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Retinopathy of prematurity: a study of prevalence and risk factors
Abdel H A A Hakeem1, Gamal B Mohamed, Mohamed F Othman
1Department of Pediatrics, Faculty of Medicine, Al Minia University, Egypt.
Insights
Retinopathy of prematurity (ROP) affects 19.2% of premature infants, with low gestational age and sepsis being key risk factors. Laser therapy effectively treats advanced ROP, preventing blindness.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a critical complication of preterm infant care, posing a significant risk of blindness.
- Early detection and intervention are crucial for managing ROP and preventing vision loss.
Purpose of the Study:
- To determine the prevalence of ROP in preterm infants within a Neonatal Intensive Care Unit (NICU).
- To identify risk factors associated with ROP development.
- To evaluate the outcomes of ROP cases and the effectiveness of treatment.
Main Methods:
- A prospective screening survey of 172 preterm infants (gestational age ≤32 weeks or birth weight ≤1500 g, or >32 weeks/1500 g with >7 days oxygen therapy).
- Retinal evaluations using indirect ophthalmoscopy from the fourth postnatal week.
- Univariate and multivariate analyses to assess perinatal risk factors.
- Laser therapy for infants progressing to stage 3 ROP.
Main Results:
- ROP prevalence was 19.2% (33 out of 172 infants).
- Stage 3 ROP occurred in 6 infants, who received laser therapy.
- Significant risk factors included low gestational age, sepsis, oxygen therapy, and frequent blood transfusions.
- No significant association was found with sex, birth weight, or respiratory support methods.
Conclusions:
- The study identified a 19.2% prevalence of ROP, highlighting low gestational age, sepsis, oxygen therapy, and blood transfusions as significant risk factors.
- Laser therapy demonstrated effectiveness in treating ROP and preventing its progression.
- A nationwide survey in Egypt is recommended to assess regional ROP prevalence differences.
Background:
Retinopathy of prematurity (ROP) is a serious complication of prematurity treatment and can lead to blindness unless recognized and treated early.
Objective:
The objective was to estimate the prevalence of ROP in preterm infants in the Neonatal Intensive Care Unit (NICU), to identify the risk factors which predispose to ROP, and to assess the outcome of these cases.
Materials And Methods:
A ROP prospective screening survey was performed enrolling all prematures admitted to the NICU from January 2009 to December 2010, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whose gestational age was >32 weeks or birth weight was >1500 g were included if they were exposed to oxygen therapy for more than 7 days. A total of 172 infants (84 males and 88 females) had retinal evaluation by indirect ophthalmoscopy from the fourth postnatal week and followed up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed to stage 3 ROP were given laser therapy.
Results:
Out of the studied 172 infants, 33 infants (19.2%) developed ROP in one or both eyes; 18 (54.5%) cases stage 1, 9 (27.3%) cases stage 2, and 6 (18.2%) cases stage 3. None of the studied neonates presented ROP at stages 4 or 5. The six cases diagnosed as ROP stage 3 underwent laser ablative therapy. Univariate analysis showed that there was a significant relationship between the occurrence of ROP and gestational age (P = 0.000), sepsis (P = 0.004), oxygen therapy (P = 0.018), and frequency of blood transfusions (P = 0.030). However, an insignificant relationship was found between the occurrence of ROP and sex, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension, phototherapy, duration of oxygen therapy, mechanical ventilation, and CPAP (all P > 0.05). Gestational age, sepsis, oxygen therapy, and frequency of blood transfusions remained significant variables after logistic regression analysis.
Conclusion:
The prevalence of ROP in this study was 19.2%; low gestational age, sepsis, oxygen therapy, and frequent blood transfusions were significant risk factors for ROP. Laser was effective in treatment and decreasing the progression of ROP. As this is a unit-based study, a comprehensive countrywide survey on ROP in Egypt is recommended to determine any regional differences in disease prevalence.
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