Retinopathy of prematurity: a study of incidence and risk factors
Keywords:Laser photocoagulation, Retinopathyof prematurity, Risk factors, Telemedicine
Background:A historic cohort observational study was conducted between 2009-2014 in NICU of a tertiary care hospital to study the incidence and risk factors predisposing to retinopathy of prematurity (ROP) using wide field digital fundus camera.
Methods: Preterm babies with birth weight < 2000 g and gestation ≤ 34 weeks were screened for ROP at 2-3 weeks after birth. Babies with gestation > 34 weeks were screened only if they had additional risk factors. Those meeting early treatment for ROP study guidelines (ETROP) were treated by laser.
Results:The incidence of ROP in the 154 babies who were screened using wide field digital fundus camera was 28.57% (44 babies) and incidence of severe ROP was 4.5% (7 babies). All babies with severe ROP were treated with laser photocoagulation. The mean gestational age of ROP babies was 30.1(±1.9) weeks; 39 (88.6%) were ≤ 32 weeks and 5 (11.4%) were >32 weeks. As the gestational age decreased, the incidence of ROP increased (P = 0.001). Birth weight of ROP babies ranged from 628 gm to 1650 g with a mean of 1160 (±230) g. The incidence of ROP in infants ≤1250 gm was 55.1% and >1250 was 16%. On multivariate analysis the higher incidence of risk factors such as RDS, blood transfusion, apnea, low birth weight and low gestational age (prematurity) were independent and significant determinants of ROP (P-value < 0.05 for all) while anaemia requiring blood transfusion and apnea were significant risk factors for severe ROP.
Conclusions:ROP screening can be effectively done by using RETCAM. Risk factors predisposing to ROP were apnea, respiratory distress syndrome, anemia requiring blood transfusion, low birth weight and low gestational age (prematurity) while anemia requiring blood transfusion and apnea were significant risk factors for severe ROP.
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