Four Years Experience in Retinopathy of Prematurity

Purpose: Analysis of the results of screening and treatment for retinopathy of prematurity (ROP) in a sample of prematurely born babies evaluated in the Neonatal Intensive Care Unit and Neonatology Prematures Clinic of Targu Mures, between January 2008 and January 2012.
Material and method: We conducted a prospective study on all premature infants born with less than 34 weeks gestational age (GA) and lower than 2000 g birth weight (BW). The first ophthalmoscopic examination was performed between 4 and 6 weeks after birth, regardless of gestational age. The treatment was needed in threshold (or prethreshold) disease.
Results: Different stages of ROP were found in 24.1% from the total 503 infants: stage 1 in 34 eyes (28.1%), stage 2 in 65 eyes (53.7%), stage 3 in 16 eyes (13.2%) and stage 5 in 6 eyes (5%). We didn’t have cases with stage 4 ROP. Statistical analysis showed that GA and BW are highly significant risk factors for the development of ROP, with a risk reduction as the values of gestational age and birth weight were higher. The indication for laser treatment was set at 3.97% of all premature, respectively in 16.53% of children with ROP. Favorable evolution after laser treatment was observed in 80% of cases. From the others, who had no positive response to laser treatment, 75% had aggressive posterior ROP (APROP). We recorded a statistically significant association between BW and the incidence of cases which required laser therapy (p=0.0058), but no statistically association was found between GA and grades of diseases that needed laser (p=0.0789).
Conclusions: Screening for retinopathy of prematurity requires an experienced paediatrician-ophthalmologist, recognition of severe disease that requires treatment being crucial. Performed strictly and in accordance with international protocols, screening remains the first step in the detection and management of retinopathy of prematurity.

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