Title: Outcome of Aggressive Posterior Retinopathy of Prematurity in a Tertiary Care Hospital in South India
Authors: Anuja Sathar, Shanavas A, Jasmin L B, Girija Devi P S
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.182
Abstract
Objective: The aim of this study is to assess the incidence, clinical pattern, factors associated and outcome of Aggressive Posterior Retinopathy of Prematurity (APROP) in a tertiary care hospital in South India.
Methods: A prospective follow up study was done by screening 1738 preterm babies with gestational age <34 weeks and or birth weight <1500 grams for a period of four years from March 2012 to February 2016. ROP of any severity was present in 412 cases of which 18 cases had APROP. Regression pattern was assessed by fundus examination at periodic intervals. Structural and functional outcome were determined at the end of one year in babies with APROP. Diode laser photocoagulation was done in all cases and additional intravitreal bevacizumab injection was given in 6 eyes of 4 babies.
Results: The incidence of APROP among the study population was 1.03% and among ROP cases were 4.37%. Important maternal risk factors were primigravida, multiple pregnancy and delivery by vaginal route. Significant postnatal risk factors included hyaline membrane disease and surfactant use. The mean post conceptional age of treatment was 32.2 weeks. Favourable structural outcome accounted for 90% of cases. Association of structural outcome with ROP parameters showed significance for pre retinal hemorrhage and fibro vascular proliferation. The predominant refractive error was myopia which was present in 17 eyes of which high myopia was present in 10 eyes. Strabismus was present in 8 eyes of 4 patients.
Conclusions: Aggressive posterior form of ROP has reasonably good structural and functional outcome if detected and treated early even with laser. Pre retinal hemorrhage and fibro vascular proliferation are associated with poor structural outcome.
Keywords: preterms, aggressive posterior, structural outcome, refractive error.
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