cohort than the UK centre possibly explained by difference in practices or higher risk factors. EPICure study [4] from the UK has shown an increased incidence of ROP needing treatment (Laser/Avastin) from 13% to 22%, however data from India for babies with ROP needing treatment (laser/Avastin) is between 16.6-20.7% [23,24]. Intraventricular haemorrhage grade 2 and above was 15.6% and 8.2% (p < 0.001) in U.K and India respectively which is slightly less than the previous studies [4,25].…”

Section: Discussionsupporting

confidence: 77%

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Comparitive Study Of Short-Term Outcomes Of Preterm Babies ≤30 Weeks In A Tertiary Care Hospital Between India And The U.K

Diggikar¹,

Nagesh²,

Kumar³

et al. 2020

Preprint

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Large numbers of preterm babies are born in middle income countries and neonatal care is improving in these countries. However, comparative clinical outcomes of preterm babies between a tertiary neonatal unit from middle income country and higher income country is limited. Objective: To compare the clinical profile and short-term outcomes of preterm babies ≤ 30 weeks gestation admitted to a tertiary care hospital in India and the U.K. Design: Retrospective cohort observational study using anonymised data from Electronic Patient Records. Setting: Regional tertiary neonatal intensive care unit (NICU) of Manipal Hospitals, Bangalore, India and Homerton University Hospital, London, UK. Participants: Preterm babies born at ≤ 30 weeks gestation admitted to NICUs over five year period (January 2011 to December 2015). Infants with major congenital abnormalities were excluded. Intervention: This is an observational study and routine care was provided as per departmental standard protocols. Main outcome measures: Comparison of neonatal unit mortality between two centres, infant morbidities till discharge from neonatal unit. Results: A total of 740 babies from the U.K centre and 294 babies from Indian centre were enrolled into the study. The mean gestational age in the U.K cohort was 26.6 ± 2.16 weeks, whereas in Indian cohort was 28.4 ± 1.66 weeks (p,<0.001). A significantly lower number of mothers received antenatal steroid (37% v 73%), and higher number of babies were inborn (78.6%) in Indian centre compared to the UK centre (67.3%; p < 0.001). Incidence of BPD and IVH ≥ grade 2 was significantly lower, and ROP needing treatment was significantly higher in Indian centre. Higher number of babies were treated for ductus arteriosus and incidence of culture positive sepsis was significantly high in Indian cohort babies. Survival of babies born at gestational age > 28 weeks was comparable between the U.K and Indian centres. Survival of babies born at ≤ 28 weeks gestation was lower in Indian centre. Conclusions and relevance: The survival of babies above 28 weeks prematurity was comparable between a tertiary care centre in India and the U.K. However, survival of babies ≤ 28 weeks gestation was lower in Indian centre. Incidence of ROP and sepsis was higher in Indian centre.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 77%

Comparitive Study Of Short-Term Outcomes Of Preterm Babies ≤30 Weeks In A Tertiary Care Hospital Between India And The U.K

Diggikar¹,

Nagesh²,

Kumar³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Similarly, SGA infants had a lower risk of ROP compared to non-SGA infants in the youngest GA group (25–27 weeks) only [31]. While blood transfusion was not significantly associated with ROP in three studies [21, 22, 26], a higher number of blood transfusions was a significant risk factor for ROP on multivariate analysis in two studies [19, 24]. Pre-eclampsia was associated with a lower risk of ROP in VLBW infants in two studies [19, 34].…”

Section: Resultsmentioning

confidence: 99%

Demographic Risk Factors of Retinopathy of Prematurity: A Systematic Review of Population-Based Studies

Popović

Dhoot

et al. 2022

Neonatology

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Introduction: Current national guidelines use gestational age (GA) and birth weight (BW) as their basis for retinopathy of prematurity (ROP) screening. The strength of association of these and other demographic risk factors is inconsistent across studies. This review aims to evaluate the strength of association of documented risk factors for ROP in large sample, population-based studies. Methods: MEDLINE, EMBASE, and Cochrane Library were searched from January 2010 to May 2020. Original studies reporting the risk of ROP in a region and demographic risk factors were included. Results: Eighteen studies comprising 342,005 infants were included. The overall risk of ROP in preterm infants was 18.8%. For every week decrease in GA, there was a median adjusted odds ratio (aOR) of 1.4 times (range 1.2–1.9) of developing ROP. For every 100-g decrease in BW, the median aOR was 1.8 times (range 1.2–2.7). Higher risk was found in infants with neonatal sepsis and bronchopulmonary dysplasia. The risk of any, severe, and treatment-requiring ROP was highest for 23 weeks GA, which was 66.5, 40.3, and 39.4%, respectively. Regions with higher neonatal mortality rates had the highest mean GA of infants with ROP. Conclusion: For every week decrease in GA and every 100-g decrease in BW, there was a median of 1.4 times and 1.8 times the odds of developing ROP, respectively. Further research is required to clarify the role of additional risk factors.

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“…In parallel, the MII Ret Cam device has also emerged as a powerful tool in smartphone-based imaging in ROP [ 32 , 33 ]. The device is used with a 20-diopter lens and a smartphone in video mode (with flash) to perform indirect ophthalmoscopy by an ROP specialist.…”

Section: Framework For Live Rdfi-tm Programsmentioning

confidence: 99%

The Role of Telemedicine to Alleviate an Increasingly Burdened Healthcare System: Retinopathy of Prematurity

et al. 2020

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Telemedicine-based remote digital fundus imaging (RDFI-TM) offers a promising platform for the screening of retinopathy of prematurity. RDFI-TM addresses some of the challenges faced by ophthalmologists in examining this vulnerable population in both low-and high-income countries. In this review, we studied the evidence on the use of RDFI-TM and analyzed the practical framework for RDFI-TM systems. We assessed the novel technological advances that can be deployed within RDFI-TM systems including noncontact imaging systems, smartphone-based imaging tools, and deep learning algorithms.

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Neonatal Intensive Care Unit-based screening program for retinopathy of prematurity and its treatment in an Indian population

Cited by 12 publications

References 23 publications

Comparitive Study Of Short-Term Outcomes Of Preterm Babies ≤30 Weeks In A Tertiary Care Hospital Between India And The U.K

Comparitive Study Of Short-Term Outcomes Of Preterm Babies ≤30 Weeks In A Tertiary Care Hospital Between India And The U.K

Demographic Risk Factors of Retinopathy of Prematurity: A Systematic Review of Population-Based Studies

The Role of Telemedicine to Alleviate an Increasingly Burdened Healthcare System: Retinopathy of Prematurity

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