The Incidence, Risk Factors and Outcome of Retinopathy of Prematurity at a Tertiary Care Centre in South India

Retinopathy of prematurity (ROP) is a retinal disease that principally affects preterm neonates. It is recognized as the leading cause of preventable blindness and visual impairment in paediatric population, the major brunt of the disease affecting relatively immature newborns. An increase in survival of very young preterm infants, due to the advances in neonatology, have subjected them to the risk of developing ROP. This study has been undertaken to determine the incidence of ROP, its association with various clinical and social risk factors and also to study the vasculogenesis and outcome of the ROP positive cases detected in the course of screening. Materials and Methods: 94 preterm neonates with gestational age less than 36 completed weeks and weighing less than 2000 grams at birth, being born or admitted at Justice K. S. Hegde Charitable Hospital, Mangalore, were included in the study. Dilated fundus examination of these neonates was done at 31 weeks post conceptional age or 3 – 4 weeks chronological age, whichever is earlier. Follow up fundus examinations were carried out as per the fundus findings. Results: Out of the 94 neonates screened, 12 cases (12.76%) had ROP; in which 6.38% were in stage 1 and 6.38% were in stage 2. 66.66% of the ROP positive cases were below 34 weeks gestational age. All the neonates weighing 1500 grams or less were found to develop ROP. Longer duration of hospital stay, higher duration of NICU stay, sepsis, hyperbilirubinemia, hypocalcemia, previous preterm delivery were some of the factors found to be significantly associated with ROP in this study. Max pO2 with a mean of 97.4% in ROP positive cases was also found to be statistically significant. Conclusion: Most of the positive cases were below 34 weeks of gestational age and weighed less than 1500grams at birth. Thus the need for a routine screening programme for the detection of Retinopathy of prematurity in preterm and sick neonates is indispensible in our clinical setting.