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

Author(s):  
Ramamani Dalai ◽  
Kedarnath Das ◽  
Diptimayee Nayak ◽  
Mangal Charan Murmu ◽  
Prasanta Kumar Nanda

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.

2019 ◽  
Vol 6 (2) ◽  
pp. 693
Author(s):  
Srinivasa V. ◽  
Vijay Yadav ◽  
Kumar G. V.

Background: Retinopathy of prematurity (ROP) is a disease process mostly reported in preterm neonates with a wide spectrum, ranging from mild, transient changes in the retina with regression to severe progressive vasoproliferation, scarring, detachment of retina and blindness. 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: A cross sectional study was undertaken among all neonates born between 28-34 weeks of gestation admitted in NICU, who are under oxygen, screened for ROP. Babies with ocular disorder which interfere with fundus examination, babies who did not complete follow up till complete vascularisation of retina and babies with congenital retinal abnormalities were excluded from the study.Results: About 13.3% of male children and 18.0% of the female children had retinopathy of prematurity. Among the infants born before 30 weeks, 46.7% had retinopathy of prematurity. In the children with gestational age between 30- 32 weeks, 15.4%, 8.5% in the 32-35 weeks and none among those born between more than 35 weeks. About 27.9% of the newborns with birth weight of less than 1.5kgs and 5.8% of those who had birth weight of 1.5-2.5kgs had retinopathy of prematurity.Conclusions: This study had shown a significant association of retinopathy of prematurity with the low gestational age, birth weight and oxygen therapy. Reducing subsequent post-natal risk factors depends on optimal perinatal and postnatal care, as well as adhering to strict ROP screening guidelines. Recognizing and treating ROP in a timely fashion is critical for achieving the best visual outcome.


2020 ◽  
Vol 7 (10) ◽  
pp. 2005
Author(s):  
Hrishikesh S. Pai ◽  
Rojo Joy ◽  
Varghese Cherian ◽  
Preethy Peter

Background: Retinopathy of prematurity (ROP) is a vaso proliferative disorder of retina among preterm infants. Significant cause of blindness in children with increased survival of premature infants with improved neonatal care. Potential risk factors for development of ROP include low gestational age, low birth weight, bronchopulmonary dysplasia, sepsis, acidosis, oxygen therapy. Anemia as a cause for retinopathy of prematurity has been postulated but there are very few studies addressed the effect of anemia on incidence and severity of ROP. The objective of this study was to determine the effect of anemia on incidence and severity of retinopathy of prematurity and to determine other factors associated with development of retinopathy of prematurity.Methods: Retrospective descriptive study of 120 babies born premature less than 34 weeks for the development of Retinopathy of prematurity and its severity and for associated conditions. All babies screened for retinopathy of prematurity at 3 weeks of age and further followed up for progression of ROP. Factors analysed included hemoglobin levels at 3 weeks of life, number of blood transfusions, days on ventilator, gestational age, birth weight, duration of oxygen requirement, bronchopulmonary dysplasia for the development of retinopathy of prematurity. Findings described in simple descriptive manner.Results: Anemia and increased requirement for blood transfusion are associated with higher incidence and severity of ROP. Low gestational age, birth weight, prolonged oxygen requirement, intraventricular hemorrhage (IVH), sepsis are other risk factors.Conclusions: It is significant to screen preterm babies for ROP and to anticipate in the background of these risk factors. Minimise oxygen duration and blood loss for sampling to prevent anemia and reduce transfusions.


2021 ◽  
Vol 8 (6) ◽  
pp. 1033
Author(s):  
Manjunathaswmy R. ◽  
Anjana H. Rao ◽  
Vinayaka P. Hegade ◽  
Pradeep Kumar ◽  
Ravindra B. Patil

Background: Retinopathy of prematurity is a preventable cause of childhood blindness. Proper understanding of the classification, risk factors and treatment methods is a must in tackling this disease. The aim of this study was to know the incidence of ROP in preterm infants in a tertiary care centre and to improvise the selection criteria in future in Indian babies.Methods: A retrospective study of all infants admitted to the NICU from 2016 to 2018 who met the criteria for ROP screening were included in the study. Examination of the eyes was done by a trained technician using a Ret Cam digital imaging in collaboration with KIDROP, Narayana Nethralaya and later interpreted by trained ophthalmologists using the concept of teleopthalmology. Babies were followed up and screened accordingly. Qualified infants were treated with argon laser photocoagulation within 48h of diagnosis. They were followed until the disease was successfully treated.Results: In current study, incidence of ROP was found to be 10.2%. The gestational age ranged from 28-36 weeks with a mean of 30.5±1.5 weeks. In current study, the most prevalent prenatal risk factor was multiple gestation and postnatal risk factors was anemia, low birth weight ,low gestational age and the use of oxygen therapy.Conclusions: Screening for ROP, in India, should be performed in all preterm neonates who are born <34 weeks gestation and/or <1800 grams birth weight; as well as in babies 34-36 weeks gestation or 1800-2000 grams birth weight if they have risk factors for ROP.


2019 ◽  
Vol 7 (1) ◽  
pp. 90
Author(s):  
Uma Devi Rachamadugu ◽  
Sravani Devana ◽  
Srikanth Sandanala

Background: Advancing technology in antenatal and neonatal care has resulted in better survival of preterm neonates in developing countries in the past few decades. This has resulted in an apparent increase in the incidence of Retinopathy of Prematurity (ROP), which is the most important cause of preventable blindness in infants.Methods: A prospective clinical study was done for 18 months in 400 preterm babies less than 34 weeks of Gestational Age (GA) or less than 1750 gm of Birth Weight (BW). ROP screening was performed. The babies who developed any stage of ROP were taken as cases and the babies who did not have ROP were taken as controls. Statistical analysis was performed using SPSS software (Version 20.0). p value <0.05 was taken as statistically significant.Results: Four hundred babies were thus examined. The overall incidence of ROP in the study group was 10.25% (41 babies). Out of them, 38 babies (92.6%) had stage-1 ROP and 3 babies (7.31%) had stage-2 ROP. three babies (7.31%) required laser treatment. Risk factor analysis revealed that gestational age at birth, low birth weight, need foroxygenation, RDS, clinical sepsis, HIE, AKI, NNS, resuscitation, apnea.Conclusions: Screening should be intensified in the presence of risk factors like resuscitation, oxygen requirement, apnoea and prolonged hospital stay, which can reduce the incidence of severe stages of ROP as shown by this study.


2008 ◽  
Vol 47 (169) ◽  
Author(s):  
Srijana Adhikari ◽  
B P Badhu ◽  
N K Bhatta ◽  
R S Rajbhandari ◽  
B K Kalakheti

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening


2016 ◽  
Vol 45 (6) ◽  
pp. 270
Author(s):  
Rinawati Rohsiswatmo

Background Retinopathy of prematurity (ROP) is one of the ma-jor causes of infant blindness. There are several factors known asrisk factors for ROP. Recent studies show ROP as a disease ofmultifactorial origin.Objective To report the prevalence of ROP in Cipto MangunkusumoHospital, Jakarta and its relation to several risk factors.Methods A cross-sectional descriptive study was conducted fromDecember 2003-May 2005. All infants with birth weight 2500 gramsor less, or gestational age 37 weeks or less, were enrolled con-secutively and underwent the screening of ROP at 4 to 6 weeks ofchronological age or 31 to 33 weeks of postconceptional age.Result Of 73 infant who met the inclusion criteria, 26% (19 out of73 infant) had ROP in various degrees. About 36.8% (7 out of 19infants) were in stage III or more/threshold ROP. No ROP wasnoted in infants born >35 weeks of gestational age, and birth weight>2100 grams. No severe ROP was found in gestational age >34weeks and birth weight >1600 grams. None of full-term, small forgestational age infants experienced ROP. Birth weight, sepsis,apneu, asphyxia, multiple blood transfusions, and oxygen therapyfor more than 7 days were statistically significant with the develop-ment of ROP. However, using multivariate analysis, only asphyxia,multiple blood transfusions, and oxygen therapy for more than 7days were statistically significant with the development of ROP.Conclusion Screening of ROP should be performed in infantsborn 34 weeks of gestational age and/or birth weight <1600 grams.Infants with birth weight from 1600-<2100 grams need to bescreened only if supplemental oxygen is necessary or with clini-cally severe illness


2021 ◽  
pp. 48-50
Author(s):  
Kajaldeep Kaur ◽  
Gursharn Singh

BACKGROUND: Retinopathy of prematurity (ROP) is a multifactorial retinal vaso-proliferative disorder which remains a leading cause of childhood blindness worldwide despite improvements in neonatal care and management guidelines. This study was conducted to determine the incidence of ROP among preterm neonates and to determine the risk factors. METHODS: All preterm infants with birth weight <1750 gm and gestation <34 weeks were screened for ROP at 4 weeks of birth for rst screening. Prenatal and postnatal risk factors, neonatal problems, treatment given, procedures and interventions done during stay in neonatal intensive care unit were recorded as per the proforma. The data from the study was systematically collected, compiled and statistically analyzed with SPSS Statistics-26 version to draw relevant conclusions. RESULTS: The incidence of ROP in 89 infants who were screened was 44%. The mean gestational age of babies with ROP was 32 weeks. In our study, pneumonia, apnea, sepsis, thrombocytopenia, NEC, shock, acidosis, IVH, BPD, the use of Bubble CPAP, Venti-CPAP and mechanical ventilator, the vasopressor use and blood transfusion were signicant risk factors. CONCLUSIONS: The incidence of ROP was signicantly higher in babies <34 weeks. It was observed in our that lower the birth weight and lower the gestational age, higher is the risk for the development of ROP. Careful and timed retinal examination of all at risk infants will minimize the development of ROP and later on blindness.


2021 ◽  
pp. 56-58
Author(s):  
Monisha SP ◽  
Prempal Kaur ◽  
Karamjit Singh ◽  
Ashwani Kumar ◽  
Upasna Ajmani

Retinopathy of prematurity (ROP) is one of the major cause of the preventable childhood blindness worldwide. One year prospective interventional study was conducted in a tertiary care centre in Northern India. All neonates with birth weight ≤ 2000 grams with gestational age ≤35 weeks were screened for ROP and divided into two groups, infants with birth weight <1750 grams (Group A) and ≥1750 grams (Group B). Prevalence of ROP, risk factors and laser treatment outcomes were compared between two groups. Of 191 neonates screened, 61(31.93%) developed ROP, out of which Infants with very low birth weight were at signicantly higher risk of developing severe ROP requiring treatment. In addition, high concentration and uctuating oxygen administration, sepsis, shock, intravenous uids >10 days were observed to be statistically signicant risk factors in infants <1750 grams. Timely screening and early treatment of threshold ROP results in desirable structural and functional outcome.


2021 ◽  
pp. 63-65
Author(s):  
Pranoy Dey ◽  
L. Lotha ◽  
Sawant Kumar Sahu ◽  
Rajlakshmi Borgohain

Majority of neonatal deaths occurs in low and middle income countries indicating poor quality of health services provided by the government of the respective countries.In a developing country like India , a high morbidity and mortality serves as an sensitive indicator reecting the poor maternal and child health care services of the country.Most of the neonatal deaths can be attributed to avoidable factors which can be minimized by the effective utilization of antenatal services , early detection of high risk pregnancy and timely referral of these cases.The current study was conducted to determine the neonatal outcomes in booked and unbooked pregnancy cases in the tertiary care centre ,Assam Medical College and Hospital, Dibrugarh. METHODS: Close ended structured questionnaires were used to collect information from the parents (150 booked and 150 unbooked).Neonatal outcomes were categorised under groups of term and preterm ,live birth and stillbirts, birthweight, Gestational age, iugr, large for gestational age APGAR score ,NICU admissions and clinical course during hospital stay,course during rst 28 days of life along with complications,if any are all taken into consideration. RESULTS: During the study period 28.67% had low birth weight in booked cases and 41.33% had low birth weight in unbooked cases.The incidence of stillbirth and early neonatal deaths were 2%,4% respectively in booked cases and 4.67% , 6% respectively in unbooked cases.Higher incidence of MSL,prematurity ,birth asphyxia ,respiratory problems ,birth injuries,congenital malformations,infections and hyperbilirubinemia were seen in unbooked cases. CONCLUSIONS: The inference derived from the study ,showed that availability of antenatal care is directly proportional to the neonatal outcome .Thus unavailbility or lack of proper medical attention during the pregnancy results in unfavourable neonatal outcomes which can be prevented by increasing the range of availability , utilization and effectiveness of maternal and child health services alongwith ensuring booking of all the pregnancy cases in our country.


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