Retinopathy of prematurity care in peripheral districts in Odisha, India: Pilot for a sustainable model

Padhi, Tapas Ranjan; Pradhan, Lingaraj; Padhy, Srikanta Kumar; Meherda, Ashwani; Samantaray, Balakrushna; Patro, Kumari; Devi, Sapna; Mishra, Mita; Mahapatra, Sujit; Sutar, Samir; Nayak, Sameer; Kelgaonkar, Anup; Khalsa, Ashish; Shukla, Rajan; Gilbert, Clare

doi:10.4103/ijo.ijo_1914_19

Cited by 7 publications

(5 citation statements)

References 1 publication

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“…We already had a ROP network spread to some peripheral districts of Odisha, sustained by the local ophthalmologists trained in the past. [ 9 ] We had a formal discussion, training, and interaction, virtually, during this period devising the best use of the existing ROP skills in ensuring less referral without missing a treatment-warranting baby. They also helped in the follow-up care of babies after treatment (injection, laser) and babies identified with immature retina and low-risk, pre-threshold ROPs.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the institute also assists the local ophthalmologists trained in ROP (with different levels of competence) in the peripheral districts of the state. [ 9 ] Suspected and treatment warranting ROP babies are referred for confirmation or additional care. The study compared the outcome of ROP care for five months, from April to August 2020, at the height of the COVID-19 lockdown and a similar period in the previous year, from April to August 2019.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of a revised care plan for babies with retinopathy of prematurity during SARS-CoV-2 pandemic in India

Suhan

Singh

Bhusal

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To analyze the impact of a revised care plan for retinopathy of prematurity (ROP) during SARS-CoV-2 pandemic in a tertiary eye care facility in eastern India. Methods: In a retrospective study, we analyzed the medical records of babies managed for ROP during the peak of the SARS-CoV-2 pandemic, with particular reference to the challenges, and the revised strategies addressing travel restrictions for five months, from April to August 2020. The strategy included selective referral (babies with higher treatment probability), longer follow-up intervals (babies with non-alarming findings), use of locally available workforce, and teleconsultation whenever feasible. Results: In the given period, 222 babies were examined versus 624 in the preceding year ( P = 0.001). The average gestational age, birth weight, and postmenstrual age at presentation were 30.4 weeks, 1.31 kg, and 37.7 weeks, respectively. The first examination was on time in 40.1% of babies but was delayed by a median of 23 days in the remaining babies. In the cohort, 56.7% of babies had any ROP, and 27.9% required treatment (versus 8.8% in the previous year; P < 0.001). The intravitreal anti–vascular growth factor (anti-VEGF) injection was more often used than in the previous year ( n = 72 vs 36; P < 0.0001). The treatment outcome was comparable before and after the SARS-CoV-2 lockdown period. There was no report of health issues among the care providers attributable to ROP care. Conclusion: The revised strategy resulted in a smaller pool of babies screened but a larger proportion of babies treated for ROP. This strategy could be used more profitably in future ROP care.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluation of a revised care plan for babies with retinopathy of prematurity during SARS-CoV-2 pandemic in India

Suhan

Singh

Bhusal

et al. 2022

Indian Journal of Ophthalmology

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“…The ophthalmologist was also blinded to the results of WINROP. The babies <32 weeks of gestational age were enrolled for online WINROP algorithm ( http://winrop.com )[ 6 ] for daily weight gain.…”

Section: Methodsmentioning

confidence: 99%

“…Of the babies screened for ROP 10–50% develop ROP and of these, only 5–10% require treatment. [ 4 5 6 7 ] Keeping in mind the limited number of retina specialists trained for screening and treating these neonates for ROP, we need a simpler algorithm which can be applied by the health workers of primary health centers. The health workers can then make necessary referrals of babies to higher centers for treatment.…”

mentioning

confidence: 99%

Use of an online screening algorithm - Weight, Insulin-derived growth factor 1, Neonatal Retinopathy of Prematurity (WINROP) for predicting retinopathy of prematurity in Indian preterm babies

Sute

Jain

Chawla

et al. 2021

Indian Journal of Ophthalmology

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Purpose: Inopathy of prematurity (WINROP) Weight, insulin-derived growth factor 1, neonatal ROP algorithm is an online tool that has been validated as a predictor of retinopathy of prematurity (ROP) in various countries. The current study was designed to evaluate the predictive ability of WINROP algorithm ( http://winrop.com ) using postnatal weight gain in detecting Type 1 ROP in Indian babies. Methods: Prospective single centre observational study of 153 consecutive preterm babies who were eligible for screening for ROP as per the standard guidelines. Sixteen babies were excluded from the study because of various reasons. Thirty-five babies had gestational age ≥32 weeks and were ineligible for WINROP algorithm. Online WINROP algorithm was used for 102 babies with gestation at birth less than 32 weeks. The alarms triggered by WINROP were documented. Results: Laser treatment was done in 30 babies who developed Type 1 ROP. Of these, WINROP alarm was signaled in 24 babies and 6 babies developed ROP without any WINROP alarm. These babies had associated comorbidities like respiratory distress syndrome, patent ductus arteriosus, bacterial sepsis, and ventilatory support. WINROP alarm was significantly associated with Type 1 ROP ( P < 0.001). The sensitivity of WINROP was 80% and specificity was 80.6% with a positive predictive value of 63.2% and negative predictive value of 90.6% in detecting Type 1 ROP. In the present study, no baby who was ineligible for WINROP developed Type 1 ROP. Conclusion: WINROP provides a novel online monitoring screening tool for identifying babies at risk of developing Type 1 ROP. In our cohort, none of the babies whose period of gestation was more than or equal to 32 weeks developed sight threatening Type 1 ROP. WINROP algorithm may also be useful in Indian population.

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“…20 Over the last decade, there have been multiple partnerships that have helped establish a screening model in the states of Maharashtra and Odisha. 21 , 22 …”

Section: Learning From Gpeimentioning

confidence: 99%

Retinopathy of prematurity in India – what can we learn from the polio legacy?

Athikarisamy

Vinekar

Patole

2023

The Lancet Regional Health - Southeast Asia

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Retinopathy of prematurity care in peripheral districts in Odisha, India: Pilot for a sustainable model

Cited by 7 publications

References 1 publication

Evaluation of a revised care plan for babies with retinopathy of prematurity during SARS-CoV-2 pandemic in India

Evaluation of a revised care plan for babies with retinopathy of prematurity during SARS-CoV-2 pandemic in India

Use of an online screening algorithm - Weight, Insulin-derived growth factor 1, Neonatal Retinopathy of Prematurity (WINROP) for predicting retinopathy of prematurity in Indian preterm babies

Retinopathy of prematurity in India – what can we learn from the polio legacy?

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