Objective: To analyze the risk factors involved in retinopathy of prematurity (ROP) and to report the incidence of ROP in premature infants from Mureș county, Romania.
Material and methods: Our study was based on a prospective study of premature infants with risk for developing ROP, based on international protocols, admitted to the Neonatal Intensive Care Unit from Tîrgu Mureș, between March 2008 and March 2010. In the study were included all the premature babies with gestational age ≤32 weeks and birth weight ≤1500 g, and those with gestational age >32 weeks and birth weight >1500 g, but with unstable perinatal evolution. Ophthalmic examinations were started at 4–6 weeks after birth, and followed until complete resolution of ROP or complete maturation of the retina. We used Chi square test and Fisher test to estimated relative risk (RR), associated with the risk factors of ROP.
Results: In our group of 137 premature babies monitored, 22% were in different stages of ROP. The advanced types of illness that needed therapeutic intervention represented 3% of all premature babies monitored and 13% of all babies with ROP. We found a statistically significant association between low birth weight (≤1500 g), low gestational age (≤32 weeks), mechanical ventilation for more than 7 days, intrauterine risk factors (maternal preeclampsia), respiratory distress syndrome, and the development of ROP. We also found a statistically significant association between extremely low birth weight (≤1000 g) and the development of severe forms of ROP. The other followed risk factors (blood transfusion, anemia or sepsis) were not linked significantly to the risk of ROP development.
Conclusions: Despite progress in neonatal intensive care, ROP persists and can be explained by greater prematurity and early screening. Effective screening procedures performed between the 4th and 6th week of life can improve the prognosis of the disease.
Tag Archives: retinopathy of prematurity
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.