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[Retinopathy of prematurity--frequency and risk factors]
B Slŭncheva1, L Vakrilova, Z Emilova
1University Ob. & Gyn. Hospital Majchin dom, Sofia.
Insights
Retinopathy of prematurity (ROP) affects 11.2% of very low birth weight infants, with severe ROP occurring in 4.2%. Key risk factors include extremely low birth weight and gestational age, necessitating strict neonatal intensive care unit (NICU) monitoring.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
- Public health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature infants.
- Very low birth weight (VLBW) neonates in neonatal intensive care units (NICUs) are particularly susceptible to ROP.
- Effective ROP screening programs are crucial for early detection and intervention.
Purpose of the Study:
- To evaluate the incidence and severity of ROP in a VLBW population.
- To identify primary risk factors associated with ROP development.
- To assess the need for retinal surgery and prophylactic strategies in ROP management.
Main Methods:
- A retrospective study was conducted over three years, analyzing 188 VLBW infants meeting ROP screening criteria.
- Ophthalmic examinations were initiated at three weeks of age and continued bi-weekly until retinal vascularization was complete.
- Data on birth weight, gestational age, and clinical outcomes were collected and analyzed.
Main Results:
- The overall incidence of any stage ROP was 11.2% (21/188), with 4.2% (8/188) having ROP stage ≥3.
- ROP was significantly more prevalent in infants with lower birth weight (mean 982g vs. 1258g) and earlier gestational age (mean 27.9 weeks vs. 30.9 weeks).
- Infants with ROP required longer mechanical ventilation, supplemental oxygen, and had higher rates of bronchopulmonary dysplasia, severe intraventricular hemorrhage (IVH), and neonatal sepsis.
Conclusions:
- The study observed a relatively low frequency and severity of ROP, attributed to stringent NICU care.
- Extremely low birth weight and gestational age are primary risk factors for ROP.
- Severe ROP is often associated with severe respiratory distress syndrome, prolonged ventilation, IVH, and neonatal sepsis, highlighting the need for comprehensive infant monitoring.
Unlabelled:
Retinopathy of prematurity (ROP) is a significant problem in very low birth weight (VLBW) newborns, patients of the neonatal intensive care units (NICU). The aim of the present investigation is to report the results of our ROP-screening program: 1. Current frequency of ROP and the need for retinal surgery; 2. Main risk factors and the prophylactic possibilities for ROP.
Study Design:
This is a retrospective study for 3 years period: 08.'98-07.01. 188 survived premature newborn patients of NICU, "Majchin dom", Sofia, met the criteria for ROP screening. The first eye exam was performed at 3 weeks of age, followed by exams every 2 weeks until complete vascularisation of the retina.
Results:
The incidence of ROP any stage was 11.2% (21 of 188) and 4.2% (8) for stage > or = 3. The mean birth weight of the ROP (+) group was 982 g, the mean gestational age (g.a.)--27.9 g.w., comparing with 1258 g and 30.9 g.w. respectively of the ROP(-) group (p < 0.05). ROP stage > or = 3 was diagnosed as a rule among the newborns with birth weight < 1000 g 14.6% (7 of 48) and g.a. < 28 g.w. (6 of 41). Seven children have undergone successful retinal surgery. The children of ROP(+) group needed significantly longer mechanical ventilation and supplemental O2, they developed more often bronchopulmonary dysplasia and severe grade III-IV IVH, the percent of neonatal sepsis and the need of blood transfusions in the first month was greater too.
Conclusion:
The frequency and severity of ROP in our study is relatively low and that depends on the strict monitoring of the intensive cares. Main risk factors are extremely low birth weight and gestational age; severe RDS with longer duration of mechanical ventilation and supplemental oxygen. Grade III-IV IVH and neonatal sepsis are often a parallel finding with severe ROP. Other risk factors are the greater number of blood transfusions and the developing of chronic lung disease.