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Category: Volume 09 Issue 12 December 2021
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Title: Incidence of Retinopathy of Prematurity in Preterms on Vitamin A Supplementation in NICU of Tertiary Care Centre

Authors: Dr Shruti Dhale, Dr Nisha Yadav, Dr Fareena Ansari, Dr Poonam Mane

 DOI: https://dx.doi.org/10.18535/jmscr/v9i12.41

Abstract

Background: Retinopathy of prematurity (ROP) is a multi-factoral vaso-proliferative retinal condition that affects mostly premature infants. In India, the prevalence of ROP in premature babies ranges from 35 to 60%. Some of the risk factors associated with ROP includes low gestational age, late onset of sepsis, low birth weight, blood transfusion and use of surfactants and intraventricular haemorrhage. Preventive measures are still lacking behind. Some of the clinical trials showed reduced oxygen dependency in preterm babies who were given vitamin A as preventive measures of ROP2. Vascular endothelial growth factor (VEGF) demonstrated to have a role in pathogenesis of ROP, and Vitamin A may help prevent neovascularisation due to oxygen induced retinopathy, by down regulating VEGF expression thus deterring ROP onset.

Objective: To study the incidence of Retinopathy in preterms receiving Vitamin A.

Material & Methods: Institutional cross sectional study of 37 preterms with gestational age <34 weeks and birth weight <1750g were selected from January 2021 to November 2021. Consent of the mother or the father of the study participants were taken prior to including the infants in the study. All infants were started on oral Vitamin A supplement (5000 IU/oral on alternate days x 3 weeks), along with enteral nutrition once hemodynamically stable. The retinologist examines the infants after 3-4 weeks of birth or at 30-32 weeks of postconceptional age. First examination details were used to validate the findings, also the infants who had severe ROP; underwent laser therapy. Data was analysed by using the SPSS software and the incidence was then calculated.

Results: 11 out of 37preterms on vitamin A supplementation developed some degree of ROP in one or both eyes (29.7% ). Severity increased with decreasing gestational age. Based on the criteria of The International Classification for Retinopathy of Prematurity (ICROP), the disease reached stage 1,2 and 3 in 2.7%(1), 8.1% (3) and 16.2%(6), respectively. No stage 4 and 5 ROP were detected.

Conclusion: The overall incidence of ROP in preterm who received Vitamin A supplementation was less by 29.7% when compared to the studies done earlier.-This shows that there is high likelihood of infants benefitting from Vitamin A supplementation in reducing Retinopathy of Prematurity.

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Corresponding Author

Dr Nisha Yadav

Senior Resident M.D. Pediatrics, Department of Pediatrics, Grant Government Medical College, Mumbai