Retinopathy of prematurity in neonatal care unit


  • Poonam H. Singh Department of Pediatrics, SMIMER, Surat, Gujarat, India
  • Amita U. Surana Department of Pediatrics, SMIMER, Surat, Gujarat, India
  • Ashwini N. Shah Fellow Intensive Care, Nirmal Hospital, Surat, Gujarat, India



ROP, Risk factors, Prematurity


Background:The objectives of the study were to find the incidence of retinopathy of prematurity and risk factors associated with its development.

Methods: Observational study was carried out at tertiary care hospital. Inclusion criteria: All hospitalized preterm infants with birth weight <1.5 Kg and gestational age ≤32 weeks. Selected preterm 1.5 to ≤2 Kg and gestational age >32 to ≤37 week, with additional risk factors (neonatal & maternal).

Results:The overall incidence of ROP in present study was 21.87%. Of these 14.28% had stage І, 64.28% had stage ІІ ROP and 21.42% had plus disease. ROP was bilateral in all 14 neonates. The incidence was high in ELBW (100%), in the gestational age group 28-30 weeks (61.53%). Among the neonatal risk factors, oxygen therapy was a significant risk factor and chances of developing ROP were increased as duration of oxygen therapy increased (>72 hr) (p=0.0005). Episodes of hyperoxia, >3 episodes (p=0.0002) and hypoxia with 2-3 episodes, (p=0.008) were associated with development of ROP. Acidosis, (p=0.006), NEC (p=0.00002), proven sepsis (p=0.002), hyperbilirubinemia requiring intensive phototherapy (p=0.002), PDA (p=0.0007) and partial parenteral nutrition (p=0.02) were other risk factors associated. Mean NICU stay was longer in patients with ROP (p=0.001). Stage 1 and 2 ROP without plus disease showed spontaneous regression (100%) on follow up. Overall incidence of babies requiring laser treatment was 14.28%.

Conclusions:We should screen all preterm with birth weight <1500 g and gestational age ≤32 weeks, irrespective of risk factors and babies between 1.5 to 2 kg and between 32 and 37 weeks, having risk factors for ROP.


Phan MH, Nguyen PN, Reynolds JD. Incidence and severity of Retinopathy of Prematurity in Vietnam, a developing middle-income country. J Pediatric Ophthalmol Strabismus. 2003;40:208-12.

Flynn JT. Retinopathy of Prematurity. Pediatric Clin N Am. 1987;34:1487-516.

Chawla D, Agarwal R, Deorari AK, Paul VK. Retinopathy of Prematurity. Indian J Pediatric. 2008;75:73-6.

Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of Prematurity in a Tertiary Care centre- Incidence and Risk Factors and Outcome. Indian Pediatric. 2009;33:999-1003.

Pardeep K, Jeeva Sankar M, Deorari AK, Rajvardhan A, Parijat C. Risk Factors for severe Retinopathy of Prematurity in Preterm Low Birth Weight Neonates. Indian J Pediatric. 2011;78(7):812-6.

American Academy of Pediatrics. Screening examination of premature infants for Retinopathy of prematurity. Pediatrics. 2006;108:809-11.

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

Maheshwari R, Kumar H, Paul VK, Singh M, Deorari AK, Tiwari AK. Incidence and risk factors of Retinopathy of prematurity in a tertiary care newborn unit in New Delhi. Nall Med J Ind. 1996;9(5):211-4.

Schalij-Delfos NE, Zijlmans BL, Wittebol-Post D, Tan KE, Cats BP. Screening for retinopathy of prematurity: do former guidelines still apply? J Pediatr Ophthalmol Strabismus. 1996;33(1):35-8.

Chye JK, Lim CT, Leong HI, Wong PK. Retinopathy of prematurity in very low birth weight infants. Ann Acad Med Singapore. 1996;28(2):193-8.

Nair PM, Ganesh A, Mitra S, Ganguly SS. retinopathy of prematurity in VLBW and ELBW babies. Indian J Pediatric. 2003;70:303-6.

Patil J, Deodhar J, Wagh S, Pandit AN. High risk factors for development of retinaopathy of prematurity. Indian pediatrics. 1997;34:1024-7.

Darwani S, Parwani S, Jain S. Fundus examination for retinopathy of prematurity. Indian pediatrics. 1996;33:250-2.

Gharaibeh A, Khassawneh M, Khriesat W, Alkhatib S, Migdadi Y. Adopting western Retinopathy of prematurity Screening Programs in Eastern Countries, are we screening properly? Middle East African Journal of Ophthalmology. 2011;18(3):209-13.

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

Aggarwal R, Deorari AK, Azad RV, Kumar H, Talwar D, Shethi AI. Changing profile of retinopathy of prematurity. Trop pediatric. 2002;48:239-42.

Shah VA, Yeo CL, Ling YLF, Ho LY. Incidence, risk factors of retinopathy of prematurity among very low birth weight infants in Singapore. Ann Acad Med Singapore. 2005;34:169-78.

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

Saili A, Bhat S, Shenoi A. Guha’s neonatology, principal and practice, 3rd edition volume 2, chapter 85, retinopathy of prematurity. page no: 114373.

Dutta S, Narang A, Dogra MR, Gupta A. Risk factors of threshold retinopathy of prematurity. Indian Pediatr. 2004;41:665-71.

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.

Hussain N, Clive J, Bhandari V. Current incidence of retinopathy of prematurity, 1989-1997. 1999;104(3):e26.

Murthy KR, Nagendra, Murthy PR, Babu K, Benekappa N, Niranjan. Analysis of risk factors for the development of retinopathy of prematurity in preterm infants at tertiary referral hospital in south India. Acta Med Lituanica. 2006;13(3):147-51.

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.

Lucey JF Dangman B. A reexaminatiuon of the role of oxygen in retrolental fibroplasias. Pediatrics. 1984;73:82-96.

Phleps DL. Retinopathy of prematurity. Pediatric Clinic North AM. 1993;40:705-14.

Al-Essa M, Rashwan N, Al-Ajmi M. Retinopathy of prematurity in infants with birth weight above 1500 grams. East Afr Med J. 2000;77:562-4.

Sashidharan CK, Kuamr MS, Anoop P, Symala B, Das BN. spontaneous regression of ROP. Indian J pediatrics. 2003;70:369-60.






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