Retinopathy of prematurity; a study of frequency and risk factors

ABSTRACT

Retinopathy of prematurity [ROP] is a serious complication of prematurity treatment and extension of survival in premature infants and can lead to blindness unless recognized and treated early. The aim of this prospective study was to estimate the incidence of ROP in our country and to identify the risk factors which predispose to ROP in the Neonatal Intensive Care Unit [NICU] graduates. An ROP prospective screening survey was performed enrolling all premature admitted to the NICU from 1st September 2007 to 31st August 2008, with a gestational age [GA]of 32 weeks or less at birth and those of birth weight [BW] of 1500gm or less. Infants whom GA was>32 week or BW was>1500 gm were included if they were exposed to high oxygen [FiO2>21%].A total of 175 infants had retinal evaluation by indirect ophthalmoscopy at 4 weeks of gestation and followed up periodically. All clinical and epidemiological data were statistically analyzed. ROP was diagnosed in 34 [19.4%] infants; one of whom was diagnosed as threshold ROP and underwent Laser Ablative therapy. Out of the 175 neonate, 86 [49.1%] were males and 89 [50.9%] were females. The mean gestational age was 33.01 +/- 1.73 weeks; 25 were less than 32 weeks and 150 were>32 weeks. The birth weight ranged from 0.67 to 2 kg with a mean of 1.5 +/- 0.24 Kg. Using univariate comparison between the risk factors in neonates who developed ROP and those who didn't we found a statistically significant correlation between the occurrence of ROP and gestational age, supplemental oxygen therapy and frequency of packed RBC transfusions. However insignificant correlation was found with sepsis, respiratory distress syndrome [RDS], intraventricular hemorrhage [IVH], patent ductus arteriosus [PDA] and the use of phototherapy. The incidence of ROP in our study was 19.4%.Short gestation, supplemental oxygen administration and frequency of packed RBC transfusions were significant risk factors for ROP. Laser was effective in regressing ROP