Volume 25 Issue 3
Risk Factors of and Screening Protocol for Retinopathy of Prematurity
Komal Usha Madineni, Swathi Padankatti, Kuruvilla Thomas
Abstract
Background: Retinopathy of prematurity (ROP) is a vasoproliferative retinal disorder that affects premature low-birth-weight neonates and is a leading cause of preventable blindness.
Aim: To determine the incidence of ROP in a level 3 NICU, and to study the outcome and risk factors of ROP in preterm neonates
Materials and Methods: Overall, 107 preterm neonates born at < 34 weeks of gestational age (GA) and with a birth weight < 2,000 g were included. The ROP screening reports of the preterm neonates admitted to the NICU between January 2011 and December 2014 were analyzed. All the preterm neonates admitted to the NICU during January to December 2015 were subjected to ROP screening according to the established protocol and followed up. The data obtained were statistically analyzed.
Results: The incidence of ROP was found to be 16%, and 11.2% of them required laser ablation. ROP regressed after laser ablation. Apnea of prematurity (P < .05) and multiple births (P < .05) were the only risk factors that had a significant independent association with ROP. GA ≤ 28 weeks was a significant risk factor for the development of ROP on univariate analyses. Because of multicollinearity, GA was not considered for multiple logistic regression analyses. Birth weight < 1,500 g, need for mechanical ventilation, prolonged oxygen therapy, anemia, blood transfusion, and use of FiO2 > 40% did not show significance on multiple variable logistic regression analyses.
Conclusion: The incidence of ROP increased with decreasing birth weight, with the highest incidence seen in neonates having birth weight < 1,000 g. Timely retinal screening according to guidelines can help identify all neonates at the stage of prethreshold type 1 ROP. A carefully timed retinal examination of at-risk neonates (determined by a pediatrician and done by an ophthalmologist) helps in preventing neonates from developing advanced ROP and its sequelae.
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