DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20194989

A clinical study on retinopathy of prematurity in a tertiary care centre

Ramamani Dalai, Kedarnath Das, Diptimayee Nayak, Mangal Charan Murmu, Prasanta Kumar Nanda

Abstract


Background: Retinopathy of prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with decreasing gestational age. India shares 20% of the world childhood blindness. Besides congenital cataract, congenital glaucoma and ocular injuries, ROP is emerging as one of the important causes of childhood blindness in India.

Methods: This hospital based prospective study was undertaken during October 2016 to September 2018 in the Department of Ophthalmology, SCB Medical College. Authors included (a) all preterm infants weighing less than 1750gm or gestational age less than 34 weeks at birth, (b) infants with birth weight between 1750gm to 2000gm and gestational age more than 34 weeks (late preterm and term infants) those were considered as high risk.

Results: Among the 328 babies included in our study, the incidence of ROP was 29.57%. Bilateral ROP was found in 76.29% with nearly equal stages in both eyes and only 23 neonates showed unilateral involvement.

Conclusions: Low birth weight, lower gestational age, blood transfusion, Respiratory Distress Syndrome (RDS), apnoea, supplemental oxygen therapy, maternal anaemia and gestational diabetes mellitus (GDM) were strongly associated with development of ROP.


Keywords


Hyperoxia, Lasers, Retinopathy of prematurity, Risk factors

Full Text:

PDF

References


Ertl T, Gyarmati J, Gaál V, SzabóI.Relationship between hyperglycemia and retinopathy of prematurity in very low birth weight infants. Biol Neonate. 2006;89(1):56-9.

Hartnett ME. Pathophysiology and mechanisms of severe retinopathy of prematurity. Ophthalmology. 2015 Jan 1;122(1):200-10.

Walter M. Fierson Screening Examination of Premature Infants for Retinopathy of Prematurity Pediatrics American Academy of Pediatrics Section on Ophthalmology, american academy of ophthalmology, american association for pediatric ophthalmology and strabismus, american association of certified orthoptists December 2018, 142;6:117(2):572

Shah VA1, Yeo CL, Ling YL, Ho LY. Incidence, risk factors of retinopathy of prematurity among very low birth weight infants in Singapore. Ann Acad Med Singapore. 2005 Mar;34(2):169-78.

Adhikari S , Badhu BP , Bhatta NK , Rajbhandari RS , Kalakheti BK , Retinopathy of prematurity in a tertiary care hospital in eastern Nepal, JNMA; Journal of the Nepal Medical Association 01 Jan 2008, 47(169):24-7.

Palmer EA, Results of U.S. randomized clinical trial of cryotherapy for ROP (CRYO-ROP), Doc Ophthalmol. 1990 Mar;74(3):245-51

Teoh SL, Boo NY, Ong LC, Nyein MK, Lye MS, Au MK. Duration of oxygen therapy and exchange transfusion as risk factors associated with retinopathy of prematurity in very low birthweight infants. Eye. 1995;9(6):733-7.

Chaudhuri S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care center-incidence, risk factors and outcome. Indian Pediar. 2009;46(3):219-24.

Ng YK, Fielder AR, shaw DE, Levene MI. Epidemiology of retinopathy of prematurity. Lancet. 1988;2(8622):1235-1238.

Holmstrom G, el AzaziM, Jacobson L, Lennerstrand G. A population based, prospective study of the development of ROP in prematurely born children in the Stockholm area of Sweden. Br J Ophthalmol, 1993;77(7):417-23.

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

Sood V, Chellani H, Arya S, Guliani BP. Changing spectrum of retinopathy of prematurity (ROP) and variations among siblings of multiple gestation. The Ind J Pediatr. 2012 Jul 1;79(7):905-10.

Hungi B, Vinekar A, Datti N, Kariyappa P, Braganza S, Chinnaiah S, et al. Retinopathy of Prematurity in a rural Neonatal Intensive Care Unit in South India--a prospective study. Indian J Pediatr. 2012 Jul;79(7):911-5.

Gopal L, Sharma T, Ramachandran S, Shanmugasundaram R, Asha V. Retinopathy of Premaurity-a study. Ind J Opthalmol 1995;43(2):59-61.

Gupta VP, Dhaliwal U, Sharma R, Gupta P, Rohatgi J. Retinopathy of prematurity-risk factors. Indian J Pediatr. 2004;71:887-92.

Maheswari R, Kumar H, Paul VK, Singh M, deorari AK, Tiwari HK. Incidence and risk factors of Retinopathy of prematurity in a tertiary care newborn unit in New Delhi. Natl Med J india. 1996; 9(5):211-4.

Charan R, Dogra MR, Gupta A, Narang A. The incidence of retinopathy of prematurity in a neonatal care unit. Ind J Ophthalmol. 1995 Jul 1;43(3):123.

Fielder AR, Shaw DE, Robinson J, Ng YK, Natural history of retinopathy of prematurity: a prospective study, Eye (Lond). 1992;6(3):233-42.

Hussain N, Clive J, Bhandori V. Current incidence of retinopathy of prematurity, 1989-1997. Pediatr. 1999 Sep;104(3):e26.

Nødgaard H, Andreasen H, Hansen H, Sørensen HT. Risk factors associated with retinopathy of prematurity (ROP) in Northern Jutland, Denmark 1990-1993. Acta Ophthalmol Scand. 1996;74(3):306-10.

Yang CS, Chen SJ, Lee FL, Hsu WM, Liu JH. Retinopathy of prematurity: screening, incidence and risk factors analysis. Chinese Medical Journal (Taipei) 2001;64:706-12.

Kim HY, Yu YS. Retinopathy of prematurity-mimicking retinopathy in full-term babies. Korean J Ophthalmol. 1998 Dec 1;12(2):98-10234.

Chen LN, He XP, Huang LP. A survey of high risk factors affecting retinopathy in full-term infants in China. Int J Ophthalmol. 2012;5(2):177.

Ratra D, Akhundova L, Das MK. Retinopathy of prematurity like retinopathy in full-term infants. Oman J Ophthalmol. 2017 Sep;10(3):167.

Patz A, Hoeck LE, De La Cruz E. Studies on the Effect of High Oxygen Administration in Retrolental Fibroplasia: I. Nursery Observations. Am J Ophthalmol. 1952 Sep 1;35(9):1248-53.

Saugstad OD. Bronchopulmonary dysplasia-oxidative stress and antioxidants. Semin Neonatol. 2003;8:39-49.

Smith J, Spurrier N, Goggin M. Retinopathy of prematurity in a south Australian neonatal intensive care unit. Australian and New Zealand J ophthalmol. 1995 Feb;23(1):49-54.

Englert JA, Saunders RA, Purohit D, Hulsey TC, Ebeling M. The effect of anemia on retinopathy of prematurity in extremely low birth weight infants. J Perinatol. 2001 Jan-Feb;21(1):21-6.

Bifano EM, Bode MM, D’Eugenio DB. Prospective randomized trial of high vs. low hematocrit in extremely low birthweight (ELBW) infants: One year growth and neurodevelopmental outcome. Pediatr Res. 2002;51(4):325a.

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 Sep 1;104(3):514-8.

Dani C, Reali MF, Bertini G, Martelli E, Pezzati M, Rubaltelli FF. The role of blood transfusions and iron intake on retinopathy of prematurity. Early Hum Dev. 2001 Apr;62(1):57-63.

Sullivan JL. Iron, plasma antioxidants and the oxygen radical disease of prematurity. Am J Dis Child. 1988;142:1341-4.

Varughese S, Jain S, Gupta N, Singh S, Tyagi V, Puliyel JM. Magnitude of the problem of retinopathy of prematurity. Experience in a large maternity unit with a medium size level-3 nursery. Ind J ophthalmol. 2001 Jul 1;49(3):187.

Murthy KR, Nagendra BK. Analysis of risk factors for the development of ROP in preterm infants at a tertiary referral hospital in South India. Acta Med Lituanica. 2006;13:147-51.

Chou YH, Teng RJ, Yau KIT, Yang CM. Retinopathy of pre - maturity: an anal y sis of risk factors. J Formos Med Assoc. 1993;92:440-5.

Tunay ZÖ, Özdemir Ö, Acar DE, Öztuna D, Uraş N. Maternal Diabetes as an Independent Risk Factor for Retinopathy of Prematurity in Infants With Birth Weight of 1500 g or More Am J Ophthalmol. 2016 Aug;168:201-6.

Kavurt S, Özcan B, Aydemir O, Bas AY, Demirel N. Risk of retinopathy of prematurity in small for gestational age premature infants. Ind pediatr. 2014 Oct 1;51(10):804-6.

Hammer ME, Mullen PW, Ferguson JG, Pai S, Cosby C, Jackson KL. Logistic analysis of risk factors in acute retinopathy of prematurity. Am J Ophthalmol. 1986;102(1):1-6.

Higgins RD, Mendelsohn AL, DeFeo MJ, Ucsel R, Hendricks-Munoz KD. Antenatal dexamethasone and decreased severity of retinopathy of prematurity. Arch Ophthalmol. 1998;116(5):601-5.

Sobel DB, Philip AG. Prolonged dexamethasone therapy reduces the incidence of cryotherapy for retinopathy of prematurity in infants of less than 1 kilogram birth weight with bronchopulmonary dysplasia. Pediatr. 1992;90(4):529-33.