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Frequency and Risk Factors for Retinopathy of Prematurity (ROP) in Neonates in NICU of Mymensingh Medical College
M S Islam1, M N Islam, K Chakroborty
1Dr Md Shahinul Islam, Assistant Professor (Paediatrics) In Situ, Saltha Upazila Health Complex, Saltha, Faridpur, Bangladesh;
Insights
Retinopathy of prematurity (ROP) affects 27.5% of neonates in a Bangladesh NICU. Early screening and intervention are crucial for preventing childhood blindness from ROP.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of preventable childhood blindness globally.
- Advancements in neonatal care increase survival rates of premature infants, leading to a rise in ROP incidence.
- Understanding ROP frequency and risk factors in specific regions is vital for targeted interventions.
Purpose of the Study:
- To determine the frequency of retinopathy of prematurity (ROP) in neonates admitted to the Neonatal Intensive Care Unit (NICU) of Mymensingh Medical College Hospital (MMCH), Bangladesh.
- To identify key risk factors associated with ROP development in this specific patient population.
- To evaluate the immediate outcomes and treatment needs for ROP cases.
Main Methods:
- A prospective observational study conducted from July 2020 to June 2022 at MMCH, Bangladesh.
- Inclusion of 171 neonates meeting specific criteria, with ROP screening following the Bangladesh Medical University (BMU) protocol.
- Data collection on birth weight, ROP stage, zone, plus disease, aggressive posterior ROP (AP-ROP), treatment requirements, and outcomes.
Main Results:
- The overall frequency of retinopathy of prematurity (ROP) was found to be 27.5% among the 171 evaluated neonates.
- ROP was more prevalent in neonates with a birth weight below 1000 grams.
- Stage 2 ROP was most common; Zone I plus disease occurred in 21 cases and aggressive posterior ROP (AP-ROP) in 14. 31.9% required intravitreal bevacizumab, while 61.7% needed only follow-up.
Conclusions:
- A significant proportion of premature neonates in this Bangladeshi NICU developed ROP, highlighting the need for vigilant screening.
- Lower birth weight (<1000gms) emerged as a key risk factor for ROP.
- Timely screening, intervention, and monitoring are essential to reduce vision-threatening complications and prevent long-term childhood blindness due to ROP.
Abstract:
Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness in both developed and developing countries. With the advancement of neonatal health services, premature babies are now surviving more and at the same time the incidence of retinopathy of prematurity is increasing simultaneously. The aim of this study was to find out the frequency and risk factors of retinopathy of prematurity in neonates in NICU of Mymensingh Medical College Hospital (MMCH), Bangladesh. This was a prospective observational study and was carried out in the Department of Neonatology, MMCH, Bangladesh with the collaboration of Dr K Zaman BNSB Eye Hospital, Mymensingh from July 2020 to June 2022. Considering all inclusion and exclusion criteria, total 171 neonates were evaluated in this study. ROP screening was performed as per Bangladesh Medical University (BMU) protocol. Among 171 study neonates, 47 developed ROP. The overall frequency of retinopathy of prematurity was 27.5%. Stage 1-4 ROP was identified across affected neonates, with most in stage 2 and zone I plus disease occurred in 21 cases and AP-ROP in 14. In this study frequency of ROP was higher in <1000gms birth weight group. Among affected infants, 31.9% required intravitreal bevacizumab, while most (61.7%) needed follow-up only. Among 47 ROP patients, 18 received treatment and 29 patients needed follow up. The overall frequency of ROP was 27.5%. All ROP patients had immediate good outcome. Early screening, timely intervention and strict monitoring of high-risk neonates can significantly reduce vision-threatening complications and long-term childhood blindness.
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