Incidence Of Retinopathy Of Prematurity Research Articles

Effect of Kangaroo Mother Care on Retinopathy of Prematurity in Neonates Less Than 1,800 g or Below 34 Weeks of Gestation

Introduction KMC (Kangaroo Mother Care) is an established intervention to reduce mortality and morbidity in low birth weight (LBW) neonates. A multitude of risk factors and preventive strategies for ROP (retinopathy of prematurity) have been studied, however, the effect of KMC on ROP has not been reported. This study aims to study the effect of KMC on ROP in neonates with birth weights between 1,000 and 1,800 g. Methods The babies who received effective KMC (>6 hours per 24 hours for three consecutive days) were analysed in the intervention group and those with ineffective KMC were analysed in the control group. Variables significant in univariate analysis were entered into backward regression models in multivariate analysis. Odds ratios and 95% confidence intervals were calculated. P values < .05 are taken as significant. Results Of 783 neonates enrolled, 66 (8.4%) developed ROP (any stage). The incidence of ROP requiring intervention was 1.02%. Effective KMC reduced the risk of ROP by 95%, RR 0.05 (0.02–0.12) and number needed to treat = 5. The proportion of neonates with ROP in zone 1 and stage 3 was more in the ineffective KMC (42.4% vs. 1.5%) group than in the effective KMC group (51.5% vs. 0%) ( P < .001). Ineffective KMC, gestation <30 weeks, small for gestation, obstetric complications, asphyxia, sepsis, higher initial PEEP and lack of breastfeeding were significant risk factors for developing ROP. Conclusion KMC, an effective intervention to improve the mortality and morbidity in LBW neonates, was significantly associated with the reduction of any stage ROP and ROP needing intervention, potentially preventing a significant cause of childhood blindness.

The incidence and risk factors of retinopathy of prematurity in South Korea: A nationwide cohort study.

Retinopathy of prematurity (ROP) is a major treatable cause of childhood blindness. Thus, epidemiological investigations are necessary for detecting and preventing ROP. Determining risk factors for ROP are also essential to improve screening methods. Therefore, we aimed to investigate the incidence and risk factors of ROP in Korea. The National Health Insurance Service (NHIS) covers almost all Koreans. Furthermore, the National Health Screening Program for Infants and Children (NHSPIC) is a government-run, health-screening program for children aged < 6 years. We used the NHIS-Infants and Children's Health Screening cohort database to evaluate the incidence of preterm infants and ROP. The database contains data on 84,005 participants, drawn from 5% of the NHSPIC survey on participants born annually during 2008 to 2012. Sociodemographic factors and systemic diseases were assessed as potential risk factors for ROP. We identified 2615 premature infants (3.11%); 846 of them had ROP (cumulative incidence: 32.4%). Although preterm births increased annually in 2008 to 2012, the ROP incidence in preterm infants did not increase by the birth year. Twenty patients (2.4%) with ROP underwent laser photocoagulation or surgery. Extremely low birth weight was a high risk factor (odds ratio [OR] = 49.86, P < .001). Moreover, chorioamnionitis (OR = 2.77, P = .028), respiratory distress syndrome (OR = 4.09, P < .001), apnea (OR = 1.59, P = .008), anemia (OR = 2.41, P < .001), and intraventricular hemorrhage (OR = 2.34, P < .001) were found to be risk factors for ROP. In conclusion, the incidence of premature babies increased between 2008 and 2012. However, the overall incidence of ROP among premature infants remained unchanged by birth year. Our findings revealed the roles of birth weight, respiratory conditions, anemia, and intraventricular hemorrhage in ROP.

Nutritional interventions to prevent retinopathy of prematurity.

Very preterm infants are at high risk of growth failure. Poor weight gain is a prominent risk factor for retinopathy of prematurity (ROP) and optimizing nutrition could potentially promote growth and reduce ROP. Most infants at risk of ROP need parenteral nutrition initially and studies of enhanced parenteral provision of lipids and amino acids have suggested a beneficial effect on ROP. Higher amino acid intake was associated with lower incidence of hyperglycemia, a risk factor for ROP. For very preterm infants, providing unpasteurized fortified raw maternal breast milk appears to have a dose-dependent preventive effect on ROP. These infants become deficient in arachidonic acid (ArA)and docosahexaenoic acid(DHA) after birth when the maternal supply is lost. Earlier studies have investigated the impact of omega-3 fatty acids on ROP with mixed results. In a recent study, early enteral supplementation of ArA 100 mg/kg/d and DHA 50 mg/kg/d until term equivalent age reduced the incidence of severe ROP by 50%. IMPACT: Previous reviews of nutritional interventions to prevent morbidities in preterm infants have mainly addressed bronchopulmonary dysplasia, brain lesions and neurodevelopmental outcome. This review focusses on ROP. Neonatal enteral supplementation with arachidonic acid and docosahexaenoic acid, at levels similar to the fetal accretion rate, has been found to reduce severe ROP by 50% in randomized controlled trials.

Retinopathy of prematurity in triplets - Indian twin city ROP study report number 12.

To evaluate the incidence and severity of retinopathy of prematurity (ROP) amongst surviving triplets. Records of preterm babies born to mothers with triplet pregnancies were retrieved from our Indian twin city ROP study database between 1 Jan 2000 and 31 Dec 2020 and analyzed. 253 surviving triplet babies born to 108 mothers were evaluated. 48 out of 108 (44%) mothers received treatment for infertility. Data was available and analyzed for 242 babies (484 eyes). Mean gestational age was 31.76 ± 3.74 weeks (26- 38 weeks). The mean birth weight was 1.44 ± 0.37 kg (0.57-2.76 kg). At the first screening, incomplete vascularization was noted in 67% (131 babies;322 eyes) of which ROP was diagnosed in 14% (28 babies; 56 eyes). Among them, only 18 babies (53%) were the smallest birth weight babies in each of the triplet sets. Treatment with laser or bevacizumab was performed in 14 babies (5.8%), one eye of one baby additionally needed vitreoretinal surgical intervention. Good anatomical outcomes in terms of regression of ROP without sequelae were achieved in all babies. The present study reveals low incidence and favorable outcomes of ROP in triplet pregnancies in a large cohort of babies from a middle-income country. Our cohort did not show any difference in the treatment-requiring ROP among the larger or smaller birth weight babies of the same gestational age. In multiple pregnancies, gestational age remains a critical factor for ROP development; however, this does not necessitate modifying screening or treatment criteria in such triplet pregnancies.

A Study of the Demographic Profile, Screening, and Management of Patients Visiting a Retinopathy of Prematurity Clinic.

Background and objective Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease affecting premature infants. Despite improvements in neonatal care and management, ROP still remains a major cause of childhood blindness worldwide. Studying the demographic profile and screening is essential to develop predictive models, to gain insights into the cause of retinal vascular diseases and diseases of prematurity, and to determine the future management and research in ROP. The objective of the present study was to estimate the incidence of ROP, to identify the risk factors that predispose to ROP, and to assess the outcome of these cases. Hence, this study was conducted in a tertiary care hospital in Maharashtra. Method A prospective, observational study was conducted from 10 August 2022 to 10 October 2022.Infants withgestational ages < 34 weeks, birth weights< 2000 g, infants who received supplemental oxygen therapy, or patients who required NICU stay were screenedfor ROP. Demographic details were recorded to assess the risk factors and treatment was given according to the severity of ROP grade. Result A total of 160 eyes of80 infants were screened and analysed. The overall incidence of "any ROP" was19 patients (38 eyes), i.e., 24%. Out of 80 patients, six were of 28 weeks gestational age, of whomfour (67%) were positive for ROP. The mean birth weight of infants with ROP was 1331.58 ± 238.532 g (p < 0.0001). ROP stage 1 was seen in five patients (26.32%), stage 2 in 10 patients (52.63%), and stage 3 in four patients (21.0%), with no subjects in stages 4 & 5. Out of 19 patients, six (32%) had type 1 ROP, and 13 (68%) had type 2 ROP.Out of 19cases, 13 (68%) received follow-upcare based on the severity of their disease, and six (32%) were treated with panretinal photocoagulation (PRP) laser. Conclusion Incidence of any ROP was 24%. Prematurity, low birth weight, and oxygen therapy remain the most significant risk factors associated with the development of ROP. Early referral, diagnosis, and timely intervention will play a monumental role in improving the prognosis of this potentially blinding disease.

Frequency and risk factors of retinopathy of prematurity: a 5-year single-center study in a Tertiary Care Hospital

Aim Our study aimed to determine the frequency of retinopathy of prematurity (ROP) in a cohort of premature infants screened for ROP, to confirm the efficacy of our screening program used in the NICU to avoid childhood blindness. In addition, we aimed to study the associated risk factors affecting ocular status including birth weight (BW), gestational age (GA), mechanical ventilation, length of intensive care unit (ICU) stay, and number of ROP follow-up. Methods This was a retrospective cohort study conducted from March 2016 to March 2021. Data were retrieved from the records of preterm infants admitted to the neonatal intensive care unit in King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. The included data: Comprised perinatal data such as sex, BW, GA, multifetal gestation, and delivery type. Neonatal course: Need for surfactant, oxygen therapy, and mechanical ventilation (MV) duration. Neonatal complications: Chronic lung diseases [(respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD)], sepsis, neonatal jaundice, patent ductus arteriosus (PDA), hydrocephalus, and intraventricular hemorrhage (IVH). ROP examination: stage, zone, plus disease, extent, treatment, and number of the follow-up. Results In all, 337 preterm infants met the screening criteria and were included in the study. The majority (52%, n=177) were male; 148 (43.9%) were products of multifetal gestation, the mean GA was 29.35±2.77, and the median BW was 1195.1±338 gm. Caesarean section was the main mode of delivery in 80.5% of our sample (269 babies). ROP was detected in 181 (53.7%) infants, of which 110 (32.6%) had Stage 1, 57 (17%) Stage 2, and 14 (4.15%) had Stage 3. The majority (89.4%) were involved in zone 2–3, and five patients had the plus disease (1.48%). The number of ROP follow-up ranged between 2 and 25 visits either in the NICU or in the eye clinic following their discharge with a mean of 2.347. Conclusion The incidence of ROP in our sample was high relative to other local studies, which was related to the relatively high number of multifetal gestations with high chance of low birth weight as our center is an expert facility in in vitro fertilization. Male patient had a high incidence of development of different stages of ROP. Preterm babies with complicated neonatal course like NEC, Chronic Lung Disease, and IVH had high incidence of development of ROP.

Risk Factors for Retinopathy of Prematurity in Preterm Infants in Kerman, Iran.

Retinopathy of prematurity (ROP) is the main cause of blindness in premature infants. Despite developments in neonatal care and management guidelines, ROP is becoming increasingly prevalent worldwide. Hence, the identification of risk factors for ROP is critical to diminish the burden of the disease. This cross-sectional study included all infants with gestational age 36 weeks referred to the ophthalmology clinic at Shafa hospital, Kerman, Iran from 2014 to 2015. Ophthalmologic examinations were performed followed by demographic and ophthalmic data collection and analysis. A total of 579 preterm neonates were screened including 325 boys and 254 girls. The incidence of ROP was 17.96%. Mean birth weight (BW) and gestational age (GA) were 1668.0 grams and 31.2 weeks, respectively. The results indicated that BW, GA, duration of hospitalization and oxygen therapy were significantly related to the development of ROP, however, after multivariate logistic regression analysis, only BW and duration of hospitalization remained significant. There were no significant associations between gender, type of delivery, or assisted reproductive technologies, and ROP (P = 0.461, 0.461, and 0.826, respectively). BW and duration of hospitalization were significant risk factors for ROP in the current study. BW was also strongly associated with the need for therapy.

Association of Oxygen Therapy Concentration and Duration with Retinopathy of Prematurity Incidence at Naresuan University Hospital

Objective: This study aimed to evaluate the association between the concentration and duration of oxygen therapy and the development and severity of retinopathy of prematurity (ROP). Additionally, it sought to examine the incidence of ROP at Naresuan University Hospital. Materials and Methods: A retrospective observational cohort study was conducted, utilizing data from the medical records of infants admitted to the Neonatal Intensive Care Unit at Naresuan University Hospital, Phitsanulok, Thailand, from January 1, 2016, to December 31, 2022. The duration of various oxygen therapies was recorded in hours, and the concentration of oxygen administered per hour was calculated as the average fraction of inspired oxygen for each infant. These data were subsequently analyzed using STATA version 11.0. Results: Out of 100 eligible infants, 27 (27%) were diagnosed with ROP at different severity levels: 17 infants (62.96%) with ROP stage 1, 9 infants (33.33%) with stage 2, and 1 infant (3.70%) with stage 3. There were no cases of Stage 4 or 5 ROP. The adjusted risk ratio revealed that infants receiving an average FiO2 of 0.3 or higher had a 1.64 times greater risk of developing ROP [95%CI 1.03-2.62], (P-value=0.038). Further analysis using mean difference regression showed a significant correlation between the duration of oxygen therapy and the severity of ROP. Conclusion: This study suggests that regulating oxygen therapy to not exceed an FiO2 of 0.3 and administering it strictly as needed may mitigate the risk of developing ROP and its severe manifestations.

Comparative effectiveness of two lipid emulsions in preventing retinopathy of prematurity in preterm infants requiring parenteral nutrition

ObjectivesThe main aim was to compare the effects of 2 parenteral lipid emulsions on retinopathy of prematurity (ROP) incidence, severity, and need for treatment. Secondary aim was to compare the effect on weight gain in the first 6 weeks of life. MethodsSingle-center, observational, retrospective study analyzing preterm infants with a gestational age (GA) <31 weeks and a birth weight <1251 g born between April 2015 and December 2018. The infants' medical records were reviewed to collect clinical data. Parenteral nutrition (PN) details were obtained from the hospital pharmacy database. ResultsIn total, 180 patients were included: 90 received ClinOleic® and 90 received SMOFlipid®. No significant differences were observed for the incidence of ROP (40% in ClinOleic® group and 41% in SMOFlipid® group, p=.88) or ROP requiring treatment (4% and 10%, respectively, p=.152). Weekly weight gain was similar in the 2 groups. ConclusionsThis study showed no difference between the 2 groups regarding ROP, ROP requiring treatment, or weekly weight gain in the first 6 weeks of life.

Active versus restrictive ligation strategy for patent ductus arteriosus – A retrospective two-center study of extremely preterm infants born between 22 + 0 and 25 + 6 weeks of gestational age

BackgroundPatent ductus arteriosus (PDA) in premature infants is associated with adverse clinical outcomes. Mode and timing of treatment are still controversial. Data are limited in the most extremely premature infants <26 weeks of gestational age (GA), where clinical problems are most significant and patients are most vulnerable. AimsTo investigate whether different approaches to surgical closure of PDA in two large Swedish centers has an impact on clinical outcomes including mortality in extremely preterm infants born <26 weeks GA. Study designRetrospective, two-center, cohort study. SubjectsInfants born at 22+0–25+6 weeks GA between 2010 and 2016 at Uppsala University Children's Hospital (UUCH; n = 228) and Queen Silvia Children's Hospital Gothenburg (QSCHG; n = 220). Main outcome measuresSurvival, bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). ResultsSurgical closure of PDA was more common and performed earlier at QSCHG (50 % vs 16 %; median age 11 vs 44 days; p < 0.01). Survival was similar in both centres. There was a higher incidence of severe BPD and longer duration of mechanical ventilation at UUCH (p < 0.01). There was a higher incidence of ROP, IVH and sepsis at QSCH (p < 0.05, p < 0.01 and p < 0.01). A sub-group analysis matching all surgically treated infants at QSCHG with infants at UUCH with the same GA showed similar results as the total cohort. ConclusionEarlier and higher rate of surgical PDA closure in this cohort of extremely preterms born <26 weeks GA did not impact mortality but was associated with lower rates of severe BPD and higher rates of severe ROP.

Effect of Nasal Continuous Positive Airway Pressure on Retinopathy of Prematurity in Preterm Newborns: A Comparative Analysis with Mechanical Ventilation and High-Flow Nasal Cannula Therapy.

BACKGROUND Retinopathy of prematurity (ROP), originally described as retrolental fibroplasia, represents an abnormal growth of blood vessels in the premature retina that can occur in response to oxygen therapy. The association between ROP and invasive mechanical ventilation has been widely studied in the literature; however, the relationships between different types of ventilation and ROP have not been as well documented. This study aimed to compare the association of ROP incidence with mechanical ventilation (MV), nasal continuous positive airway pressure (nCPAP), and high-flow nasal cannula (HFNC) therapies in 130 pre-term infants with gestational ages <32 weeks. MATERIAL AND METHODS The study includes 130 premature newborns, out of which 54 underwent MV therapy, either alone or in combination with nCPAP or HFNC therapy, 63 underwent nCPAP therapy, either alone or in combination with MV or HFNC therapy, and 23 underwent HFNC therapy, either alone or in combination with MV or nCPAP therapy. The relationships between ROP and the 3 types of ventilation were analyzed by univariate followed by multivariate logistic regression. RESULTS When adjusting for covariates, only nCPAP and birth weight were significantly associated with ROP, the former being a strong risk factor, with an adjusted odds ratio (AOR) of 7.264 (95% CI, 2.622-20.120; P<0.001), and the latter being a weak protective factor, with an AOR of 0.998 (95% CI, 0.996-0.999; P<0.05). CONCLUSIONS The results showed nCPAP was a strong ROP risk factor, birth weight was a weak ROP protective factor, and MV and HFNC were not significantly associated with increased ROP risk.

Vision on wheels: Technician-assisted retinopathy of prematurity screening in rural Tamil Nadu and Andhra Pradesh: 2018-2021 Project Report.

To analyze the incidence of sight-threatening retinopathy of prematurity (ROP) in premature infants in rural Tamil Nadu and Andhra Pradesh from 2018 to 2021, and to analyze its association with birthweight (BW), gestational age (GA), and postconceptional age (PCA). Project Vision on Wheels is a free ROP screening and treatment program initiated by a tertiary eye care center in South India in June 2018 to screen preterm infants in rural areas in 11 centers in Tamil Nadu and Andhra Pradesh by trained technicians. Infants with sight-threatening ROP were immediately shifted for vision-preserving laser. Of the 18,117 infants screened from 2018 to 2021, 1046 infants underwent laser, with the majority being bigger and more mature when compared to Western data. There was a yearly increase in the number of infants with sight-threatening ROP in the lower BW, GA, and PCA categories. The timely detection of the condition by committed screening led to salvage of vision by timely laser in 100% of the treated babies in all the years. The incidence of sight-threatening ROP had a yearly decrease in higher BW, GA, and PCA categories. These trends were statistically significant ( P = 0.001 for ROP and BW, P = 0.037 for ROP and GA, and P = 0.001 for ROP and PCA). The statistically significant trend of decreasing sight-threatening ROP in babies with higher BW, GA, and PCA and increasing treatable ROP in younger and smaller babies (with lower BWs, GAs, and PCAs) in rural India, over time, is a hitherto unreported finding. This is the first such study in rural Tamil Nadu and Andhra Pradesh combined, with the largest data to date (as per MEDLINE search) to document this healthier trend.

Nomogram to predict severe retinopathy of prematurity in Southeast China.

To define the predictive factors of severe retinopathy of prematurity (ROP) and develop a nomogram for predicting severe ROP in southeast China. Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children's Hospital were included. Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively. Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction, which was compared with WINROP model and Digirop-Birth model. Infants from the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University (n=478) were randomly allocated into training (n=402) and internal validation group (n=76). Infants from Taizhou Women and Children's Hospital were set as external validation group (n=76). Severe ROP were found in 52 of 402 infants, 12 of 76 infants, and 7 of 76 infants in training group, internal validation group, and external validation group, respectively. Birth weight [odds ratio (OR), 0.997; 95% confidence interval (CI), 0.996-0.999; P<0.001], multiple births (OR, 1.885; 95%CI, 1.013-3.506; P=0.045), and non-invasive ventilation (OR, 0.288; 95%CI, 0.146-0.570; P<0.001) were identified as predictive factors for the prediction of severe ROP, by univariate analysis and multivariate analysis. For predicting severe ROP based on the internal validation group, the areas under receiver operating characteristic curve (AUC) was 78.1 (95%CI, 64.2-92.0) for the nomogram, 32.9 (95%CI, 15.3-50.5) for WINROP model, 70.2 (95%CI, 55.8-84.6) for Digirop-Birth model. In external validation group, AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model (80.2 versus 51.1 and 63.4). The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model. The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability. Birth weight, multiple births, and non-invasive ventilation are independent predictors of severe ROP. The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.

OVERVIEW OF PATIENTS SCREENED FOR AND DIAGNOSED WITH ROP IN PEDIATRIC OPHTHALMOLOGY OUTPATIENT CLINIC BEFORE, DURING, AND AFTER THE COVID-19 PANDEMIC

Introduction &amp; Objectives : The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, leading to significant changes in the delivery of medical services. Non-urgent ophthalmology visits were canceled. However, premature infants at risk of retinopathy of prematurity (ROP) require timely and in-person care to prevent vision loss. This study aims to report on the high-risk babies screened and diagnosed with ROP before, during, and after the COVID-19 pandemic&#x0D; Methods : This is a descriptive study conducted on premature infants who visited the pediatric ophthalmology outpatient clinic at Cipto Mangunkusumo Hospital Jakarta between January 2019 and December 2022. Data was collected using medical records and presented using tables and charts&#x0D; Results : A total of 368 babies were screened for ROP in 2019, and 75% were diagnosed with ROP. During the lockdown in 2020, the number of babies screened for ROP decreased to 286, and the incidence of ROP was 38.5%. In 2021 and 2022, ROP screening increased to 458 and 515 babies per year, respectively. After the COVID-19 pandemic subsided, ROP screenings increased significantly from 2020 to 2021. The number of babies screened in 2021 and 2022 was similar, but the incidence of ROP decreased from 45.4% in 2021 to 20.3% in 2022&#x0D; Conclusion : This study highlights the impact of the COVID-19 pandemic on ROP screening and diagnosis in a pediatric ophthalmology outpatient clinic. After the COVID-19 pandemic, the number of babies screened for ROP increased due to the end of the lockdown

CHARACTERISTICS OF RETINOPATHY OF PREMATURITY IN MAKASSAR BETWEEN JANUARY 2020 AND DECEMBER 2022

Introduction &amp; Objectives : Introduction: Retinopathy of Prematurity (ROP) is one of the leading causes of irreversible visual impairment in infants, especially in premature infants. Preterm birth leads to incomplete development of retina that will cause ROP. ROP screening is an early strategy to prevent irreversible blindness in ROP. Objective: The purpose of this study was to describe the characteristics of ROP in Makassar between January 2020 and December 2022.&#x0D; Methods : A multi-center observational descriptive study at ten hospitals in Makassar.&#x0D; Results : The total patients in this study were 168 infants (336 eyes) included 53.25% male and 46.15% female. The incidence of ROP in Makassar between January 2020 and December 2022 was 14.87%. Most of the patients had history of preterm birth with gestational age ranged from 28 to 33 weeks and low birth weight less than 1500 gram in 50% patients. Majority of patients had history of oxygen therapy (77.98%), and other risk factors such as sepsis, twin birth, history of transfusion, or apnea. About 98.81% patients had bilateral ROP and 33.93% were diagnosed with stage 3 at first screening. Photocoagulation laser was done in 41 patients (24.40%).&#x0D; Conclusion : The ROP screening in Makassar had a good outcome in managing the premature infants, so they can be diagnosed and got treated earlier. A sustainable screening program is required to prevent the irreversible blindness due to ROP.

RETINOPATHY OF PREMATURITY IN TERTIARY REFERRAL EYE HOSPITAL IN INDONESIA: CHARACTERISTICS AND MANAGEMENT

Abstract&#x0D; Introduction &amp; Objectives : Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina that occurs in premature infants. Incidence of ROP is higher in middle- and lower-income countries, including Indonesia; hence information about the characteristics of the patients is essential to make strategies regarding its management. The aim of this study is to describe the characteristics and managementof patients with retinopathy of prematurity at the National Eye Center, Cicendo Eye Hospital.&#x0D; Methods : Data were obtained retrospectively from medical records from January 2018 until December 2020 using ICD-10 coding for retinopathy of prematurity. Variables include demographic data, clinical characteristics, and management.&#x0D; Results : In total, 177 patients (340 eyes) were included in this study. Demographically, 53.7% of the patients were boys; 67.8% came from West Java; 93.2% were referred; and 85.9% were health coverage users. The mean gestational age was 29.9±2.6 weeks and the mean birth weight was 1415.6±393.1 grams. Most of the patients have bilateral conditions and already have stage 5 ROP, regardless of their gestational age and birth weight. Conservative management was given to 95.5% of stage 5 ROP patients. As many as 50% of stage 4 patients underwent pars plana vitrectomy, and 85.4% stage 3 patients were managed by laser photocoagulation. Those in earlier stages were mainly observed first.&#x0D; Conclusion : Patients with ROP at Cicendo Eye Hospital mostly came in the advanced stage of the disease with conservative management. Early screening, timely referral, and prompt treatment are recommended in order to prevent blindness in premature infants.

Retinopathy of Prematurity in Very Low Birthweight Neonates of Gestation Less Than 32weeks in Malaysia.

To determine the screening rates and incidence of retinopathy of prematurity (ROP), and risk factors associated with ROP in very low birthweight (VLBW, <1500g) neonates of gestation <32 wk admitted to neonatal intensive care units (NICUs) in a middle-income country. It was a retrospective cohort study of prospectively submitted data by 44 Malaysian NICUs participating in the Malaysian National Neonatal Registry. All VLBW neonates of gestation <32 wk born in 2015-2020 and survived to discharge were included. Of 11768 survivors, 90.5% (n = 10436) had ROP screening; 16.1% (1685/10436) had ROP. ROP was significantly more common in neonates <28 wk gestation (extremely preterm, EPT) than ≥28 wk gestation (37.7% vs. 9.7%; p <0.001), and more common in those with birthweight <1000g (extremely low birthweight, ELBW) than ≥1000g (32.9% vs. 9.1%; p <0.001). Multiple logistic regression analysis showed that the significant independent factors associated with increased risk of ROP were ELBW, EPT, Indian ethnic group, vaginal delivery, mechanical ventilation >5 d, high frequency ventilation, total parenteral nutrition, late-onset sepsis, bronchopulmonary dysplasia, and intraventricular hemorrhage. Receiving oxygen therapy at birth was associated with significantly lower risk of ROP. The incidence and severity of ROP increased with decreasing gestation and birthweight. Prolonged duration of oxygen therapy, infection, invasive respiratory support, and conditions commonly causing fluctuations of oxygenation were significant factors associated with increased risk of ROP. Receiving oxygen at birth did not increase risk.

Effect of Breast Milk Feeding on Retinopathy of Prematurity in Neonates Less than 1800 Grams: A Cohort

Introduction Human milk has many antioxidants like Docosahexaenoic acid (DHA), inositol, and vitamin E that combat oxidative stress deregulating VEGF which is implicated in the pathogenesis of retinopathy of prematurity (ROP). Thus, it is biologically plausible that human milk is protective towards ROP. Aim and objective The study aimed to find the association between ROP and breast milk feeding. Methodology The prospective cohort study was carried out for 18 months at the Newborn unit, SJH. In our study, mothers were asked to maintain a feeding diary (type of milk fed) and history was taken from the mother regularly. Each neonate was later assigned a feeding category including exclusively breast milk fed, more than 50% breast milk fed, more than 50% top milk-fed, and exclusively top milk fed. At four weeks of age, all these neonates were called to undergo screening for ROP. In the case of immature retina, neonates were followed up for repeat fundus exams and results were included in the study. Result A study on 521 neonates between birth weight of 1–1.8 kgs found that predominant breast milk feeding reduces the chance of any stage ROP (needing repeat screening or intervention). The total incidence of any stage ROP in this study was noted to be 16.2% where 4.1% of total neonates from the predominantly breastfed group as compared to 37.8% from the predominantly top-fed group developed any stage ROP. Conclusion Breast milk feeding has a significant benefit in reducing any stage ROP and ROP needing intervention, thus it has the potential to prevent a significant cause of childhood blindness. What is already known – Breast milk feeding may be protective towards ROP What the study adds – Breast milk feeding is independently protective towards ROP

Postnatal weight gain and retinopathy of prematurity in preterm infants: a population-based retrospective cohort study

Objective Infants who meet the screening guidelines for retinopathy of prematurity (ROP) based on birth weight and gestational age undergo serial ophthalmological examinations for its detection and treatment. However, <10% of patients require treatment, and less than half develop ROP. Poor postnatal weight gain has been reported to be a strong indicator of ROP development; however, the information regarding this is unclear. Therefore, this study aimed to determine the relationship between postnatal weight gain and ROP development in preterm infants. Methods The data of 675 preterm infants with gestational age ≤32 weeks, who were hospitalized in our neonatal intensive care unit, were obtained retrospectively from file records. The infants’ demographic characteristics, clinical findings, and weekly weight gain (g/kg/day) during the first 8 weeks were recorded. The univariate was used to examine the risk factors for ROP followed by multivariate regression. Results The incidence of ROP in the infants included in the study was 41% (n = 278) and 13.3% (n = 37) of them required treatment. In the infants of the group that developed ROP, the mean birth weight and gestational age were significantly lower than those in the group that did not develop ROP (973 ± 288 and 1301 ± 349 g, p = 0.001 and 28.48 ± 1.95 and 30.08 ± 1.60 weeks, p = 0.001, respectively). As the gestational week and birth weight decreased, ROP development and the risk of ROP-requiring treatment increased. In the infants of the group that developed ROP, the mean weight gain in the postnatal third week was detected as significantly lower compared to those in the group that did not develop ROP (13.9 ± 8.2 and 15.4 ± 6.8 g, p = 0.034). On multiple logistic regression analysis, birth weight (<750 g) (odds ratio [OR], 8.67; 95% confidence interval [CI], 3.99–18.82, p = 0.001), blood transfusion (OR, 2.39; 95% CI, 1.34–4.24, p = 0.003), necrotizing enterocolitis (OR, 4.79; 95% CI, 1.05–26.85, p = 0.045), bronchopulmonary dysplasia (OR, 2.03; 95% CI, 1.22–3.36, p = 0.006), antenatal steroid therapy (OR, 1.60; 95% CI, 1.05–2.43, p = 0.028), surfactant administration (OR, 2.06; 95% CI, 1.32–3.2, p = 0.001) were independent risk factors for ROP development. Conclusion Postnatal weight gain may not be an accurate predictor of ROP development after adjusting for confounding factors. However, the analysis of independent risk factors that influenced the development of ROP revealed a statistically significant effect in cases of low birth weight, blood transfusion, necrotizing enterocolitis, bronchopulmonary dysplasia, and antenatal steroid and surfactant therapies. These findings may help ophthalmologists and neonatologists to pay special attention to this patient group during ROP scanning.

Insights into Risk: Exploring Retinopathy of Prematurity and Short-term Comorbidities in Moderate-to-Late Preterm Infants.

Retinopathy of prematurity (ROP) and short-term comorbidity data moderate-to-late preterm (MLP) infants in Saudi Arabia are limited. The present study mainly aimed to identify ROP incidence and severity in MLP infants. The secondary objective was to explore whether moderate preterm infants are more prone to systemic short-term comorbidities compared to late preterm infants. This retrospective study was conducted at King Abdulaziz University Hospital, a tertiary center in Jeddah, Saudi Arabia. Two-hundred and sixty-eight MLP infants born with gestational ages (GAs) of 32 to 36 + 6 weeks were included. Births were classified as moderate preterm (GA 32 to 33 + 6 weeks) and late preterm (GA 34 to 36 + 6 weeks) and the two groups were compared with an independent t-test. ROP incidence was 1.5%; all cases were stage 1 and involved zone II or III. No patient had type 1 ROP requiring treatment. The short-term comorbidity incidence was high (76.1%) and included hyperbilirubinemia (n = 206, 76.7%), respiratory distress syndrome (n = 178, 66.4%), hypoglycemia (n = 32, 11.9%,), and transient tachypnea of newborn (n = 25, 9.3%). Moderate preterm infants were more likely to have lower birth weight (P < 0.001), any-stage ROP (P = 0.032), respiratory distress syndrome (P = 0.031), intraventricular hemorrhage (P = 0.038), and hyperbilirubinemia (P < 0.001) compared to the late preterm infants. Any-stage ROP incidence among MLP infants was low, with no type 1 ROP cases requiring treatment. Short-term comorbidity incidence was relatively high among the moderate preterm infants. Despite the low non-type 1 ROP incidence at our center, MLP infants require proper surveillance of systemic short-term comorbidities.