Retinopathy of prematurity: A revisit to the incidence, risk factors, and its response to laser therapy

Abstract

: The debilitating vasoproliferative retinal disorder retinopathy of prematurity (ROP), a prequel to neonatal blindness is known to be increasing in recent years with improved advances in neonatal care and survival. Aim of this study was to study the incidence of ROP, risk factors, and response to the gold standard treatment of laser has been explored in this study.: In this prospective observational study of all neonates referred to the retina clinic of a tertiary care centre, from both in-house referrals and peripheral centres. Demographic data, both maternal and neonatal data were recorded. Neonates complying to inclusion and exclusion criteria were examined under 28 diopter lens and all ROP were documented using RetCam. Laser photocoagulation was performed and later followed up according to ETROP schedule.: 699 neonates were screened in the study and ROP was detected in 13.73% (182/1398) of this population, with mean gestational age 31.82±2.44 weeks and mean birth weight 1425.36±287.73 grams. Neonatal risk factors of gestational age <34 weeks, low birth weight, ventilatory support, RDS, oxygen supplementation, sepsis, birth asphyxia, blood transfusion, and phototherapy were found to have significant association for incidence of ROP and those requiring treatment. When 67.58% regressed spontaneously, all 59 eyes requiring treatment underwent laser therapy. 46 out of these 59 eyes (77.97%) showed regression and remaining seven eyes required further intervention.: Better premature neonates survival rates has shown an increased incidence of ROP over the past decades. Red flag signs like low gestational age, low birth weight, RDS, oxygen supplementation, sepsis, blood transfusion, AGA and twin pregnancy are confirmed to have significant association with the development of ROP. Laser therapy still remains effective in controlling progression of the disease.