Retinopathy of Prematurity in A Tertiary Care Hospital in Eastern Nepal

Abstract

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening

Neonatal oxygen therapy in low- and middle-income countries: a pragmatic review

“…Neonatal oxygen therapy in low-and middle-income countries: a pragmatic review Journal of Global Health Reports T Fourteen publications provided information on the relationship between neonatal oxygen therapy and retinopathy of prematurity, with eleven of those publications describing studies in South Asia, one in Egypt, and another two in Nigeria. 7,21,[24][25][26][27][28][29][30][31][32][33][34][35][36] All of these publications reflected studies conducted at tertiary care hospitals and described neonates who had been given care in their facility. 7,21,[24][25][26][27][28][29][30][31][32][33][34]36 Eleven out of the fourteen publications described cohort studies that selected a group of neonates with risk factors for retinopathy of prematurity and attempted to describe the prevalence and risk factors for the development of retinopathy of prematurity.…”

“…7,21,[24][25][26][27][28][29][30][31][32][33][34][35][36] All of these publications reflected studies conducted at tertiary care hospitals and described neonates who had been given care in their facility. 7,21,[24][25][26][27][28][29][30][31][32][33][34]36 Eleven out of the fourteen publications described cohort studies that selected a group of neonates with risk factors for retinopathy of prematurity and attempted to describe the prevalence and risk factors for the development of retinopathy of prematurity. 21,24,26,27,[29][30][31][32][33][34]36 The selection criteria for the neonates varied from study to study, but generally involved gestational age and weight criteria for screening, and then included other neonates who met other risk factors for retinopathy of prematurity.…”

“…7,21,[24][25][26][27][28][29][30][31][32][33][34]36 Eleven out of the fourteen publications described cohort studies that selected a group of neonates with risk factors for retinopathy of prematurity and attempted to describe the prevalence and risk factors for the development of retinopathy of prematurity. 21,24,26,27,[29][30][31][32][33][34]36 The selection criteria for the neonates varied from study to study, but generally involved gestational age and weight criteria for screening, and then included other neonates who met other risk factors for retinopathy of prematurity. 21,24,26,27,[29][30][31][32][33][34]36 Clinical information on the monitoring of oxygen therapy in neonates was not provided in nine out of the eleven publications, while Sathar et al and Adio et al each described continuous monitoring of SpO2 on a pulse oximeter with a target SpO2 under 95%.…”

“…21,24,26,27,[29][30][31][32][33][34]36 The selection criteria for the neonates varied from study to study, but generally involved gestational age and weight criteria for screening, and then included other neonates who met other risk factors for retinopathy of prematurity. 21,24,26,27,[29][30][31][32][33][34]36 Clinical information on the monitoring of oxygen therapy in neonates was not provided in nine out of the eleven publications, while Sathar et al and Adio et al each described continuous monitoring of SpO2 on a pulse oximeter with a target SpO2 under 95%. 21,24,26,27,[29][30][31][32][33][34]36 Of these eleven publications, four found oxygen therapy to be significantly associated with retinopathy of prematurity, and six found oxygen therapy to be a risk factor for the development of retinopathy of prematurity.…”

“…21,24,26,27,[29][30][31][32][33][34]36 Clinical information on the monitoring of oxygen therapy in neonates was not provided in nine out of the eleven publications, while Sathar et al and Adio et al each described continuous monitoring of SpO2 on a pulse oximeter with a target SpO2 under 95%. 21,24,26,27,[29][30][31][32][33][34]36 Of these eleven publications, four found oxygen therapy to be significantly associated with retinopathy of prematurity, and six found oxygen therapy to be a risk factor for the development of retinopathy of prematurity. 21,24,26,27,29,[31][32][33][34]36 The eleventh study found oxygen therapy to be associated with retinopathy of prematurity, P=0.11, but not significantly so.…”