TO STUDY THE INCIDENCE AND RISK FACTORS OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

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.

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


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.


2018 ◽  
Vol 5 (4) ◽  
pp. 1414
Author(s):  
Saurabh Kapoor ◽  
Ravi Sharma ◽  
Anil Kumar Sapare ◽  
Rajiv Aggarwal

Background: The objective of the current study was to evaluate the incidence of intraventricular haemorrhage and its associated risk factors in preterm neonates.Methods: This cohort study done at Neonatal Intensive Care Unit of a tertiary care hospital in south India enrolled 104 preterm neonates with either gestational age <32weeks and/or birth weight <1500 grams at birth. These babies were serially screened for intraventricular haemorrhage by doing a neurosonogram on day3 and day 14 of life.Results: Incidence of IVH was found to be 18.2%. Amongst these cases 52.6% babies had Grade I, 36.8% babies had Grade II and 10.6% babies had Grade III intraventricular hemorrhage with ventriculomegaly, as per Papile grading system. It was seen that hypotension needing use of inotropes and neonatal sepsis were significantly associated with IVH.Conclusions: The incidence of IVH in babies born with gestational age <32weeks and/or birth weight <1500 grams was 18.2% in our study. Neonatal sepsis and hypotension requiring use of inotropes were found to be the significant risk factors in this population.


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 6 (3) ◽  
pp. 1228
Author(s):  
Sarvesh Kossambe ◽  
Shilpa Joglekar ◽  
Annely D'lima ◽  
M. P. Silveira

Background: To report the incidence and risk factors leading to the development of retinopathy of prematurity (ROP) from a tertiary care center in the western Indian state of Goa, India.Methods: This was a prospective observational study carried out in a level II neonatal intensive care unit (NICU) for a period of 18 months. Babies born at < 34 weeks’ gestation and having a birth weight of <1500gm were screened for ROP and laser photocoagulation was done for those who developed threshold ROP. Group differences between any ROP and threshold ROP were analysed using the chi-square test.Results: Out of the 244 preterm neonates screened, 37 developed ROP (15.16%), and 14 out of them (5.73%) developed threshold ROP requiring laser photocoagulation. Very low birth weight, prematurity, apnea, anemia, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, blood transfusions, exchange transfusions and days taken to reach full enteral feeds and regain birth weight were significantly associated with the development of ROP.Conclusions: This is the first report of ROP from Goa where less than 1 in 5 babies developed ROP. This is similar to that reported across the rest of the country. Judicious oxygen use, ventilation strategies, transfusions guidelines, control of sepsis, early enteral feeds and adequate nutrition may help prevent the development of ROP in the future.


2021 ◽  
Vol 8 (18) ◽  
pp. 1299-1303
Author(s):  
Pinaki Sengupta ◽  
Sheuli Kumar ◽  
Mohua Mazumdar ◽  
Soumyadeep Majumdar ◽  
Manideepa Pande

BACKGROUND Retinopathy of prematurity (ROP) is one of the leading causes of ocular morbidity and mortality throughout the world. Prematurity, low–birth, and oxygen therapy are considered to be the common risk factors. The maldeveloped retina in those affected are very much prone to develop refractive error, neo-vasculopathy, and neurosensory detachment. The purpose of our study was to find out the incidence and ascertain the risk factors of retinopathy of prematurity among the neonates attending the sick neonatal care unit and OPD of Calcutta National Medical College & Hospital. METHODS This is an institution based cross-sectional observational study conducted in the sick newborn care unit of a tertiary care hospital. Informed consent was obtained from the parents along with proper birth history. Indirect ophthalmoscopy with a + 20 dioptre (+ 20 D) lens with a paediatric scleral depressor was performed in each eye under the guidance of the neonatologist after pupillary dilatation. If either eye was found to have ROP, the baby was considered as an ROP case in the study and each eye was considered as a single case. RESULTS 50.27 % babies (N = 91) were delivered by Lower Uterine Segment Caesarean Section (LSCS) and 55. 24 % babies were < 32 weeks of gestational age whereas 21.45 % (N = 39) babies were having < 1500 gm birth weight. Phototherapy was needed in 50 % of the babies (N = 92) whereas hyperbilirubinemia was present in 59.66 % of total babies. Bradycardia, apnoea, and sepsis were present in 29.83 % (N = 54), 25.41 % (N = 46), 41.98 % (N = 76) of the babies respectively. When compared in the two independent groups (ROP present and absent), low gestational age and low birth weight of the babies were found to be statistically significant (P < 0.05) for the development of ROP. After adjusting with different factors in the regression model we have found that low birth weight and oxygen therapy after birth were statistically significant with the development of ROP (P < 0.05). CONCLUSIONS ROP screening, specifically for those babies with low-birthweight, low gestational age, and those who received oxygen therapy for other systemic reasons, is mandatory to have an early diagnosis and treatment done. KEYWORDS ROP, Low-Birthweight, Gestational Age, Oxygen Therapy


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 ◽  
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.


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