Retinopathy of prematurity in a tertiary care hospital in eastern Nepal

World Health Organization's Vision 2020 program has recognized Retinopathy of Prematurity (ROP) as an important cause of childhood blindness in industrialized and developing countries. In the last few years, it has been identified in many under developed countries as well, as a result of improved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitals but there is no published data on this disease. The purpose of this study was to find out the incidence, severity and risk factors of ROP among infants screened in a tertiary care hospital in the Eastern Region of Nepal. A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and, or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination of all babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up till the retinal vascularization was complete. Classification of ROP was done according to international classification (ICROP). Maternal and neonatal risk factors were also noted. A total of 55 babies fulfilled the screening criteria. ROP was present in 25.45% (n=14) of the babies. Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01) and low gestational age (p<0.01) was significantly associated with the incidence of ROP. Oxygen supplementation (p=<0.01) was an independent risk factor. ROP screening should be performed in all preterm low birth weight infants where there is availability of good neonatal intensive care units. The examination should be intensified in those having risk factors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help to establish the screening criteria for Nepalese infants.