Retinopathy of prematurity in a tertiary care hospital: incidence and risk factors
Keywords:
Birth weight, Gestational age, Oxygen therapy, Prematurity, ROP
Abstract
Objective: To study the incidence and risk factors predisposing to retinopathy of prematurity (ROP) in Bapuji child Health Institute NICU.
Design: Prospective cohort observational study.
Setting: Infants admitted to a neonatal intensive care unit of Bapuji child Health Institute NICU in a period of two years.
Methods: Preterm infants with birth weight < 1500g and gestation <34 weeks were screened for ROP at 4 weeks after birth or 31-33 weeks post conceptional age, whichever was later. Infants with birth weight >1500g and gestation >34weeks were screened only if they had additional risk factors. Those found to have high risk ROP had laser photocoagulation.
Results: The incidence of ROP in the 200 infants who were screened was 13.5%. No ROP was found in infants weighing >2000g or with a gestational age more than 36weeks. Risk factors predisposing to ROP were oxygen therapy (P=0.04), apnea [p=0.001], ventilation [0.001] , anemia [0.001],blood and blood product transfusion [0.001 ].
Conclusion: One third of the infants with ROP needed laser photo coagulation, the outcome of which was good. Risk factors predisposing to ROP were oxygen therapy, apnea, ventilation, blood transfusion, exchange transfusion.
Downloads
Download data is not yet available.
References
1. The Committee for the Classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity. Arch Ophthalmol. 1984; 102:1130–1134. [PubMed]
2. Terry, TL: Extreme prematurity and fibroblastic overgrowth of persistent vascular sheath behind each crystalline lens. I. Preliminary report, Am J Ophthalmol. 1942:25:203-204.
3. Gilbert C. Changing challenges in the control of blindness in children. Eye (Lond) 2007; 21: 1338–43.
4. Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev 2008; 84 : 77–82. [PubMed]
5. Park JE, Park K. Preventive medicine in obstretics, paediatrics and geriatrics.In: Park JE, Park K (eds), Park's Textbook of Preventive and Social Medicine. New Delhi, Banarasidas Bahnot, 1991, pp.306-320.
6. Charan R, Dogra M R, Gupta A, Narang A. The incidence of retinopathy of prematurity in a neonatal care unit. Indian J Ophthalmol 1995; 43:123-6. [PubMed]
7. Global initiative for the elimination of avoidable blindness. Geneva, World Health Organization, 1998 (unpublished document WHO/PBL/97.61). [PubMed]
8. Foster A, Gilbert CE. Epidemiology of childhood blindness. Eye 1992; 6:173–6. [PubMed]
9. Coats DK, Aaron MM, Mohamed AH. Involution of retinopathy of prematurity after laser treatment: Factors associated with development of retinal detachment. Am J Ophthalmol. 2005; 140:214–22. [PubMed]
10. Terry, TL: Fibroblastic overgrowth of persistent tunica vasculosa lentis in premature infants. II. Report of cases—clinical aspects, Arch Ophthalmol. 1943:29:36-53.
11. Quinn GE, Johnson L, Abbasi S. Onset' of retinopathy of prematurity as related topostnatal and postconceptual age. Br J Ophthalmol 1992b; 76: 284-8. [PubMed]
12. Fielder AR, Levene MI. Screening for retinopathy of prematurity. Arch Dis Child 1992; 67: 860-7. [PubMed]
13. Kinsey VE. Retrolental fibroplasia: cooperative study of retrolental fibroplasia and the use of oxygen. AMA Arch Ophthalmol. 1956 Oct; 56(4):481-543.
14. Lanman, IT, Guy, LP, and Dancis, J: Retziolental fibroplasia and oxygen therapy, JAMA 1954: 155:223-226. [PubMed]
15. Patz, A, Eastham, A, Higginbotham, DH, and Kleh, T: Oxygen studies in retrolental fibroplasia. II. The production of the microscopic changes of retrolental fibroplasia in experimental animals, Am J Ophthalmol. 1953:36:1511-1522. [PubMed]
16. Provis IM. Development of the primate retinal vasculature. Prog Retin Eye Res. 2001 Nov; 20(6):799-821. [PubMed]
17. Sellheyer K, Spitznas M. Morphology of the developing choroidal vasculature in the human fetus. Graefe's Arch Clin Exp Ophthalmol 1988; 226: 461-7. [PubMed]
18. Ashton N. Retinal angiogenesis in the human embryo. Br Med Bull 1970; 26: 103-6. [PubMed]
19. Keshet E. Preventing pathological regression of blood vessels. J Clin Invest 2003; 112: 27-9. [PubMed]
20. Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care center--incidence, risk factors and outcome. Indian Pediatr 2009; 46:219-24. [PubMed]
21. Aggarwal R, Deorari AK, Azad RV, et al. Changing profile of retinopathy of prematurity. J Trop Pediatr 2002; 48:239-42. [PubMed]
22. Varughese S, Jain S, Gupta N, Singh S, Tyagi V, Puliyel JM. Magnitude of the problem of retinopathy of prematurity. Experience in a large maternity unit with a medium size level-3 nursery. Indian J Ophthalmol 2001; 49:187-8.
23. Kinsey VE, Arnold HI, Kalina RE, et al. Pa02 levels and retrolental fibroplasia: a report of the co-operative study. Pediatrics 1977; 60: 655-68. [PubMed]
24. Fielder AR, Levene MI. Screening for retinopathy of prematurity. Arch Dis Child 1992; 67: 860-7. [PubMed]
25. Schaffer DB, Palmer EA, Plotsky DF, et al, on behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Prognostic, factors in the natural course of retinopathy of prematurity: Ophthalmology 1993; 100: 230-7. [PubMed]
26. Fielder AR, Shaw DE, Robinson J, et al. Natural history of retinopathy of prematurity: a prospective study. Eye 1992b; 6: 233-42. [PubMed]
27. Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care center--incidence, risk factors and outcome. Indian Pediatr 2009; 46:219-24. [PubMed]
28. Saito Y, Omoto T, Cho Y, et al. The progression of retinopathy of prematurity and fluctuation in blood gas tension. Graefe's Arch Clin Exp Ophthalrnol 1993; 231: 151-6. [PubMed]
29. Cunningham S, Fleck BWElton RA, et al. Transcutaneous oxygen levels in retinopathy of prematurity. Lancet, 1995; 346: 1464-5. [PubMed]
30. York JR, Landers S, Kirby RS, et al. Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. J Perinatology 2004; 24: 82-7. [PubMed]
31. Ng YK, Fielder AR, Levene MI, et al. Are severe retinopathy of prematurity and severe pe-Fiventricular leucomalacia both ischaemic insults? Br J Ophthalmol 1989; 73: 111-14. [PubMed]
32. Ashton N, Henkind P. Experimental occlusion of retinal arterioles. Br J Ophthalmol 1965; 49: 225-34.
33. Rekha S, Battu RR. Retinopathy of prematurity: incidence and risk factors. Indian Pediatr 1996; 33:999-1003. [PubMed]
34. Gupta VP, Dhaliwal U, Sharma R, Gupta P, Rohatgi J. Retinopathy of prematurity risk factors. Indian J Pediatr 2004; 71:887-92.
35. Dutta S, Narang S, Narang A, Dogra M, Gupta A. Risk factors of threshold retinopathy of prematurity. Indian Pediatr 2004; 41:665-71.
36. Pinheiro AM,Silva WA.Incidence and risk factors of retinopathy of prematurity in university hospital Onfore Lopes,Brazil.Arq Bras Ophtalmol.2009;72(4):451-6.
37. Hakeem AHAA, Mohammed GB, Otham M.Retinopathy of prematurity. J Clin Neonatol. 2012 Apr-Jun; 1(2): 76–81 [PubMed]
38. Karna P, Muttineni J, Anjell L, Karmaus W.Retinopathy of prematurity and risk factors:a prospective cohort study. BMC Pediatrics 2005, 5:18. [PubMed]
39. Liu L,Tian T, Zheng CX,Ileana v,Loana A,Tatiana C,Oana R.Risk factors and laser therapy for retinopathy of prematurity in neonatal intensive care unit. World J Pediatr 2009; 5(4):304-307. [PubMed]
2. Terry, TL: Extreme prematurity and fibroblastic overgrowth of persistent vascular sheath behind each crystalline lens. I. Preliminary report, Am J Ophthalmol. 1942:25:203-204.
3. Gilbert C. Changing challenges in the control of blindness in children. Eye (Lond) 2007; 21: 1338–43.
4. Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev 2008; 84 : 77–82. [PubMed]
5. Park JE, Park K. Preventive medicine in obstretics, paediatrics and geriatrics.In: Park JE, Park K (eds), Park's Textbook of Preventive and Social Medicine. New Delhi, Banarasidas Bahnot, 1991, pp.306-320.
6. Charan R, Dogra M R, Gupta A, Narang A. The incidence of retinopathy of prematurity in a neonatal care unit. Indian J Ophthalmol 1995; 43:123-6. [PubMed]
7. Global initiative for the elimination of avoidable blindness. Geneva, World Health Organization, 1998 (unpublished document WHO/PBL/97.61). [PubMed]
8. Foster A, Gilbert CE. Epidemiology of childhood blindness. Eye 1992; 6:173–6. [PubMed]
9. Coats DK, Aaron MM, Mohamed AH. Involution of retinopathy of prematurity after laser treatment: Factors associated with development of retinal detachment. Am J Ophthalmol. 2005; 140:214–22. [PubMed]
10. Terry, TL: Fibroblastic overgrowth of persistent tunica vasculosa lentis in premature infants. II. Report of cases—clinical aspects, Arch Ophthalmol. 1943:29:36-53.
11. Quinn GE, Johnson L, Abbasi S. Onset' of retinopathy of prematurity as related topostnatal and postconceptual age. Br J Ophthalmol 1992b; 76: 284-8. [PubMed]
12. Fielder AR, Levene MI. Screening for retinopathy of prematurity. Arch Dis Child 1992; 67: 860-7. [PubMed]
13. Kinsey VE. Retrolental fibroplasia: cooperative study of retrolental fibroplasia and the use of oxygen. AMA Arch Ophthalmol. 1956 Oct; 56(4):481-543.
14. Lanman, IT, Guy, LP, and Dancis, J: Retziolental fibroplasia and oxygen therapy, JAMA 1954: 155:223-226. [PubMed]
15. Patz, A, Eastham, A, Higginbotham, DH, and Kleh, T: Oxygen studies in retrolental fibroplasia. II. The production of the microscopic changes of retrolental fibroplasia in experimental animals, Am J Ophthalmol. 1953:36:1511-1522. [PubMed]
16. Provis IM. Development of the primate retinal vasculature. Prog Retin Eye Res. 2001 Nov; 20(6):799-821. [PubMed]
17. Sellheyer K, Spitznas M. Morphology of the developing choroidal vasculature in the human fetus. Graefe's Arch Clin Exp Ophthalmol 1988; 226: 461-7. [PubMed]
18. Ashton N. Retinal angiogenesis in the human embryo. Br Med Bull 1970; 26: 103-6. [PubMed]
19. Keshet E. Preventing pathological regression of blood vessels. J Clin Invest 2003; 112: 27-9. [PubMed]
20. Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care center--incidence, risk factors and outcome. Indian Pediatr 2009; 46:219-24. [PubMed]
21. Aggarwal R, Deorari AK, Azad RV, et al. Changing profile of retinopathy of prematurity. J Trop Pediatr 2002; 48:239-42. [PubMed]
22. Varughese S, Jain S, Gupta N, Singh S, Tyagi V, Puliyel JM. Magnitude of the problem of retinopathy of prematurity. Experience in a large maternity unit with a medium size level-3 nursery. Indian J Ophthalmol 2001; 49:187-8.
23. Kinsey VE, Arnold HI, Kalina RE, et al. Pa02 levels and retrolental fibroplasia: a report of the co-operative study. Pediatrics 1977; 60: 655-68. [PubMed]
24. Fielder AR, Levene MI. Screening for retinopathy of prematurity. Arch Dis Child 1992; 67: 860-7. [PubMed]
25. Schaffer DB, Palmer EA, Plotsky DF, et al, on behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Prognostic, factors in the natural course of retinopathy of prematurity: Ophthalmology 1993; 100: 230-7. [PubMed]
26. Fielder AR, Shaw DE, Robinson J, et al. Natural history of retinopathy of prematurity: a prospective study. Eye 1992b; 6: 233-42. [PubMed]
27. Chaudhari S, Patwardhan V, Vaidya U, Kadam S, Kamat A. Retinopathy of prematurity in a tertiary care center--incidence, risk factors and outcome. Indian Pediatr 2009; 46:219-24. [PubMed]
28. Saito Y, Omoto T, Cho Y, et al. The progression of retinopathy of prematurity and fluctuation in blood gas tension. Graefe's Arch Clin Exp Ophthalrnol 1993; 231: 151-6. [PubMed]
29. Cunningham S, Fleck BWElton RA, et al. Transcutaneous oxygen levels in retinopathy of prematurity. Lancet, 1995; 346: 1464-5. [PubMed]
30. York JR, Landers S, Kirby RS, et al. Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. J Perinatology 2004; 24: 82-7. [PubMed]
31. Ng YK, Fielder AR, Levene MI, et al. Are severe retinopathy of prematurity and severe pe-Fiventricular leucomalacia both ischaemic insults? Br J Ophthalmol 1989; 73: 111-14. [PubMed]
32. Ashton N, Henkind P. Experimental occlusion of retinal arterioles. Br J Ophthalmol 1965; 49: 225-34.
33. Rekha S, Battu RR. Retinopathy of prematurity: incidence and risk factors. Indian Pediatr 1996; 33:999-1003. [PubMed]
34. Gupta VP, Dhaliwal U, Sharma R, Gupta P, Rohatgi J. Retinopathy of prematurity risk factors. Indian J Pediatr 2004; 71:887-92.
35. Dutta S, Narang S, Narang A, Dogra M, Gupta A. Risk factors of threshold retinopathy of prematurity. Indian Pediatr 2004; 41:665-71.
36. Pinheiro AM,Silva WA.Incidence and risk factors of retinopathy of prematurity in university hospital Onfore Lopes,Brazil.Arq Bras Ophtalmol.2009;72(4):451-6.
37. Hakeem AHAA, Mohammed GB, Otham M.Retinopathy of prematurity. J Clin Neonatol. 2012 Apr-Jun; 1(2): 76–81 [PubMed]
38. Karna P, Muttineni J, Anjell L, Karmaus W.Retinopathy of prematurity and risk factors:a prospective cohort study. BMC Pediatrics 2005, 5:18. [PubMed]
39. Liu L,Tian T, Zheng CX,Ileana v,Loana A,Tatiana C,Oana R.Risk factors and laser therapy for retinopathy of prematurity in neonatal intensive care unit. World J Pediatr 2009; 5(4):304-307. [PubMed]
CITATION
DOI: 10.17511/ijpr.2016.i05.17
Published: 2016-05-31
How to Cite
Dr Bharath Reddy, Dr Raghavendra M Doddamani, Dr M.B. Koujalagi, Dr Guruprasad G, Dr Ashwini R C, Dr Gayathri H Aradya, & Dr Chaithali Raghoji. (2016). Retinopathy of prematurity in a tertiary care hospital: incidence and risk factors. Pediatric Review: International Journal of Pediatric Research, 3(5), 364-370. https://doi.org/10.17511/ijpr.2016.i05.17
Issue
Section
Original Article
Copyright (c) 2016 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
