Screening and management of retinopathy of prematurity at a tertiary health care centre

Abstract

Background: Retinopathy of Prematurity is a serious vaso-proliferative disorder that affects premature babies. ROP is a significant cause of childhood blindness unless recognized and treated timely and adequately. Objectives : 1) To determine the magnitude of ROP among premature neonates of less than or equal to 36 weeks of gestational age at SSIMS & RC, NICU. 2) To determine its association with certain risk factors. 3) To assess the response to laser photocoagulation given to babies with prethreshold ROP type1 and threshold ROP and APROP cases. Materials: 1) All premature neonates of either sex less than or equal to 36 weeks of G.A. 2) Birth weight less than or equal to 2000gm. Methods of data Collection: 1) Place of study: SSIMS & RC HOSPITAL, LEVEL3 NICU. 2) Duration of study: 1 st DEC 2012 to 30 th NOV 2013. 3) Sample Size: 110. Results: Out of 110 babies screened for ROP 43 (39.1%) of them showed signs of ROP in one or both eyes. Statistical analysis showed that incidence of ROP increased as gestational age decreased and also as birth weight decreased. Oxygen therapy, apnoea, RDS, anaemia, blood transfusion, sepsis were found to be significant risk factors. Out of 43 cases with ROP, 13 cases were treated by diode laser. Signs of regression were noted in all 13 cases. Conclusion: The prevalence of ROP in this study was 39.1%, indicating that it is quite a significant cause for childhood blindness. Laser treatment has proved that timely intervention can eliminate blindness due to ROP. Laser photocoagulation is an established technique for the treatment of ROP. At present, the standard of care in ROP is the diode red laser indirect ophthalmoscope. Laser indeed has many advantages over cryotherapy like less post treatment pain, adnexal edema, exudative retinal detachment, vitreo retinal traction and vitreous hemorrhage due to reduced break down of the blood retinal barrier. The limitations of the present study were the number of patients included in the study population.