scholarly journals A Longitudinal Study of Retinopathy of Prematurity at Great Eastern Medical School and Hospital, Srikakulam

2021 ◽  
Vol 8 (11) ◽  
pp. 593-596
Author(s):  
Lakshmi Sativada ◽  
Dineshkanth Vudayana ◽  
Tejapraveen P ◽  
Jogendra Prasad Behra

BACKGROUND Retinopathy of prematurity (ROP) is a vasculopathy affecting the premature retina. In India ROP is increasing due to the increased premature deliveries, well improved neonatal care and better neonatal survival rate. ROP screening by an experienced ophthalmologist plays an important role in screening, identifying and management of at-risk premature infants. Nowadays, the gold standard treatment is laser photocoagulation of avascular retina and anti-vascular endothelial growth factor (VEGF) depending on the severity of disease. METHODS This observational study included 152 babies who were referred to the Department of Ophthalmology at Great Eastern Medical School (GEMS), Srikakulam for ROP screening. The screening of eyes was done with a binocular indirect ophthalmoscope with 20 D lens. Eyes were examined by application of topical anaesthetic drops after applying topical tropicamide drops till full dilatation was noted. ROP was staged and treatment was given accordingly. RESULTS Totally 152 infants were screened for ROP in the Department of Ophthalmology. Babies with gestational age between 26 weeks and 36 weeks were included in the present study. Babies with birth weight between 900 gm and 2000 gm were also included in the study. Of the 152 babies which were included in the study, 54 babies presented with different stages of ROP. The incidence of ROP in the present study was found out to be 35.5 %. When incidence of ROP was noted with respect to birthweight, in extremely low birth weight (ELBW) babies, incidence was found out to be 71.4 %; in very low birth weight (VLBW) babies incidence rate was found to be 48.4 %. When incidence of ROP was noted with respect to gestational age ROP incidence was found to be 65.2 % in babies with gestational age of < 32 weeks. There was no association with gender in the incidence of ROP. When ROP incidence was noted in babies who received O2 therapy 59.2 % babies who received O2 therapy developed ROP. CONCLUSIONS In our study, at our institute the incidence of ROP was 35.5 %. With appropriate screening for the babies at risk we can prevent the development of ROP and further complications. According to study results our recommendations are that initial screening should to be done as early as 4 weeks of postnatal age or 34 - 35 weeks post conceptional age and to be followed till term gestation. In the present study we found that usage of anti VEGF came out with promising outcome results. The procedure of anti VEGF was relatively safe and easy with a smaller number of complications when compared to laser photocoagulation. KEYWORDS Retinopathy of Prematurity, Laser Photocoagulation, Indirect Ophthalmoscope, Tropicamide, Anti VEGF

Author(s):  
Shantisena Mishra ◽  
Anjali Saji ◽  
Saiprasanna Behera ◽  
Sridhar Mohanty

Background: Retinopathy of prematurity is a multifactorial vasoproliferative retinal disease that increases in incidence with decreasing gestational age and is one of the leading causes of preventable childhood blindness in India. Advances in neonatology have led to dramatic increase in survival of preterm neonates and in turn, to the risk of developing ROP. Since most of the risk factors associated with ROP mentioned above arise in the neonatal intensive care unit (NICU) itself and most of them are avoidable, cautious monitoring of the risk factors, early screening, follow up and surgical intervention have been shown to reduce the incidence and improve the outcome of ROP.Methods: This was a prospective observational study conducted for a period of 2 years. A total of 151 infants admitted in NICU /SNCU who satisfied the inclusion criteria were enrolled in this study. Initial and follow up screening was conducted in three phases the results were documented in proforma after ethical clearance.Results: Comparison of risk factors between eyes with and without ROP was done using Chi-square test. A p-value of<0.05 was considered to be statistically significant. Incidence of ROP in centre is found to be 33.8%. Among maternal risk factors, multiple gestation and PROM/PPROM is found to be significant in the development of ROP from this study. However, mode of delivery and gestational hypertension, were found to be not significant in ROP. Among neonatal risk factors, low birth weight, lower gestational age, prolonged oxygen exposure, blood transfusion, mechanical ventilation, sepsis, phototherapy was found to be significant in this study.Conclusions: ROP, being an emerging cause for potentially blinding visual disability, needs to be diagnosed early. Due to the advancements in neonatology and better survival of preterm babies, timely screening, regular follow up, early detection and intervention is mandatory. A multidisciplinary approach is required in diagnosis and treatment of the disease. Proper counselling and motivation for parents of preterm and low birth weight babies for regular follow up is also essential.


2019 ◽  
Vol 6 (2) ◽  
pp. 264
Author(s):  
R. Nikhil ◽  
K. Rajendran ◽  
Bala Krishnan

Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ≤ 1500 grams and/or gestational age ≤32 weeks in a tertiary care center.Methods: The study was conducted in Kovai Medical Centre and Hospital Coimbatore in 2016. The sample size is 95 babies. All preterm infants admitted with a birth weight of ≤1500 grams and/or ≤ 32 weeks of gestation and baby those at risk of ROP.Results: 95 babies have enrolled during the study period of which 78 babies fulfilled the inclusion criteria and completed this prospective study.12 babies could not complete the follow-up protocol and 5 babies died before full vascularization of the retina. 78 babies who fulfilled the inclusion criteria were screened and 15 babies were found to have ROP. The prevalence of ROP in this study is 19.2%.Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP.


PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e109460 ◽  
Author(s):  
Pia Lundgren ◽  
Anna Kistner ◽  
Eva M. Andersson ◽  
Ingrid Hansen Pupp ◽  
Gerd Holmström ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hemang K. Pandya ◽  
Lisa J. Faia ◽  
Joshua Robinson ◽  
Kimberly A. Drenser

Purpose. To report anatomic outcomes after early and confluent laser photocoagulation of the entire avascular retina, including areas in close proximity to the fovea, in patients with APROP. We aspire to demonstrate fundoscopic evidence of transverse growth and macular development following laser treatment in APROP.Methods. Retrospective review of 6 eyes with APROP that underwent confluent laser photocoagulation of the entire avascular retina. Photographic fundoscopic imaging was performed using the RetCam to compare outcomes after treatment.Results. Mean birth weight and gestational age were 704.8 g and 24.33 weeks, respectively. There were 2 females and 1 male. The average time to laser was 9.3 weeks after birth, with the mean postmenstrual age of 34 weeks. Two eyes had zone 1 and 4 eyes had posterior zone 2 disease. Three eyes developed 4A detachments, which were successfully treated. All 6 eyes experienced transverse growth, with expansion of the posterior pole and anterior displacement of the laser treatment.Conclusion. Confluent photocoagulation of the entire avascular retina, regardless of foveal proximity, should be the mainstay for treating APROP. Examination should be conducted within 5–10 days to examine areas previously hidden by neovascularization to ensure prudent therapy. Macular development involves both transverse and anterior-posterior growth.


2020 ◽  
Vol 47 (2) ◽  
pp. 55-60
Author(s):  
B.A. Olusanya ◽  
T.S. Oluleye ◽  
O.O. Tongo ◽  
M.O. Ugalahi ◽  
Y.O. Babalola ◽  
...  

Background: Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the  development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening  program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks.  Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those  without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening  programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards  developing country-specific screening guidelines. Keywords: Retinopathy; Prematurity; Preterm; Neonates; Nigeria; Africa


Author(s):  
Binit Singh ◽  
Rizwan Haider ◽  
Ved Prakash Gupta

Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ? 1500 grams and/or gestational age ?32 weeks in a tertiary care center. Material and methods: The study was conducted in a tertiary care center of Bihar region India The sample size is 145 babies. All preterm infants admitted with a birth weight of ?1500 grams and/or ? 32 weeks of gestation and baby those at risk of ROP. Results: 145 babies have enrolled during the study period of which 124 babies fulfilled the inclusion criteria and completed this prospective study.15 babies could not complete the follow-up protocol and 6 babies died before full vascularization of the retina. 124 babies who fulfilled the inclusion criteria were screened and 33 babies were found to have ROP. The prevalence of ROP in this study is 26.6%. Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP. Keywords: Low birth weight, Prematurity in preterm infant, Retinopathy, Oxygen therapy


2018 ◽  
Vol 13 (2) ◽  
pp. 76-80
Author(s):  
L. A Katargina ◽  
E. V Denisova ◽  
N. A Osipova ◽  
Anna Y. Panova

Retinopathy of prematurity is the main cause of visual impairment and blindness in infants with low birth weight and preterm gestational age, in spite of the achievements in neonatology and wide applying of diagnostic and treatment guidelines. The pathogenetic role of VEGF is determined in course of normal angiogenesis and in retinopathy of prematurity. Scientists continue the search of another significant vasoprolifirative factors and methods how to inhibit them. This review is devoted to monoamines’ role in angiogenesis. The search for the relevant literature was carried out using the Medline database.


2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Muhammad Asghar Ali ◽  
Muhammad Anwar ◽  
Malik Muhammad Naeem

Objectives: To find out Association with risk factors of retinopathy of prematurity (ROP) of in-hospital newborns of low birth weight (LBW). Study Design: Cross sectional study. Setting: Department of Paediatrics, Civil Hospital Bahawalpur. Period: March 2017 to May 2018. Material and Methods: Sixty infants having birth weight 800 gram to 2500 gram, gestational age from 28 weeks to 40 weeks, either male or female were selected. Retinopathy of prematurity (ROP) was assessed in selected patients. Results: Mean gestational age was 32.67 ± 3.8 weeks, mean weight was 1484.17 ± 532.9 gram and mean duration of hospital stay was 14.52 ± 6.6 days. ROP was noted in 20 (33%) patients. Grade I ROP was noted in 11 (55%) patients followed by grade II 7 (35%) and grade III in 2 (10%) patients. Very low birth weight (VLBW), longer duration of oxygen supplementation and male gender were found to be significantly associated (p value < 0.05) with ROP while other variables turned out to be insignificant. Conclusion: Association and risk factors of ROP in LBW infants is high and most of the cases were found with grade I ROP. ROP developed in all very premature infants. Significant association of ROP was noted with VLBW, prolonged duration of oxygen supplementation and male gender.


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.


2016 ◽  
Vol 35 (3) ◽  
pp. 247-252 ◽  
Author(s):  
AK Pal ◽  
Somen Sur ◽  
AK Gupta

Introduction: The objectives of this study were to study the incidence and risk factors of retinopathy of prematurity (ROP) among preterm low birth weight babies and its association with oxygen therapy.Material and Methods: During one year study period, 50 neonates, who had fulfilled the inclusion criteria (born at gestational age ≤ 35 wks), were included in the present study. They were examined by indirect ophthalmoscopy by an ophthalmologist in NICU or ophthalmology outdoor. Staging of ROP was done according to the International classification. Data obtained from this study were entered in Microsoft Excel and subsequently analysed in SPSS version 20.0.Results: Among study population, 12 neonates (24%) showed evidence of retinopathy of prematurity, and Stage 2 ROP was most common (41.7%) within this group. Those neonates who had born ≤28 wks gestational age, showed more incidence (75%) of ROP. There was significant association between ROP and prematurity, low birth weight, mechanical ventilation, duration and concentration of oxygen therapy.Conclusion: Apart from prematurity and low birth weight, oxygen therapy also carries significant risk for ROP. Thus, judicious use of oxygen in premature babies can reduce incidence of ROP significantly.J Nepal Paediatr Soc 2015;35(3):247-252


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