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Severe retinopathy of prematurity in big babies in India: history repeating itself?
Parag K Shah1, V Narendran, N Kalpana
1Pediatric Retina Services, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Avinashi Road, Coimbatore 641 014, Tamil Nadu, India. drshahpk@vsnl.net
Insights
Severe retinopathy of prematurity (ROP) is affecting larger, more mature infants in South India. This trend mirrors historical ROP epidemics, necessitating updated oxygenation and screening guidelines to prevent avoidable blindness.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of preventable blindness in preterm infants.
- The epidemiology of severe ROP in South India has not been well-characterized.
- Understanding the characteristics of affected infants is crucial for developing targeted interventions.
Purpose of the Study:
- To characterize infants with severe retinopathy of prematurity (ROP) presenting to a tertiary eye hospital in South India.
- To identify risk factors and clinical features associated with severe ROP in this population.
- To inform public health strategies for ROP prevention and management in the region.
Main Methods:
- Retrospective review of medical records for consecutive preterm infants with severe ROP.
- Data collection spanned from July 2002 to October 2007.
- Severe ROP was defined as high-risk prethreshold disease or worse.
Main Results:
- 144 infants with severe ROP were analyzed.
- Mean gestational age was 30.7 weeks; mean birth weight was 1410 g.
- Most infants received unmonitored supplemental oxygen, a potential contributing factor.
Conclusions:
- South India is observing severe ROP in larger, more mature infants compared to industrialized nations.
- The clinical profile resembles ROP epidemics from the mid-20th century.
- Collaborative guidelines between pediatricians and ophthalmologists are essential to curb this avoidable cause of blindness.
Objective:
To describe the characteristics of babies with severe retinopathy of prematurity (ROP) attending a tertiary referral eye hospital in South India.
Methods:
Data on consecutive preterm infants with severe ROP presenting between July 2002 and October 2007 were retrieved from medical records. Severe ROP was defined as high risk prethreshold disease or worse.
Results:
144 babies with severe ROP were divided into two groups: group 1 had high risk prethreshold or threshold ROP while group 2 had stages 4 or 5 ROP. The overall mean gestational age was 30.7 weeks (range 25-35 weeks) and the mean birth weight was 1410 g (range 650-2310 g). Most babies had received unmonitored supplemental oxygen (ascertained through discussion with the treating pediatricians).
Conclusion:
More bigger and mature babies are developing severe ROP in South India than in industrialized countries. The characteristics of babies affected are similar to those seen during the first epidemic of ROP which occurred during the 1950s in Europe and North America. Guidelines on oxygenation and screening policies should be jointly developed by pediatricians and ophthalmologists to end this epidemic of avoidable blindness in India.
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