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Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study
1Department of Ophthalmology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa. eyemay@absamail.co.za
Insights
Retinopathy of prematurity (ROP) affects 16.3% of infants screened, with a projected threshold ROP (tROP) rate of 2.9%. Lowering the birth weight screening criterion to 1250g is suggested for this population.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of childhood blindness.
- ROP is increasingly observed in urban African areas with neonatal care facilities.
- Current screening criteria for ROP may not be optimal for all populations.
Purpose of the Study:
- To determine the frequency of ROP in a specific patient cohort.
- To evaluate the applicability of existing ROP screening criteria.
- To identify optimal screening parameters for ROP in the studied population.
Main Methods:
- Screening of infants with birth weight ≤1500g and/or gestational age ≤32 weeks.
- A single examiner conducted ROP screenings over 2.5 years.
- Analysis of ROP prevalence and progression to threshold disease (tROP).
Main Results:
- ROP was detected in 16.3% of 514 infants.
- 1.6% of the total cohort had threshold ROP (tROP).
- Lowering the birth weight criterion to 1250g showed no tROP, suggesting its potential safety.
Conclusions:
- The estimated tROP rate is comparable to that in other Black populations.
- Gestational age was found to be an unreliable risk parameter for ROP in this cohort.
- The study suggests safely lowering the birth weight screening criterion for ROP to 1250g.
Background And Objectives:
World Health Organization's vision 20/20 programme has recognized retinopathy of prematurity (ROP) as an important cause of childhood blindness in industrialized and middle-income countries. While ROP is virtually nonexistent in many African countries, ROP is seen in urban areas where facilities for neonatal care exist. The aim of this study is to establish the frequency of ROP in a cohort of patients screened for ROP and to establish if current screening criteria apply to our patients.
Patients And Methods:
Infants with birth weight (BW) of 1500 g or less and/or gestational age of 32 weeks or less were screened for ROP over a 2(1/2)-year period by a single examiner.
Results:
ROP was observed in 84 of 514 (16.3%) of infants included for analysis. Threshold disease (tROP) was noted in 1.6% of the total cohort although 41/84 babies with ROP were lost prior to regression or progression to tROP. Of the 43/84 adequately followed up, eight (18.6%) developed tROP. An estimated frequency of tROP was more likely to be 2.9%. There was no tROP noted in babies of BW greater than 1250 g. Gestational age was an unreliable risk parameter in our population.
Conclusion:
The projected occurrence rate of tROP is similar to that found in black population in the Multicentre Cryotherapy for ROP Trial. Our data suggest that the screening criterion based on BW can safely be lowered to 1250 g in our population.
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