Lakshmi Sativada1, Dineshkanth Vudayana2, Tejapraveen P.3, Jogendra Prasad Behra4
BACKGROUND
Retinopathy of prematurity (ROP) is a vasculopathy affecting the premature retina.
In India ROP is increasing due to the increased premature deliveries, well improved
neonatal care and better neonatal survival rate. ROP screening by an experienced
ophthalmologist plays an important role in screening, identifying and management
of at-risk premature infants. Nowadays, the gold standard treatment is laser
photocoagulation of avascular retina and anti-vascular endothelial growth factor
(VEGF) depending on the severity of disease.1
METHODS
This observational study included 152 babies who were referred to the Department
of Ophthalmology at Great Eastern Medical School (GEMS), Srikakulam for ROP
screening. The screening of eyes was done with a binocular indirect
ophthalmoscope with 20 D lens. Eyes were examined by application of topical
anaesthetic drops after applying topical tropicamide drops till full dilatation was
noted. ROP was staged and treatment was given accordingly.
RESULTS
Totally 152 infants were screened for ROP in the Department of Ophthalmology.
Babies with gestational age between 26 weeks and 36 weeks were included in the
present study. Babies with birth weight between 900 gm and 2000 gm were also
included in the study. Of the 152 babies which were included in the study, 54
babies presented with different stages of ROP. The incidence of ROP in the present
study was found out to be 35.5 %. When incidence of ROP was noted with respect
to birthweight, in extremely low birth weight (ELBW) babies, incidence was found
out to be 71.4 %; in very low birth weight (VLBW) babies incidence rate was found
to be 48.4 %. When incidence of ROP was noted with respect to gestational age
ROP incidence was found to be 65.2 % in babies with gestational age of < 32
weeks. There was no association with gender in the incidence of ROP. When ROP
incidence was noted in babies who received O2 therapy 59.2 % babies who
received O2 therapy developed ROP.
CONCLUSIONS
In our study, at our institute the incidence of ROP was 35.5 %. With appropriate
screening for the babies at risk we can prevent the development of ROP and
further complications. According to study results our recommendations are that
initial screening should to be done as early as 4 weeks of postnatal age or 34 - 35
weeks post conceptional age and to be followed till term gestation. In the present
study we found that usage of anti VEGF came out with promising outcome results.
The procedure of anti VEGF was relatively safe and easy with a smaller number of
complications when compared to laser photocoagulation.
