To Study the Incidence of Retinopathy of Prematurity in High-Risk Neonates and the Risk Factors Associated With the Disease

Abstract

Background: Retinopathy of prematurity (ROP) is a complex disease of the developing retinal vasculature in premature infant. The challenge in India is that a large number of neonatal intensive care units (NICUs) don't have an effective ROP screening strategy. Objective: To measure the incidence of ROP in neonates with gestational age (≤32 weeks) or weighing <2000 g with risk factors and evaluation of risk factor associated with ROP. Materials and Methods: This prospective study was conducted in the Department of Pediatrics and Ophthalmology from January to July 2016. Neonates with gestational age ≤32 weeks, birth weight (BW) ≤1500 g, and selected preterm infants with a BW between 1501 and 2000 g with risk factors admitted in NICU/special newborn care unit were included in the study and screened for ROP by trained ophthalmologist under supervision of the pediatrician. All data were analyzed using SPSS or MedCalc. Univariate and multivariate logistic regression was done to determine the risk factors for the development of any ROP. Result: The incidence of ROP in our study was 19%. 4% of the neonates have severe (early treatment for ROP [ETROP] Type 1) ROP while 15% have non-severe (ETROP Type 2) ROP. 8 neonates developed Stage 1 ROP (42.11%), 7 developed Stage 2 (36.84%), and 4 neonates developed Stage 3 ROP (21.05%). Conclusion: The current study revealed that the incidence of ROP in sick neonates was 19%. Significant risk factors were found to be low BW, low gestational age, supplemental oxygen, and mechanical ventilation, culture proven sepsis, anemia, apnea, and respiratory distress syndrome (RDS).

A Study of the Demographic Profile, Screening, and Management of Patients Visiting a Retinopathy of Prematurity Clinic

“…A statistically significant association was found between oxygen supplementation and the development of ROP (p-value = 0.0251). This is comparable to various other studies showing oxygen therapy as a significant risk for ROP [ 6 , 7 , 9 ]. One of the reasons why the incidence of ROP is decreasing in developed countries is due to their strict guidelines and monitoring of oxygen therapy provided to infants, which is lacking in countries like India.…”

“…This is in concurrence with studies done by Patel et al in Vadodara [ 6 ] between 2017 and 2018 with an incidence of 24.1% of the 284 neonates screened for ROP and by Thakre et al in Maharashtra [ 7 ], where the incidence of ROP was found to be 27.73% of the 119 neonates screened. The incidence in the present study was found to be lower as compared to the study by Tekchandani et al [ 8 ] conducted at a tertiary care institute in North India during 2013-2017 in which incidence was 32.3% and higher when compared with Singh et al [ 9 ], who reported an incidence of 19% in their study conducted in Ajmer in 2016. The discrepancies in observation may be due to the varying sample size taken, differences in the study duration, and geographical areas where the studies were conducted.…”

The incidence of retinopathy of prematurity in a tertiary care center in Turkey

“…In a multicenter study conducted in our country, it was found out that the incidence of ROP was 30% (10). The incidence of ROP is 17.9% in the USA, between 19% and 46% in India and 31.3% in Portugal (15)(16)(17)(18). According to our results, ROP is a serious problem that may cause potentially blindness for premature babies unless the neonatal intensive care services would be eligible conditions.…”

“…The incidence of severe ROP is 8.31% in the USA, 5% in Turkey and between 4% and 9% in India (10,(15)(16)(17). We considered treatment in 8.8% of the screened infants due to the severe ROP.…”