Screening and management of retinopathy of prematurity at a tertiary health care centre

  • Dr Chethana Warad Assistant Professor, J.N. Medical. College, K.L.E. Academy of Higher Education, Belagavi, Karnataka, India
  • Dr Prakash V Suranagi Ex-Head of the Department of Ophthalmology, S.S.I.M.S & R.C, Davangere, Karnataka. Currently, Specialist Ophthalmology, NMC Royal Medical Centre, Rasal Khaimah, U.A.E
  • Dr B.S. Prasad Principal and Director of Neonatology, SSIMS & RC, Davangere, Karnataka, India
Keywords: Childhood blindness, Retinopathy of Prematurity, Neonates

Abstract

Background: Retinopathy of Prematurity is a serious vaso-proliferative disorder that affects premature babies. ROP is a significant cause of childhood blindness unless recognized and treated timely and adequately.

Objectives: 1) To determine the magnitude of ROP among premature neonates of less than or equal to 36 weeks of gestational age at SSIMS & RC, NICU. 2) To determine its association with certain risk factors. 3) To assess the response to laser photocoagulation given to babies with prethreshold ROP type1 and threshold ROP and APROP cases.

Materials: 1) All premature neonates of either sex less than or equal to 36 weeks of G.A. 2) Birth weight less than or equal to 2000gm. Methods of data Collection: 1) Place of study: SSIMS & RC HOSPITAL, LEVEL3 NICU. 2) Duration of study: 1st DEC 2012 to 30th NOV 2013. 3) Sample Size: 110.

Results: Out of 110 babies screened for ROP 43 (39.1%) of them showed signs of ROP in one or both eyes. Statistical analysis showed that incidence of ROP increased as gestational age decreased and also as birth weight decreased. Oxygen therapy, apnoea, RDS, anaemia, blood transfusion, sepsis were found to be significant risk factors. Out of 43 cases with ROP, 13 cases were treated by diode laser. Signs of regression were noted in all 13 cases.

Conclusion: The prevalence of ROP in this study was 39.1%, indicating that it is quite a significant cause for childhood blindness. Laser treatment has proved that timely intervention can eliminate blindness due to ROP.

Downloads

Download data is not yet available.

References

Azad RV. Retinopathy of prematurity: A text and atlas. Jaypee Brothers; 2006.

Saito Y, Omoto T, Cho Y, Hatsukawa Y, Fujimura M, Takeuchi T. The progression of retinopathy of prematurity and fluctuation in blood gas tension. Graefe’s Arch Clin Exp Ophthalmol. 1993;231(3):151-156.

Gunn TR, Easdown J, Outerbridge EW, Aranda JV. Risk factors in retrolental fibroplasia. Pediat. 1980;65(6):1096-1100.

Prendiville A, Schulenburg WE. Clinical factors associated with retinopathy of prematurity. Arch Dis Child. 1988;63(5):522-527.

Brooks SE, Marcus DM, Gillis D, Pirie E, Johnson MH, Bhatia J. The effect of blood transfusion protocol on retinopathy of prematurity: a prospective, randomized study. Pediatr. 1999;104(3):514-518.

Fellows RR, McGregor ML, Bremer DL, Rogers GL, Miller D. Retinopathy of prematurity in discordant twins. J Pediat Ophthalmol Strabis. 1995;32(2):86-88.

Englert JA, Saunders RA, Purohit D, Hulsey TC, Ebeling M. The effect of anaemia on retinopathy of prematurity in extremely low birth weight infants. J Perinatol. 2001;21(1):21-26. doi: https://doi.org/10.1038/sj.jp.7200511.

Jalali S, Azad R, Trehan HS, Dogra MR, Gopal L, Narendran V. Technical aspects of laser treatment for acute retinopathy of prematurity under topical anesthesia. Indian J Ophthalmol. 2010;58(6):509-515. doi: http://www.ijo.in/text.asp?2010/58/6/509/71689.

Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care centre- incidence, risk factors and outcome. Indian Pediatr. 2009;46(3):219-224.

Gupta VP, Dhaliwal U, Sharma R, Gupta P, Rohatgi J. Retinopathy of prematurity risk factors. Indian J Pediatr 2004;71(10):887-892.

Aggarwal R, Deorari AK et al. Changing profile of retinopathy of prematurity. J Trop Pediatr. 2002;48(4):239-242. doi: https://doi.org/10.1093/tropej/48.4.239.

Varughese S, Jain S, Gupta N, Singh S, Tyagi V, Puliyel JM. Magnitude of the problem of retinopthy of prematurity experience in a large maternity unit with a medium size level-3 nursery. Indian J Ophthalmol. 2001;49(3):187-188.

Yang MB, Donovan EF, Wagge JR. Race, Gender and Clinical Risk Index for Babies (CRIB) Score as Predictors of Severe Retinopathy of Prematurity. J AAPOS. 2006;10(3):253-261. doi: https://doi.org/10.1016/j.jaapos.2006.01.004.

Rekha S, Battu RR. Retinopathy of prematurity: incidence and risk factors. Indian Pediatr 1996;33(12):999-1003.

Clark C, Gibbs JA, Maniello R, Outerbridge EW, Aranda JV. Blood Transfusion: a possible risk factor in retrolental fibroplasia. Acta Pediatr Scand. 1981;(70):535-539. doi: https://doi.org/10.1111/j.1651-2227.1981.tb05736.x.

Cooke RW, Drury JA, Yoxall CW, James C. Blood transfusion and chronic lung disease in preterm infants. Europe J Pediat. 1996;156(1):47-50. doi: https://doi.org/10.1007/s004310050551.

Kavurt S, Özcan B, Aydemir O, Bas AY, Demirel N. Risk of Retinopathy of Prematurity in Small for Gestational Age Premature Infants. Indian Paediat. 2014;51(10):804-806.

Mittal M, Dhanireddy R, Higgins RD. Candida sepsis and association with retinopathy of prematurity. Pediat. 1998;101(4 Pt 1):654–657.

CITATION
DOI: 10.17511/jooo.2019.i07.05
Published: 2019-11-30
How to Cite
Warad, C., V Suranagi, P., & Prasad, B. (2019). Screening and management of retinopathy of prematurity at a tertiary health care centre. Tropical Journal of Ophthalmology and Otolaryngology, 4(7), 425-434. https://doi.org/10.17511/jooo.2019.i07.05
Section
Original Article