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Screening for retinopathy of prematurity: a report from upper Egypt
1Department of Ophthalmology, Minia University Hospital, Al-Minia 61111, Egypt.
Insights
Retinopathy of prematurity (ROP) incidence in Upper Egypt was 36.5%, similar to global rates. A key obstacle to screening was the lack of a national protocol, leading to missed cases.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Effective screening protocols are crucial for early detection and treatment to prevent vision loss.
Purpose of the Study:
- To determine the incidence of ROP in a tertiary neonatal intensive care unit in Upper Egypt.
- To identify challenges encountered during the initial implementation of an ROP screening program.
Main Methods:
- A cohort of 52 premature infants was enrolled and screened for ROP.
- The UK ROP guideline (May 2008) was utilized for infant selection, follow-up, and treatment decisions.
- Infants underwent repeat examinations until complete retinal vascularization.
Main Results:
- The overall incidence of ROP was 36.5%, with various stages observed.
- Gestational age, not birth weight, was significantly correlated with ROP stages.
- Challenges included infant mortality (11.5%), loss to follow-up (30.8%), and successful screening completion for some.
Conclusions:
- The incidence of ROP in this Upper Egypt cohort is comparable to international data.
- The primary barrier to effective ROP screening was the absence of a national protocol, resulting in missed cases.
Aim:
To detect the incidence of retinopathy of prematurity (ROP) in a tertiary referral neonatal intensive care unit in upper Egypt and to describe the obstacles faced during implementing the screening protocol for the first time.
Methods:
Consecutive infants were enrolled at birth and screened for ROP. We used the UK ROP guideline (May 2008) for infant selection, follow up and treatment. Repeat examinations were performed until retinal vascularisation was complete.
Results:
Fifty-two infants were enrolled: 24 males and 28 females. Mean gestational age was 31.3wk (±2.8 SD) and mean birth weight was 1234.6 g (±221.1 SD). Incidence of ROP was 36.5% (stages 1, 2, 3 and 4a were 9.6%, 9.6%, 15.4% and 1.9% respectively), no stages 4b or 5 were found in this series. Six infants (11.5%) died during screening without ROP, 25 infants (48.1%) were discharged from screening with retinal vascularisation reaching zone III, 5 infants (9.6%) were treated with indirect diode with or without additional cryotherapy and 16 infants (30.8%) were lost to follow up. In this series gestational age rather than birth weight was found significantly correlated and predictive (P<0.05) with ROP stages.
Conclusion:
ROP in a single site in Upper Egypt appears to have comparable incidence to other areas worldwide. The main screening obstacle was missing cases due to the absence of a national ROP screening protocol.
