Incidence and risk factors for retinopathy of prematurity at a medical college hospital in rural Tamil Nadu, India

Authors

  • Sengodi Elumalai Department of Paediatrics, Government Thiruvannamalai Medical College, Thiruvannamalai, Tamil Nadu
  • Rajasekaran Kathavarayan Department of Paediatrics, Government Thiruvannamalai Medical College, Thiruvannamalai, Tamil Nadu
  • Venkatesh Govindasamy Department of Community Medicine, Government Thiruvannamalai Medical College, Thiruvannamalai, Tamil Nadu

DOI:

https://doi.org/10.18203/2349-3291.ijcp20204410

Keywords:

Prematurity, Retinopathy, Oxygen use, Sepsis

Abstract

Background: The objective of the research was to evaluate the incidence of retinopathy of prematurity (ROP), association of prenatal and postnatal risk factors, pattern of ROP and treatment outcomes among infants admitted to neonatal intensive care unit (NICU) of tertiary care center located in Thiruvannamalai, Tamil Nadu.

Methods: A retrospective study done in all infants admitted between April 2019 and March 2020 who met the criteria for ROP screening with gestational age (GA) less than or equal to 36 weeks or birth weight less than 2000 grams or with GA more than 36 weeks and birth weight more than 2000 gram with significant risk factors like intrauterine growth restriction, respiratory distress syndrome, sepsis, long term oxygen use, phototherapy, blood transfusion and maternal anemia. Treatment was offered to infants with stage 3 ROP and stage 2 in zone 2 with or without plus disease. Qualified infants were treated with argon laser photocoagulation within 72 hours of diagnosis. They were followed until the disease was successfully treated.

Results: Out of total 3121 neonates, 717 neonates met the screening criteria. Incidence of ROP was found to be 33% (n=237). 46.4% (n=110) of ROP belongs to 32-36 weeks GA. 42.6% (n=101) of ROP belongs to 1500-2000 gm birth weight.

Conclusions: Incidence of ROP is quite high in high risk neonates in our unit. Significant risk factors are long term oxygen use, blood transfusion and sepsis.

Author Biographies

Sengodi Elumalai, Department of Paediatrics, Government Thiruvannamalai Medical College, Thiruvannamalai, Tamil Nadu

Assistant professor

Dept of pediatrics

Govt tiruvannamalai medical college 

Tiruvannamalai,tamil nadu

Rajasekaran Kathavarayan, Department of Paediatrics, Government Thiruvannamalai Medical College, Thiruvannamalai, Tamil Nadu

Assistant professor

Dept of pediatrics

Govt tiruvannamalai medical college 

Tiruvannamalai,tamil nadu

Venkatesh Govindasamy, Department of Community Medicine, Government Thiruvannamalai Medical College, Thiruvannamalai, Tamil Nadu

Assistant professor

Dept of Community Medicine

Govt tiruvannamalai medical college 

Tiruvannamalai,tamil nadu

References

Dandona R, Dandona L, Srinivas M, Sahare P. Refractive error in children in an rural population in India. Invest Opthalmol Vis Sci. 2002;43:615-22.

World Health Organization. Cumulative official update to ICD- Feb 2009. Available at: http://www.who.int/classification/icd/official updates combined 1996 -2008. Accessed on 25 July 2015.

Murthy GVS. Magnitude and temporal trends in avoidable blindness in children (ABC) in India. Indian J Petiatr. 2017;84:924-9.

Dandona L, Williams JD, Williams BC, Rao GN. Population based assessment of childhood blindness in Southern India. Arch Opthalmol. 1998;116:545-6.

Titiyal JS, Murthy GVPN, Gupta SK, Tandom R, Vajpayee RB. Causes and Temporal trends of blindness and severe visual impairment in children in school for the blind in North India. Br J Opthalmol. 2003;87:941-5.

Rahi JS, Sripathi S, Gilbert CE, Foster A. Childhood blindness: a new born for recording causes of visual loss in children. Bull World Health Organ. 1993;71:485-9.

Ahmed MA, Duncan M, Kent A, NICUS Group. Incidence of Retinopathy of prematurity requiring treatment in infants born greater than 30 weeks gestation and with a birth weight Greater than 1250 gm from 1998 to 2002; a regional study. J Paediatr Child Health. 2006;42(6):337-40.

Azad R. Prevention of blindness due to Retinopathy of Prematurity: A national movement. Indian J Pediatr. 2014;81:1373-5.

Puri S, Sarpal S, Ashat M. Screening of Retinopathy of Prematurity: A neglected public health issue. Ann Med health Sci Res. 2014;4:65.

Karna P, Muttineni J, Angell L, Karmaus W. Retinopathy of Prematurity and risk factors: A Prospective cohort study. BMC Pediatr. 2005;5:18.

Pejaver RK, Vinekar A, Bilagi A. National Neonatology Foundation`s Evidence-Based Clinical Practice Guidelines 2010. Retinopathy of Prematurity. Available at: http://www.ontop-in.org/ontop-pen/week-12-13/ROPNNFGuidelines.pdf. Accessed on 21 May 2019.

Project operational guidelines. Prevention of blindness from Retinopathy of Prematurity in Neonatal Care Units. Available at: http://phfi.org/wp-content/uploads/2019/05/2018-ROP-operational-guidelines.pdf. Accessed on 21 May 2019.

Shah VA, Yeo CL, Ling YL, 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.

Azad R, Chandra P. Retinopathy of Prematurity. J Indian Med Assoc. 2005;103:370-2.

Austeng D, Kallen KB, Ewald UW, Jakobson PG, Holmstrom GE. Incidence of Retinopathy of Prematurity in Infants born before 27 weeks gestation in Sweden. Arch Opthalmol. 2009;127(10):1315-9.

Binkhathlan AA, Almahmoud LA, Saleh MJ, Srungeri S. Retinopathy of Prematurity in Saudi Arabia: Incidence, risk factors and the applicability of current screening criteria. Br J Opthalmol. 2008;92(2):167-9.

Fierson WM, American Academy of Pediatrics section on Ophthalmology, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Association of Certified Orthoptists. Screening of Premature infants for retinopathy of prematurity. Pediatrics. 2018;142:2018-3061.

Wilkinson AR, Haines L, Head L, Fielder AR. UK retinopathy of prematurity guideline. Eye. 2009;23:2137-9.

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;79:911-5.

Gopal L, Sharma T, Ramachandran S. Retinopathy of Prematurity: A Study in Indian J Ophthalmol. 1995;43:59-61.

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;141:966-8.

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 centre in a developing country. Indian J Opthalmol. 2007;55:331-6.

Shah PK, Narendran V, Saravanan VR, Raghuram A, Chattopadhyay A, Kashyap M, et al. Fulminate retinopathy of prematurity: Clinical characteristics and laser outcome. Indian J Ophthalmol. 2005;53:261-5.

Cavallaro G, Fillipi L, Bangoli P, La Marca G, Cristofori G, Raffaeli G, et al. The pathophysiology of retinopathy of prematurity: an update of previous and recent knowledge. Acta Ophtalmol. 2014;92:2-20.

Freitas AM, Morschbacher R, Thorell MR, Rhoden EL. Incidence and risk factors for retinopathy of prematurity: a retrospective cohort study. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 5984384/. Accessed on 11 September 2020.

Murthy KR, Murthy PR, Shah DA, Nandan MR, Niranjan HS, Benakappa N. Comparison of profile of retinopathy of prematurity in semiurban / rural and urban NICUs in Karnataka, India. Br J Ophthalmol. 2013;97:687-9.

Murthy KR, Babu K, Benakappa N, Murthy PR, Niranjan N. Analysis of risk factors for the development of retinopathy of prematurity in preterm infants at a tertiary referral hospital in South India. Acta Med Litu. 2006;13:147-51.

Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of Prematurity in atertiary care centre-Incidence, risk factors and outcome. Indian Pediatr. 2009;46:219-24.

Ashok KM, Rajalakshmi AR, Gunasekaran D, Sreeraaganidhi. A study of risk factors for retinopathy of prematurity in a medical college hospital in South India to evaluate the criteria for screening for retinopathy of prematurity. J Curr Trends Clin Med Lab Biochem. 2014;2:31-6.

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

Chang JW. Risk factor analysis for the development and progression of retinopathy of prematurity. PLoS ONE. 2019;14(7):0219934.

Yau GS, Lee JW, Tam VT, Yip S, Cheng E, Liu CC, et al. Incidence and risk factors for retinopathy of prematurity in multiple gestations: a Chinese population study. Medicine (Baltimore). 2015;94(18):867.

Slidsborg C, Jensen A, Forman JL, Rasmussen S, Bangsgaard R, Fledelius HC, et al. Neonatal Risk Factors for Treatment-Demanding Retinopathy of Prematurity: A Danish National Study. Ophthalmology. 2016;123(4):796-803.

Hesse L, Eberl W, Schlaud M, Poets CF. Blood transfusion. Iron load and retinopathy of prematurity. European journal of pediatrics. 1997;156(6):465-70.

Huang J, Tang Y, Zhu T, Li Y, Chun H, Qu Y, Mu D. Cumulative evidence for association of sepsis and retinopathy of prematurity. Medicine. 2019;98:42(e17512).

Bas AY, Demirel N, Koc E, Ulubas Isik D, Hirfanoglu İM, Tunc T, et al. Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units. Br J Ophthalmol. 2018;102:1711-6.

Reyes ZS, Al-Mulaabed SW, Bataclan F, Montemayor C, Ganesh A, Al-Zuhaibi S, et al. Retinopathy of prematurity: revisiting incidence and risk factors from Oman compared to other countries. Oman J Ophthalmol. 2017;10:26-32.

Araz-Ersan B, Kir N, Akarcay K, Aydinoglu-Candan O, Sahinoglu-Keskek N, Demirel A, et al. Epidemiological analysis of retinopathy of prematurity in a referral centre in Turkey. Br J Ophthalmol. 2013;97:15-7.

Küçükevcilioglu M, Mutlu FM, Sarici SU, Ceylan OM, Altınsoy HI, Kılıç S, et al. Frequency, risk factors and outcomes of retinopathy of prematurity in a tertiary care hospital in Turkey. Turkish J Pediatr. 2013;55:467-74.

Abdel HA, Mohamed GB, Othman MF. Retinopathy of prematurity: a study of incidence and risk factors in NICU of Al-Minya University Hospital in Egypt. J Clin Neonatol. 2012;1:76-81.

Chen M, Citil A, McCabe F, Leicht KM, Fiascone J, Dammann CE, et al. Infection, oxygen, and immaturity: interacting risk factors for retinopathy of prematurity. Neonatology. 2011;99:125-32.

Mutlu FM, Altinsoy HI, Mumcuoglu T, Kerimoglu H, Kiliç S, Kul M, et al. Screening for retinopathy of prematurity in a tertiary care newborn unit in Turkey: frequency, outcomes, and risk factor analysis. J Pediatr Ophthalmol Strabismus. 2008;45:291-8.

Downloads

Published

2020-10-21

Issue

Section

Original Research Articles