Retinopathy of prematurity in Ardabil, North West of Iran: Prevalence and risk factors

Abstract

Retinopathy of prematurity (ROP), which affects the retina of premature infants, is a leading cause of blindness in premature infants worldwide. The aim of this study was to evaluate the frequency and risk factors of retinopathy of prematurity infants referred to Alavi hospital between October 2018 and October 2019. In the present study, 400 infants with gestational age less than 34 weeks and or birth weight of 2000 g or less were enrolled in the study. Required information including sex, gestational age, maternal age, birth weight, type of delivery, oxygen therapy, septicemia, multiple gestations, consanguineous marriage, respiratory problem, and blood exchange were extracted from their hospital records and then included in the data collection form. These infants were also examined for ROP, stage and area of involvement by an experienced ophthalmologist and then classified into two groups including retinopathy and healthy group. Finally, the data were analyzed in SPSS 25 software using chi-square, fisher exact test, t-test, binary logistic regression, and ROC curve analysis. Of the 400 preterm infants studied (57.2% male and 42.8% female), 107 (26.8%) infants had ROP of whom 23 (21.5%) needed treatment (i.e. 5.8% of all infants need treatment). There were 4 (3.7%), 29 (27.1%), and 74 (69.2%) infants with zone I, II, and III, respectively. There were 91 (85%), 11 (10.3%), and 5 (4.7%) infants with stage I, II, and III, respectively. Multivariate logistic regression analysis showed that parental consanguinity (OR=2.263, 95%CI: 1.240-4.130, P=0.008), gestational age less than 32.5 weeks (OR=4.067, 95%CI: 2.340-7.069, P<0.001), and birth weight less than 1725 g (OR=4.522, 95%CI: 2.677-7.637, P<0.001) were associated with a 2.3-fold, 4.1-fold, and 4.5-fold increased risk of ROP, respectively. ROP had no significant relationship with other variables. In summary, the findings of the present study showed that one quarter of the premature infants had ROP. Furthermore, birth weight less than 1725 g, gestational age less than 32.5 weeks, and parental consanguinity were risk factors for ROP, in addition, one-fifth of the infants with ROP needed treatment.

Evaluation of Clinical Course and Outcomes in Zone I Retinopathy of Prematurity in a Tertiary Care Institute

“…In the present study, 526 infants were screened and showed an institutional incidence of ROP of 24.9% (131 out of 526 infants) and Zone I ROP of 9.5% (50 infants). Much lower incidences of 1.8% and 3.7% were reported by Braimah et al [9] (Ghana) and Fekri et al [10] (Iran). The wide variation between the incidence of Zone I ROP between the present study and other Western studies is attributable to the variation in the sample size of the studies and In our study, we found that out of 97 eyes, a total of 33 (34.02%) eyes show spontaneous regression all of them belong to stages 1 and Hence, a proper timely follow-up is also important in these patients, we cannot exclude the probability of ROP based on the first examination, because when they are present, they are very preterm so vascularization is only until Zone I.…”

Retinopathy of Prematurity in Neonatal Intensive Care Unit at King Fahd University Hospital, Eastern Province: Prevalence, Risk Factors, and pattern of severity Seven years’ experience.

“…One of the most significant and curable causes of childhood blindness is retinopathy of prematurity (ROP), a proliferative retinopathy that damages retinal blood vessels in preterm and low-birth-weight infants. 1 Retinal detachment, which results from scarring of aberrant retinal blood vessels, is the primary cause of visual impairment and blindness in patients with ROP. 2 Initially, it was speculated that ROP development was related to the complex and unreported use of oxygen supplementation in the care of premature infants placed in closed incubators for the treatment of respiratory distress.…”

“…However, because some studies believe that this condition is dependent on geographic and medical facilities, the causal association between these elements has not been definitively proven. 1 The immature vasculature develops in two stages. First, ischemia and a hyperoxic phase restrict the blood vessels in the retina.…”

“…The International Classification for ROP (ICROP) was established in 1984. According to the zones of the retina affected by the illness (1, 2, and 3), the extent of the disease as measured by clock hours (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12), and the severity of the disease as measured by different stages (0-5), the ROP is categorized. 4 Moreover, a demarcation line, ridge with height and width, proliferation of fibrovascular cells in extra retinal tissue, partial retinal detachment, and total retinal detachment are the five phases of ROP.…”

“…Parental consanguinity is linked to an increased risk of ROP. 1 Similarly, Nugud, et al done a retrospective cohort research in Dubai hospital and it was carried out between 2012 to 2014; 611 neonates were admitted to the NICU throughout the research period, out of 163 individuals who were enrolled in the study, 44 (27%) experienced ROP, whereas 119 (73%) did not have ROP at any of the subsequent ophthalmological screening assessment. Eight patients (4.9%) had stage I ROP, 27 patients Page 4 of 5 (16%) had stage II ROP, and 9 patients (5.5%) had stage III disease.…”