Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study

Abstract

Background and Objectives World Health Organization's vision 20/20 programme has recognized retinopathy of prematurity (ROP) as an important cause of childhood blindness in industrialized and middle-income countries. While ROP is virtually nonexistent in many African countries, ROP is seen in urban areas where facilities for neonatal care exist. The aim of this study is to establish the frequency of ROP in a cohort of patients screened for ROP and to establish if current screening criteria apply to our patients. Patients and Methods Infants with birth weight (BW) of 1500 g or less and/or gestational age of 32 weeks or less were screened for ROP over a 2 1 2 Àyear period by a single examiner. Results ROP was observed in 84 of 514 (16.3%) of infants included for analysis. Threshold disease (tROP) was noted in 1.6% of the total cohort although 41/84 babies with ROP were lost prior to regression or progression to tROP. Of the 43/84 adequately followed up, eight (18.6%) developed tROP. An estimated frequency of tROP was more likely to be 2.9%. There was no tROP noted in babies of BW greater than 1250 g. Gestational age was an unreliable risk parameter in our population. Conclusion The projected occurrence rate of tROP is similar to that found in black population in the Multicentre Cryotherapy for ROP Trial. Our data suggest that the screening criterion based on BW can safely be lowered to 1250 g in our population.

Retinopathy of prematurity in a cohort of neonates at Groote Schuur Hospital, Cape Town, South Africa

“…The prevalence of severe ROP was 3.2% in infants weighing <1 250 g at birth, with 4.3% requiring treatment, slightly higher than in our study. In a study in Johannesburg published in 2006, Mayet et al [5] showed a 16.3% prevalence of ROP in VLBW infants -1.6% of infants received treatment. As in other SA studies, the majority of infants with ROP weighed <1 250_g and no infant weighing >1 250 g required treatment.…”

“…This prevalence is significantly higher than in previous studies at GSH. [4,5] Infrastructure and resources in the healthcare facilities referring to GSH have improved in the past two decades. Additionally, surfactant therapy and non-invasive ventilation are more accessible, contributing to improved preterm (n= (n= RESEARCH survival.…”

“…Studies between 1995 and 2013 reported a prevalence of ROP ranging from 16.3% to 31.1%. [5][6][7][8] The prevalence of severe ROP ranged from 4.3% to 7.1%, with no infant weighing >1 250 g requiring treatment. These studies all reported infants requiring treatment for ROP.…”

An evaluation of the screening for retinopathy of prematurity in very-low-birth-weight babies at a tertiary hospital in Johannesburg, South Africa

“…A study at Chris Hani Baragwanath Academic Hospital found the incidence to be ~17%. [10] In another study undertaken at Tygerberg Children's Hospital in Cape Town, the incidence was found to be 21.8%. [13] A study by Delport et al [14] at Kalafong Hospital, Pretoria, found the incidence of ROP to be 24.5%.…”

“…In a large prospective study done at Chris Hani Baragwanath Academic Hospital to establish the frequency of ROP it was concluded that this was not the case, and the screening weight could safely be lowered to 1 250 g. [10] According to the latest ROP guidelines published in the South African Medical Journal (SAMJ), all very-low-birth-weight (VLBW) babies <1 500 g or 32 weeks' GA should be screened for ROP. [11] Screening is repeated until retinal vascularisation has reached a stage where the risk of a serious adverse outcome is considered minimal.…”