A study of risk factors and their correlation with severity of retinopathy of prematurity: a prospective study

Authors

  • Bhuvaneshwari C. Yelameli Department of Pediatrics, S. N. Medical College, Bagalkot, Karnataka, India
  • Ramesh V. Neelannavar Department of Pediatrics, S. N. Medical College, Bagalkot, Karnataka, India
  • Kiruthika Das Department of Pediatrics, S. N. Medical College, Bagalkot, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20204039

Keywords:

Retinopathy of prematurity, Blindness, Infants, Proforma, Screening

Abstract

Background: Recent advances in neonatal care in the last decade and improved survival rates have resulted in an apparent increase in the incidence of retinopathy of prematurity (ROP), which is the most important cause of preventable blindness in infants. This study was done to identify the risk factors which predispose to ROP and to assess its correlation with severity of ROP.

Methods: A total of 140 neonates with gestational age ≤34 weeks, birth weight ≤2000 grams who were admitted at NICU, S. N. Medical College and HSK Hospital, Bagalkot from December 2018 to May 2019 were considered. Babies were assessed and recorded for the risk factors of ROP in a predesigned proforma. ROP screening was performed using wide-field digital imaging on a retcam shuttle (Clarity MSI, USA).

Results: A total of 140 babies were examined, and an overall incidence of ROP was 52 (37.1%). 17 (32.7%) had stage 3, 3 (5.8%) had stage 4, and 1 (1.9%) had stage 5. Among the 52 babies with ROP, 19 (51.3%) underwent laser photoablation. Risk factors like gestational age, birth weight, maternal risk factors, apnea, intrauterine growth restriction (IUGR), hypoglycaemia, respiratory distress syndrome (RDS), sepsis, coronary heart disease (CHD), blood transfusion and oxygen requirement duration were significantly associated with ROP. Delay in the establishment of feeds has been associated with ROP (p<0.001).

Conclusions: Screening should be intensified in the presence of risk factors which can reduce the incidence of severe stages of ROP as highlighted by this study.

References

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

Solebo AL, Teoh L, Rahi J. Epidemiology of blindness in children. Arch Dis Child. 2017;102(9):853-7.

Ali MA, Begum R, Rahman F. Retinopathy of Prematurity: Incidence and Risk Factor: A Hospital-Based Study. J Clin Neonatol. 2012;18(7):5-12.

Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74(1):35-49.

Kong L, Fry M, Al-Samarraie M, Gilbert C, Steinkuller PG. An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS. 2012;16(6):501-7.

Fierson WM. Screening examination of premature infants for retinopathy of prematurity. The American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology. Pediatrics. 2001;108:809-11.

Bossi E, Koerner F. Retinopathy of prematurity. Intens Care Med. 1995;21(3):241-6.

Rao N, Wu G. Oxygen free radicals and retinopathy of prematurity. Brit J Ophthalmol. 1996;80(5):387.

Gilbert C, Fielder A, Gordillo L, Quinn G, Semiglia R, Visintin P, et al. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics.2005;115(5):e518-e25.

Terry T. Fibroblastic overgrowth of persistent tunica vasculosa lentis in infants born prematurely: II. Report of cases-linical aspects. Trans Am Ophthalmol Soc. 1942;40:262.

Gilbert C, Awan H. Blindness in children. BMJ. 2003;327(7418):760-1.

Rowlands E, Ionides A, Chinn S, Mackinnon H, Davey C. Reduced incidence of retinopathy of prematurity. Br J Ophthalmol. 2001;85(8):933-5.

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.

ARI RM, Kumar H, Paul V, Singh M, Deorari A, Tiwari H. Incidence and risk factors of retinopathy of prematurity in a tertiary care newborn unit in New Delhi. Natl Med J India. 1996;9(5):211.

Sanghi G, Dogra MR, Das P, Vinekar A, Gupta A, Dutta S. Aggressive posterior retinopathy of prematurity in Asian Indian babies: spectrum of disease and outcome after laser treatment. Retina. 2009;29(9):1335-9.

Jalali S, Matalia J, Hussain A, Anand R. Modification of screening criteria for retinopathy of prematurity in India and other middle-income countries. Am J Ophthalmol. 2006;141(5):966-8.

Phan MH, Nguyen PN, Reynolds JD. Incidence and severity of retinopathy of prematurity in Vietnam, a developing middle-income country. J Pediatr Ophthalmol Strabismus. 2003;40(4):208-12.

Chen Y, Li X. Characteristics of severe retinopathy of prematurity patients in China: a repeat of the first epidemic? Br J Ophthalmol. 2006;90(3):268-71.

Austeng D, Källen KB, Ewald UW, Jakobsson PG, Holmström GE. Incidence of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden. Arch Ophthalmol. 2009;127(10):1315-9.

Dutta S, Narang S, Narang A, Dogra M, Gupta A. Risk factors of threshold retinopathy of prematurity. Indian Pediatr. 2004;41(7):665-72.

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

Aggarwal R, Deorari AK, Azad R, Kumar H, Talwar D, Sethi A, et al. Changing profile of retinopathy of prematurity. J Trop Pediatr. 2002;48(4):239-42.

Charan R, Dogra M, Gupta A, Narang A. The incidence of retinopathy of prematurity in a neonatal care unit. Indian J Ophthalmol. 1995;43(3):123.

Higgins RD, Mendelsohn AL, DeFeo MJ, Ucsel R, Hendricks-Munoz KD. Antenatal dexamethasone and decreased severity of retinopathy of prematurity. Arch Ophthalmol. 1998;116(5):601-5.

Hammer ME, Mullen PW, Ferguson JG, Pai S, Cosby C, Jackson KL. Logistic analysis of risk factors in acute retinopathy of prematurity. Am J Ophthalmol. 1986;102(1):1-6.

Purohit DM, Ellison RC, Zierler S, Miettinen OS, Nadas AS. Risk factors for retrolental fibroplasia: experience with 3,025 premature infants. Pediatrics. 1985;76(3):339-44.

Sacks LM, Schaffer DB, Anday EK, Peckham GJ, Delivoria-Papadopoulos M. Retrolental fibroplasia and blood transfusion in very low-birth-weight infants. Pediatrics. 1981;68(6):770-4.

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(3):187.

Pierce EA, Foley ED, Smith LE. Regulation of vascular endothelial growth factor by oxygen in a model of retinopathy of prematurity. Arch Ophthalmol. 1996;114(10):1219-28.

Manzoni P, Maestri A, Leonessa M, Mostert M, Farina D, Gomirato G. Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates. J Perinatol. 2006;26(1):23-30.

Procianoy RS, Garcia‐Prats JA, Hittner HM, Adams JM, Rudolph AJ. An association between retinopathy of prematurity and intraventricular hemorrhage in very low birth weight infants. Acta Pædiatrica. 1981;70(4):473-7.

Shohat M, Reisner SH, Krikler R, Nissenkorn I, Yassur Y, Ben-Sira I. Retinopathy of prematurity: incidence and risk factors. Pediatrics. 1983;72(2):159-63.

Gunn TR, Easdown J, Outerbridge EW, Aranda JV. Risk factors in retrolental fibroplasia. Pediatrics. 1980;65(6):1096-100.

Porcelli PJ, Weaver RG, Jr. The influence of early postnatal nutrition on retinopathy of prematurity in extremely low birth weight infants. Early Hum Dev. 2010;86(6):391-6.

Downloads

Published

2020-09-21

Issue

Section

Original Research Articles