Thrombocytopenia as Type 1 ROP Biomarker: A Longitudinal Study

Area of Science:

• Neonatal Medicine
• Ophthalmology
• Hematology

Background:

• Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
• Early detection and management of ROP are crucial to prevent severe visual outcomes.
• The role of specific blood parameters, particularly platelet count, in ROP development and progression requires further elucidation.

Purpose of the Study:

• To prospectively investigate the association between platelet count and the development/evolution of retinopathy of prematurity (ROP).
• To identify platelet count as a potential biomarker for ROP requiring treatment and its progression.

Main Methods:

• Prospective evaluation of 157 preterm infants screened for ROP.
• Classification into groups: ROP requiring treatment (ROP1), ROP regressed without therapy (ROP2), and no ROP.
• Weekly monitoring of blood parameters, including platelet count, correlated with postmenstrual age and ROP severity.

Main Results:

• Lower mean platelet counts were observed in infants with ROP requiring treatment (ROP1) compared to ROP2 and no-ROP groups (p < 0.001).
• Platelet count at birth below 181 × 10^9/L was significantly associated with Type 1 ROP development and evolution (Sensitivity 76.47%, Specificity 66.12%).
• A notable increase in platelet count (spike) around 36 weeks corrected gestational age preceded the need for treatment in the ROP1 group.

Conclusions:

• Early-life thrombocytopenia (low platelet count) serves as a biomarker for the development and progression of ROP necessitating treatment.
• An increasing platelet count between 35-37 weeks corrected gestational age may indicate impending Type 1 ROP progression in preterm infants.