Risk factor and Outcome of Retinopathy of Prematurity among Premature Babies admitted to Tertiary Care Hospital: A Retrospective Observational Study

Abstract

Background: Retinopathy of Prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with gestational age. ROP is a vascular retinal disease that can cause low vision or blindness. ROP is a common blinding disease in children which is becoming increasingly prevalent in the developing world. Aim: The aim of this study is to evaluate the incidence of Retinopathy of prematurity (ROP) and its association with risk factors such as low birth weight, gestational age, oxygen therapy, respiratory distress syndrome and sepsis among premature infants admitted to the Neonatal Intensive Care Unit (NICU) of Krishna Institute of Medical Sciences, Karad. Methods: Retrospective chart review of all infants admitted to the NICU between July 2017 and July 2019, who met the criteria for ROP screening: (a) ≤32 weeks of gestation, (b) ≤1.500 kg of birth weight, (c) infants with significant risk factors including sepsis, respiratory distress syndrome, or long-term oxygen use. Treatment was offered to infants with Stage III ROP disease or Stage II in Zone II with plus disease. Qualified infants were treated with argon laser photocoagulation within 48 h of diagnosis. Results : A total of 233 neonates who met the criteria were screened for ROP. Incidence of ROP was found to be 35.62% among the babies screened (n=83) majority of whom had stage 1 ROP (83.13%). Maximum incidence was seen in neonates of gestational age between 32-35 weeks (54.22%) and neonates of birth weight between 0.750 and 1.500 kg (85.54%). Other prevalent risk factors for development of ROP include Respiratory Distress Syndrome (59%) and Oxygen therapy (65%). Four neonates were found with plus disease and six neonates required laser treatment. Conclusion: The present study reflects the problem of ROP in a tertiary care centre. Prematurity, Low Birth Weight (LBW), high oxygen supplementation, respiratory distress syndrome were found to be independent risk factors in the development of ROP in neonates. Because of advancements in neonatal intensive care in developing countries and higher survival rate of premature infants, the incidence of ROP has increased. Unrecognized and untreated ROP will cause potential blindness in children. Hence, to prevent the adverse visual outcome and possible blindness; timely screening, recognition, and treatment of ROP is essential.

Unmet Need for ROP Screening in Peripheral Rural Areas

“…10 In another study by Paranjpe et al from Maharashtra, the reported incidence of ROP was 35.62%. 11 A similar incidence with a slightly higher incidence has been reported in other studies ( Table 5 ). 12–19 The mean BW of screened babies was 1538.11gm range (580–3500), and the mean GA was 31.89 weeks range (26–39) weeks.…”