Retinopathy Of Prematurity In Babies Research Articles

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.

Course and outcome of retinopathy of prematurity in babies of multiple pregnancies

Purpose The aim of this study was to evaluate the course and outcome of retinopathy of prematurity (ROP) in babies of multiple pregnancies (twin and triplet neonates).Patients and methods This is a retrospective study in which we reviewed the records of 128 babies (all twin and triplet neonates), who were admitted to the biggest neonatal ICU in El Mahalla El-Kubra City, Gharbeya province, Egypt over the period between January 1, 2019 and July 1, 2021. The clinical information about perinatal neonates was collected. The main outcome measures were incidence, course, and final outcome of ROP in terms of regression (spontaneous or after treatment) or progression. The relationship of the clinical risk factors and the development of ROP were also analyzed.Results The overall incidence of ROP in twins and triplets was 36%, which was statistically higher in triplets (24/36=66.6%) than in twins (22/92=24%) (P<0.001). The overall incidence of type 1 ROP was 28%. In 30 pairs of twins (30/46=65%), the course was symmetrical in both babies, while in 16 (35%) pairs, the course and outcome were asymmetrical. In six triplets (6/12=50%) the course was symmetrical, while in the other six (50%) triplets the course was asymmetrical.Conclusion ROP can take asymmetrical course in twins and triplets. Even it can happen only in the heavier baby. Therefore, examination of both babies of twins and all babies of triplets is essential in ROP protocols.

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Role of anemia in incidence and progression of retinopathy of prematurity in premature infants

Aim of the study: This study aims to correlate the relationship of retinopathy of prematurity (ROP) with anemia in premature infants with regard to incidence and progression of ROP. Materials and Methods: All high-risk infants from our institution and neighboring districts as selected by neonatologist were screened at Special newborn care unit every Thursday on regular basis, and this study includes infants screened at ROP clinic during January 2017–March 2017. Conclusion: In our study at ROP clinic, high-risk premature infants who were screened showed a significant prevalence of ROP in babies weighing <2.000 kg and with female preponderance. The role of anemia and other neonatal risk factors needs to be evaluated further in our ongoing study.

Retinopathy of prematurity in babies weighing &lt;1800 g; with special reference to babies weighing between 1501 and 1800 g: An experience from a tertiary care hospital in Delhi

Background: Retinopathy of prematurity (ROP) is a disease related to low birth weight, prematurity, oxygen administration, and various other factors, which are yet to be identified. Aims: The aim was to find incidence of ROP and risk factors for causation in babies weighing Design: Prospective study. Materials and Methods: Neonates weighing ≤1800 g taking birth in our institution from January 2011 to January 2012 for a span of 1 year; were included in the study. The data were analyzed to determine risk factors for ROP causation. Information was collected using the standardized performa which included the maternal risk factors as well. Infants were classified by ophthalmologic examination findings using ICROP revisited. Statistics: Qualitative data were analyzed using Pearson's Chi-square test with Yates correction or Fisher's exact test and possible risk factors were analyzed by univariate analysis and multivariate analysis. Results: A total of 278 subjects was included in the study. Incidence of ROP in babies ≤1800 g was found to be 13.67% (38/278). Incidence of ROP in babies weighing between 1501 and 1800 g was 11.64% (17/146). Twenty-one risk factors were significant on univariate analysis in babies weighing ≤1800 g and 18 risk factors in the babies weighing between 1501 and 1800 g. Multiple gestations ( P P P P P P P P Conclusion: It should be considered to incorporate screening of babies ≤1800 g uniformly in developing nations. It is recommended that further studies be done taking representative population of babies in different sites with adequate follow-up.

Role of Hematological Parameters in Predicting Retinopathy of Prematurity (ROP) in Preterm Neonates

To study the role of hematological parameters in predicting retinopathy of prematurity (ROP) in preterm neonates. Two hundred forty eight babies less than 34 wk and/or with a birth weight of less than 2,000 g were evaluated. Peripheral blood smear and complete blood count were done on day one of life. Ophthalmological examination was done as per guidelines and grades of ROP classified and followed up till 40 wk of gestation for complete vascularisation. Cases were matched with similar number of controls (n = 67) and the sensitivity, specificity and positive predictive value of different parameters were assessed. The incidence of ROP on screening was found to be 27%. Sixty seven cases were matched with 67 controls as per birth weight and gestational age. Significant risk factors for ROP included longer duration of ventilation, higher FiO2, culture proven sepsis and apnea requiring pharmacotherapy. The incidence of Stage I was 10.5% (n = 7), Stage II 58.2% (n = 39) and Stage III was 31.3% (n = 21). The absolute nucleated RBC (ANRBC) count was found to be the only parameter which was significantly higher in babies with ROP (p < 0.001). The ANRBC was higher with increasing severity of ROP (p = 0.003). The sensitivity, specificity and positive predictive value of ANRBC with ROP was higher than other parameters. Increase in ANRBC count correlated with intrauterine hypoxia. Hence, an increase in ANRBC count could be used as a screening tool for the early prediction of ROP in babies.

SpO2 and retinopathy of prematurity: state of the art

Aim: To evaluate the relationship between arterial saturation values determined by pulse oximetry in the first weeks of life on the incidence of retinopathy of prematurity (ROP). Methods: Randomized and observational studies were sought that compare the incidence of ROP in babies with high or low oxygen saturation targeting assisted by pulse oximetry. Results: Over the last 15 years, evidence from experimental models of ROP and clinical studies, albeit not randomized trials, has shown a reduction in the incidence of ROP and other neonatal morbidities when very preterm newborns were targeted to a lower level of arterial oxygen saturation during their hospitalization, particularly in the first few weeks after birth. More recent evidence from randomized controlled trials confirms that targeting to a lower vs higher level of oxygenation from birth to 36 weeks postmenstrual age (PMA) or to hospital discharge reduces the incidence of ROP requiring treatment by 50% but is correlated with higher mortality rates. Conclusion: Future randomized, controlled trials should be designed including a cohort of infants in which a more dynamic approach to saturation targeting is adopted, i.e. lower saturation levels in the first few weeks of life and higher saturation levels after the 32 weeks of PMA.

Screening for Retinopathy of Prematurity in a Large Tertiary Neonatal Intensive Care Unit in Turkey: Frequency and Risk Factors

Purpose: We aimed to determine applicable guidelines for screening of retinopathy of prematurity (ROP), and evaluate the contribution of risk factors for severe ROP.Methods: A prospective cohort study of neonates with a gestational age (GA) < 34 weeks or birth weight < 2000g who were admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary level hospital was conducted. The study group was classified into three groups according to eye examination findings as no ROP, mild ROP and severe ROP.Results: Of the 700 neonates screened, the frequencies of ROP for any stage and severe ROP were 32.7% and 3.1%, respectively. Laser photocoagulation was needed in 9.6% of neonates with ROP. None of the neonates with a GA ≥ 31 weeks required treatment. Any ROP was detected in 199 (53.6%) of the babies < 32 weeks (n = 371), 22 (5.9%) of whom were treated with laser photocoagulation. Independent risk factors for severe ROP in babies < 32 weeks GA were birth weight, duration of mechanical ventilation and patent ductus arteriosus (PDA).Conclusion: This is the largest prospective cohort study including infants younger than 34 weeks GA from Turkey. Our data which belongs to the last 1-year period shows lower incidence of severe ROP when compared to previous reports from Turkey. According to our data, screening babies smaller than 32 weeks GA or 1500g birth weight seems reasonable. In the presence of long duration of mechanical ventilation and PDA, screening should be intensified.