Abstract
ABSTRACT To describe the prevalence of risk factors for retinopathy of prematurity and respective stages. Retrospective data were extracted from original articles addressing risk factors for retinopathy of prematurity retrieved from Scientific Electronic Library Online (SciELO), Virtual Health Library (VHL) and National Library of Medicine - NLM (PubMed) databases. In the initial search, 186 articles were found. Following title and abstract reading and application of inclusion and exclusion criteria, 25 articles were selected for this analysis. Variables of interest varied widely between studies. Gestational age and birth weight were listed as risk factors in all studies. Gender analysis revealed small gender-related differences, since approximately 52.9% of affected neonates were males and 47.1% females. As to race/color, approximately 72.7% were white, 12% were brown and 2.7% were black. However, there is a lack of consensus over the significance of these factors. The study revealed that retinopathy of prematurity is a multifactorial disease primarily associated with prematurity, low birth weight and oxygen therapy. Albeit potentially avoidable and reversible, the incidence of the condition is high. Therefore, further studies along the same lines are needed for deeper understanding of risk factors for or retinopathy of prematurity and mitigation of long-term consequences.
Highlights
Retinopathy of prematurity (ROP) is a vasoproliferative ocular disease caused by inappropriate vascularization of the immature retina of preterm newborns (PTNB).(1) The condition was first described by Terry(2) in 1942 and named retrolental fibroplasia
ROP is a multifactorial disease which may involve the following risk factors: oxygen therapy, intracranial hemorrhage, maternal factors such as multiple pregnancies, diabetes mellitus, advanced maternal age, smoking, iron deficiency, placental detachment and maternal preeclampsia, blood transfusions, septicemia, congenital infections, patent ductus arteriosus, Apgar score lower than 7 at five minutes, small stature for gestational age (GA) and especially prematurity and low birth weight (BW).(7,8) It is estimated that 66 to 68% of PTNBs weighing less than 1,251 g develop ROP and this percentage rises to 82% in PTNBs weighing less than 1,000 g.(9)
This classification is used for recognition of threshold ROP, which is defined as stage 3 plus disease with more than 5 contiguous or 8 cumulative clock hours of fibrovascular proliferation in zones I and II.(10) The clinical significance of threshold ROP lies in the fact that, in the absence of appropriate treatment, approximately 50% of cases will progress to retinal detachment and loss of vision .(11)
Summary
Retinopathy of prematurity (ROP) is a vasoproliferative ocular disease caused by inappropriate vascularization of the immature retina of preterm newborns (PTNB).(1) The condition was first described by Terry(2) in 1942 and named retrolental fibroplasia. 50,000 new cases of ROP are diagnosed annually, primarily in Latin America newborns.(1) In Brazil, 16,000 PTNBs are estimated to develop ROP each year and approximately 10% of these cases progress to blindness when left untreated.(5) Recent studies indicate a growing number of cases of ROP This may reflect larger numbers of premature births, financial constraints, delayed referral or unpreparedness of many ophthalmologists and resultant misdiagnosis and lack of appropriate treatment.(1,6). Respiratory distress syndrome or sepsis, blood transfusions, multiple pregnancies and intraventricular hemorrhage are indications for binocular indirect ophthalmoscopy, since these are thought to be risk factors for threshold ROP development.(12)
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