Incidence and risk factors of retinopathy of prematurity in Goa, India: a report from tertiary care centre

Sarvesh Kossambe, Shilpa Joglekar, Annely D'lima, M. P. Silveira


Background: To report the incidence and risk factors leading to the development of retinopathy of prematurity (ROP) from a tertiary care center in the western Indian state of Goa, India.

Methods: This was a prospective observational study carried out in a level II neonatal intensive care unit (NICU) for a period of 18 months. Babies born at < 34 weeks’ gestation and having a birth weight of <1500gm were screened for ROP and laser photocoagulation was done for those who developed threshold ROP. Group differences between any ROP and threshold ROP were analysed using the chi-square test.

Results: Out of the 244 preterm neonates screened, 37 developed ROP (15.16%), and 14 out of them (5.73%) developed threshold ROP requiring laser photocoagulation. Very low birth weight, prematurity, apnea, anemia, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, blood transfusions, exchange transfusions and days taken to reach full enteral feeds and regain birth weight were significantly associated with the development of ROP.

Conclusions: This is the first report of ROP from Goa where less than 1 in 5 babies developed ROP. This is similar to that reported across the rest of the country. Judicious oxygen use, ventilation strategies, transfusions guidelines, control of sepsis, early enteral feeds and adequate nutrition may help prevent the development of ROP in the future.


NICU, Prematurity, ROP

Full Text:



Kocur I, Kuchynka P, Rodný S, Baráková D, Schwartz EC. Causes of severe visual impairment and blindness in children attending schools for the visually handicapped in the Czech Republic. Br J Ophthalmol. 2001;85:1149-52.

Steinkuller PG, Du L, Gilbert C, Foster A, Collins ML, Coats DK. Childhood blindness. J AAPOS. 1999;3:26-32.

Gilbert C, Rahi J, Eckstein M, O’Sullivan J, Foster A. Retinopathy of prematurity in middle-income countries. Lancet. 1997;350:12-4.

Gilbert C, Foster A. Childhood blindness in the context of VISION 2020: the right to sight. Bull World Health Organization. 2001;79:227-32.

Cryotherapy for retinopathy of prematurity cooperative group. Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results. Pediatr. 1988;81(5):697-06.

Early treatment for retinopathy of prematurity cooperative group. The incidence and course of retinopathy of prematurity: findings from the early treatment for retinopathy of prematurity study. Pediat. 2005;116(1):15-23.

Fielder AR, Shaw DE, Robinson J, Ng YK. Natural history of retinopathy of prematurity: a prospective study. Eye. 1992;6(3):233.

Darlow BA. Incidence of retinopathy of prematurity in New Zealand. Archives Dis Childhood. 1988;63(9):1083-6.

Network S, Carlo WA, Finer NN, Walsh MC, Rich W, Gantz MG, et al. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med. 2010;362(21):1959-69.

Gopal L, Sharma T, Ramachandran S, Shanmugasundaram R, Asha V. Retinopathy of prematurity: a study. Indian J Ophthalmol. 1995;43:59-61.

Charan R, Dogra MR, Gupta A, Narang A. The incidence of retinopathy of prematurity in a neonatal care unit. Indian J Ophthalmol. 1995;43:123-6.

Varughese S, Jain S, Gupta N, Singh S, Tyagi V, Puliyel JM. Magnitude of the problem of retinopathy of prematurity. experience in a large maternity unit with a medium size level-3 nursery. Indian J Ophthalmol. 2001;49:187-8.

Penn JS, Henry MM, Wall PT, Tolman BL. The range of PaO2 variation determines the severity of oxygen-induced retinopathy in newborn rats. Invest Ophthalmol Visual Sci. 1995;36(10):2063-70.

Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care center- incidence, risk factors and outcome. Indian Pediatr. 2009;46:219-4.

Gupta VP, Dhaliwal U, Sharma R, Gupta P, Rohatgi J. Retinopathy of prematurity-risk factors. Indian J Pediatr. 2004;71(10):887-92.

Kumar P, Sankar MJ, Deorari A, Azad R, Chandra P, Agarwal R, et al. Risk factors for severe retinopathy of prematurity in preterm low birth weight neonates. Indian J Pediatr. 2011;78(7):812-6.

Shetty SP, Shetty J, Amin H, Shenoy RD. The incidence, risk factors and outcome of retinopathy of prematurity at a tertiary care centre in south India. J Dent Med Sci. 2015;14:77-83.

Hungi B, Vinekar A, Datti N, Kariyappa P, Braganza S, Chinnaiah S, et al. Retinopathy of prematurity in a rural neonatal intensive care unit in South India-a prospective study. Indian J Pediatr. 2012;79(7):911-5.

Rekha S, Battu RR. Retinopathy of prematurity: incidence and risk factors. Indian Pediatr. 1996;33(12):999-1003.

Chen ML, Guo L, Smith LE, Dammann CE, Dammann O. High or low oxygen saturation and severe retinopathy of prematurity: a meta-analysis. Pediatr. 2010;125(6):e1483-92.

Murthy KR, Babu K, Benakappa N, Murthy PR. Analysis of risk factors for the development of retinopathy of prematurity in preterm infants at a tertiary referral hospital in South India. Acta Medica Lituanica. 2006;13(3).

Vinekar A, Dogra MR, Sangtam T, Narang A, Gupta A. 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. Indian J Ophthalmol. 2007;55(5):331.

Taqui AM, Syed R, Chaudhry TA, Ahmad K, Salat MS. Retinopathy of prematurity: frequency and risk factors in a tertiary care hospital in Karachi, Pakistan. J Pak Med Assoc. 2008;58(4):186.

Owen LA, Morrison MA, Hoffman RO, Yoder BA, DeAngelis MM. Retinopathy of prematurity: A comprehensive risk analysis for prevention and prediction of disease. PloS One. 2017;12(2):e0171467.

Wu C, Löfqvist C, Smith LE, Vander Veen DK, Hellström A, WINROP Consortium FT. Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants: a multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity. Archives Ophthalmol. 2012;130(8):992-9.