Title: Study of Retinopathy of Prematurity in a Tertiary Care Hospital

Authors: Dr S.K.Valinjkar, Dr Gangadhar Kale, Dr Vikas

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i7.66

Abstract

OBJECTIVES

1.      To study the incidence of Retinopathy of Prematurity (ROP) in a tertiary care hospital, in a metropolitan city.

2.      To study associated etiological risk factors for development of Retinopathy of Prematurity.

3.      To study the outcome of Retinopathy of Prematurity, those treated with laser photocoagulation.

STUDY DESIGN: Prospective observational study which was conducted in a tertiary care center in a metropolitan city over a period of 2 years

METHODS: In this study 200 preterm babies were enrolled with gestational age less than 34 weeks or birth weight less than 1500 grams with or without risk factors admitted in our Neonatal intensive care unit which is a tertiary care hospital. The study aimed at studying risk factors, incidence and outcome of retinopathy of prematurity especially in those patients who were treated with laser photocoagulation.

RESULTS: The incidence of ROP was 24 % (48/200). Incidence was comparatively more in babies with gestational age less than 28 weeks and birth weight less than 1000 grams.  Incidence of ROP was more in Small for gestational age (SGA) babies than in appropriate for gestational age (AGA) babies.

 In this study group, gestational age less than 28 weeks, birth weight less than 1000 grams, oxygen therapy, apnea, septicemia and use of blood products were found to be significant risks factors by univariate analysis. Oxygen therapy, septicemia and use of blood products were significant risk factors for ROP by multiple analysis (stepwise logistic regression).

All 48 cases of ROP had symmetrical or bilateral involvement of eyes, 7.5% (15/200) had severe ROP and required laser therapy (five neonates with zone I and rest with zone II). Severe ROP who required laser therapy 9 (23.70%) were less than 28 weeks, and 7 (19.44%) were less than 1000 grams. The percentage of laser treatment increases in gestational age less than 28 weeks and birth weight less than 1000 grams.

After laser therapy, at corrected age of 6 months eyes were examined for structural outcome, only 1(6.67) infant had sequelae with discmacular drag. No any infants lost to follow up after laser and the disease had regressed in all 14 (93.33) cases. Outcomes were good after laser therapy.

Keywords: Retinopathy of prematurity, Laser photocoagulation, Prematurity, Oxygen therpy.

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Corresponding Author

Dr S.K Valinjkar

Associate Professor, Dept of Pediatrics

Grant Medical College & Sir JJ Group of Hospitals, Mumbai