Screening and Risk Factors for Retinopathy of Prematurity in a Tertiary Care Hospital in Cairo, Egypt

Abstract

Purpose To evaluate the retinopathy of prematurity (ROP) prevalence, risk factors and screening outcome in a tertiary hospital in Cairo, Egypt. Methods A prospective observational study was done in Neonatal Intensive Care Unit in Ain Shams University Hospital. A total of 159 premature infants were screened for ROP based on the most inclusive criteria reported to date. Screening included premature infants with gestational age (GA) of ≤34 weeks or birth weight (BW) of ≤2000 grams, or GA >34 weeks or BW >2000 grams, with multiple co-morbidities. The prevalence of ROP, plus disease and their correlation with risk factors of interest were studied. Results The GA of the included infants ranged from 27 to 36 weeks, mean (SD) 31.87 (± 1.81) weeks. The BW ranged from 640 to 3900 grams, mean (SD) 1784.71 (± 560.30) grams. The prevalence of ROP more than stage 0 was 25.8% (41 infants), 7.3% of the cases (11 infants) showed plus disease and 6.3% (10 infants) showed severe ROP requiring treatment. Of those, 2 cases (20%) fell outside the British Guideline’s criteria for Screening. There was a highly significant (p < 0.0001) correlation between ROP more than stage 0 and low GA, low BW, mechanical ventilation, respiratory distress syndrome, necrotizing enterocolitis, intraventricular haemorrhage, and blood transfusion. No significant correlation was found between appearance of ROP more than stage 0 and gender (p = 0.911), patent ductus arteriosus (p =0.187), or sepsis (p =0.998). Conclusion ROP is a significant problem in the premature infants in Egypt. Extremely premature infants with lower BW are more prone to develop ROP. However, cases with higher GA and BW than mentioned in the British guidelines screening criteria especially with multiple comorbidities showed severe ROP requiring intervention, which implies the need to develop a screening guideline for the Egyptian population.

Prediction of Retinopathy of Prematurity in Single and Twin Babies: The Predictive Accuracy of WINROP

“…Contrary to the present finding Sute et al 15 showed association of WINROP alarm with gestation age, BW and type I ROP. Previous studies have associated multiple comorbidities, such as RDS, blood transfusion, dysplasia, large patent ductus arteriosus and septic shock have been associated with ROP; 13,15,16 however, in this study, malnutrition (p < 0.001), RDS (p < 0.001), anemia of prematurity (p < 0.01), blood transfusion (p < 0.05) and PIH (p < 0.05) were associated with ROP. Across different studies, 15,16 RDS was the most common comorbidity which was associated with ROP.…”

“…Previous studies have associated multiple comorbidities, such as RDS, blood transfusion, dysplasia, large patent ductus arteriosus and septic shock have been associated with ROP; 13,15,16 however, in this study, malnutrition (p < 0.001), RDS (p < 0.001), anemia of prematurity (p < 0.01), blood transfusion (p < 0.05) and PIH (p < 0.05) were associated with ROP. Across different studies, 15,16 RDS was the most common comorbidity which was associated with ROP. Studies indicate that disruption of gas exchange leads to multiple complications including increased risk of ROP in preterm infants.…”

Complications of Preterm Birth—The Importance of Care for the Outcome: A Narrative Review

“…Early complications are most often manifested as respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), early sepsis, necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH) [ 19 ].…”

Vitrectomy Results for Stages 4 and 5 Retinopathy of Prematurity in Iraq

“…It can be seen that the BW was close to the results of Chandra et al, 9 while it was more than that reported by Iwahashi et al, 10 this point was mentioned before by Vinekar et al, in India back in 2007, where they stated that the BW of children with ROP may be higher in developing countries. 11 In addition, a recent study (2022) in Egypt, a developing Arab country, by Noor et al, reported that the mean BW of ROP infants was 1,900±562.2 g, 12 and this could be attributed to the differences that cause an unstable clinical course in infants-of-developing countries, regardless having GA of more than 30 weeks or BW of more than 1,500 grams. 13 In the current study, the overall surgical success rate was 64.5%, and it was 90.9% for stage 4a, 57.1% for stage 4b, and 33.3% for stage 5a.…”