Retinopathy of prematurity in Asian Indian babies weighing greater than 1250 grams at birth: Ten year data from a tertiary care center in a developing country

Vinekar, Anand; Dogra, Mangat R; Sangtam, Tiakumzuk; Narang, Anil; Gupta, Amod

doi:10.4103/0301-4738.33817

Cited by 154 publications

(80 citation statements)

References 27 publications

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“…This was in agreement with Shah et al .,[8] and Vinekar et al .,[23] which may be due to the effect of endotoxins on retinal blood vessels. On the other hand, this was in disagreement with the results of Chaudhari et al .,[24] and Smith.…”

Section: Discussionsupporting

confidence: 93%

Retinopathy of prematurity: A study of incidence and risk factors in NICU of Al-Minya University Hospital in Egypt

2012

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Background:Retinopathy of prematurity (ROP) is a serious complication of prematurity treatment and can lead to blindness unless recognized and treated early.Objective:To estimate the incidence of ROP in preterm infants in our NICU, to identify the risk factors which predispose to ROP, and to assess the outcome of these cases.Materials and Methods:ROP prospective screening survey was performed enrolling all prematures admitted to the NICU from January 2009 to December 2010, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whom gestational age was >32 weeks or birth weight was >1500 g were included if they exposed to oxygen therapy for more than 7 days. Also infants who were born between 32 and 34 weeks gestational age were examined if they had a course of instability (like sepsis, asphyxia or ventilation). A total of 172 infants (88 females) had retinal evaluation by indirect ophthalmoscopy from the 4th postnatal week and followed up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed to stage 3 ROP with plus disease were given laser therapy.Results:Out of the studied 172 infants, 33 infants (19.2%) developed ROP in one or both eyes; 18 (54.5%) cases stage 1, 9 (27.3%) cases stage 2 and 6 (18.2%) cases stage 3 with plus disease. None of the studied neonates presented ROP at stages 4 or 5. The six cases diagnosed as ROP stage 3 with plus disease underwent laser ablative therapy. Laser was effective in treatment and decreasing the progression of ROP. Univariate analysis showed that there was a significant relationship between the occurrence of ROP and gestational age (P=0.000), sepsis (P=0.004), oxygen therapy (P=0.018), and frequency of blood transfusions (P=0.030). However, nonsignificant relationship was found between the occurrence of ROP and sex, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension, phototherapy, duration of oxygen therapy, mechanical ventilation, and CPAP (all P>0.05). Gestational age, sepsis, oxygen therapy and frequency of blood transfusions remained significant variables after logistic regression analysis.Conclusion:The incidence of ROP in this study was 19.2%; low gestational age, sepsis, oxygen therapy and frequent blood transfusions were significant risk factors for ROP. Laser was effective in treatment and decreasing the progression of ROP. As this is a unit-based study, a comprehensive countrywide survey on ROP in Egypt is recommended to determine any regional differences in disease incidence.

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Section: Discussionsupporting

confidence: 93%

Retinopathy of prematurity: A study of incidence and risk factors in NICU of Al-Minya University Hospital in Egypt

2012

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“…[16–18] In contrast, most reports from western centers and developed countries focus on ROP in extremely premature infants with < 1250 g birth weight. [131418–20] The mean birth weight of infants in the present study was 1121.69 g which is much higher than 703 g for the ETROP cohort.…”

Section: Discussionmentioning

confidence: 99%

Structural sequelae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes

Katoch

Sanghi

Dogra

et al. 2011

Indian J Ophthalmol

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Aim:The aim was to study the structural sequelae and refractive outcome after laser treatment for Type 1 prethreshold retinopathy of prematurity (ROP) in Asian Indian eyes.Materials and Methods:A retrospective chart review of infants with Type 1 prethreshold ROP (defined according to the Early Treatment for Retinopathy of Prematurity study) undergoing laser treatment at a tertiary center between January 2004 and December 2008 was done. The 1-year outcome of infants was analyzed.Results:Sixty-nine eyes of 36 infants were included. The mean birth weight was 1121.69 ± 254.81 g and the gestational age was 28.99 ± 2.03 weeks. Sixty-five eyes (94.2%) had zone 2 and 4 (5.8%) had zone 1 disease. Forty-four (63.77%) eyes had stage 2 ROP with plus disease and 25 (36.23%) eyes had prethreshold (fewer than five contiguous or eight cumulative clock hours) stage 3 ROP with plus disease. None of the eyes developed retinal structural sequelae. On cycloplegic retinoscopy, 59.4% eyes had nonsignificant hyperopia [spherical equivalent (SE) ≤ 4 D], 14.5% eyes had no refractive error (SE 0 D), 24.7% eyes had low myopia (SE < 5 D), and 1.4% eyes had high myopia (SE > 5.0 D). Eyes developing myopia were associated with a greater number of clock hours of ROP, greater number of laser spots used, and a longer time to disease regression. Two infants (5.6%) had esotropia and one (2.8%) had exotropia.Conclusion:Asian Indian infants treated for Type 1 prethreshold ROP did not develop retinal structural sequelae. Myopia was seen in nearly one-fourth of the eyes.The risk factors for myopia were a greater number of clock hours of ROP, greater number of laser spots, and a longer time to regression of ROP.

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“…Even within India, the rate varied from 33% in present study to 45% in a study from Chandigarh, India. [6]…”

Section: Discussionmentioning

confidence: 99%

“…[1] In regions such as Latin America, Eastern Europe, and Asia, the number of ROP cases has grown dramatically because of higher overall birth rates and improved neonatal survival due to neonatal care facilities. [23] Persistent variability in quality of neonatal care and shortage of adequately trained ophthalmologists are concerning in view of the emerging international ROP “epidemic.”[3456] Poor accessibility and lack of awareness among parents as well as health-care providers result in late presentation and irreversible damage. [78]…”

Section: Introductionmentioning

confidence: 99%

A mobile team for screening of retinopathy of prematurity in India: Cost - effectiveness, outcomes, and impact assessment

Kelkar¹,

Kelkar²,

Sharma³

et al. 2017

Taiwan J Ophthalmol

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PURPOSE:To study the cost effectiveness, outcomes and impact of retinopathy of prematurity (ROP) screening and management model for urban neonatal intensive care units (NICUs).STUDY DESIGN:Public health intervention study.METHODS:This study was conducted in 2013. Staff of a mobile unit assessed all infants aged less than 34 weeks of Gestation age at birth and/or birth weight 1700 GM or less admitted in five NICUs between 2013 and 2015. A trained ophthalmologist performed bedside ROP screening through dilated pupils using indirect ophthalmoscope. ROP was graded and managed as per the International Classification of Retinopathy of Prematurity treatment guidelines. Counseling and laser treatment were the interventions. The incidence, grade and determinants of ROP were estimated. Direct and indirect costs were calculated to estimate the unit cost of screening and managing a child with ROP using the model.RESULTS:The study sample included 102 preterm/underweight infants. The prevalence of ROP of different grades in either eye was 32% (95% Confidence Intervals (CI): 23.2–41.5). ROP stage I was present in 75% of these eyes. The model could help in preventing/reducing visual disability in 4 infants with advanced stages of ROP. The unit cost of ROP screening, identifying one child with ROP and addressing visual disability due to ROP was US $ 198.9, 596.7 and 4,137.4 respectively.CONCLUSION:A mobile screening is likely feasible and cost-effective method to detect ROP and offer timely intervention for NICU in urban areas with limited resources.

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Retinopathy of prematurity in Asian Indian babies weighing greater than 1250 grams at birth: Ten year data from a tertiary care center in a developing country

Cited by 154 publications

References 27 publications

Retinopathy of prematurity: A study of incidence and risk factors in NICU of Al-Minya University Hospital in Egypt

Retinopathy of prematurity: A study of incidence and risk factors in NICU of Al-Minya University Hospital in Egypt

Structural sequelae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes

A mobile team for screening of retinopathy of prematurity in India: Cost - effectiveness, outcomes, and impact assessment

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