Retinopathy of prematurity in a tertiary care center: A study of prevalence, risk factors, and outcomes

Abstract

Background: Retinopathy of prematurity (ROP) is a serious complication of prematurity treatment and can lead to blindness
unless recognized and treated early. Objectives: The objectives were to estimate the prevalence of ROP in preterm infants in the
neonatal intensive care unit (NICU), to identify the risk factors which predispose to ROP, and to assess the outcome of these cases.
Methodology: A retrospective screening survey was performed enrolling all premature neonates admitted to the NICU between
January and December 2016, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whose
gestational age was >32 weeks or birth weight was >1500 g were included if they were exposed to oxygen therapy for more than
7 days. A total of 344 neonates had a retinal evaluation by indirect ophthalmoscopy from the fourth postnatal week and followed
up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed
to Stage 3 ROP were given laser therapy. Results: Out of the studied 344 neonates, 66 (19.2%) developed ROP in one or both
eyes; 36 (54.5%) cases had Stage 1, 18 (27.3%) cases Stage 2, and 12 (18.2%) cases had Stage 3 ROP. None had Stages 4 and
5 ROP. The 12 cases diagnosed as ROP Stage 3 underwent LASER therapy. Univariate analysis showed a significant relationship
between the occurrence of ROP and gestational age (p=0.001), sepsis (p=0.004), oxygen therapy (p=0.018), and frequent blood
transfusions (p=0.030). However, an insignificant relationship was found between the occurrence of ROP and factors such as
gender, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage,
hypotension, phototherapy, and duration of oxygen therapy, mechanical ventilation, and continuous positive airway pressure.
Gestational age, sepsis, oxygen therapy, and frequent blood transfusions remained significant variables after logistic regression
analysis. Conclusion: The prevalence of ROP in this study was 19.2%; low gestational age, sepsis, oxygen therapy, and frequent
blood transfusions were significant risk factors for ROP. LASER was effective in the treatment and decreasing the progression of
ROP.