Risk Factors For Retinopathy Of Prematurity Research Articles

Retinopathy of Prematurity: A Review of Risk Factors, Oxygen Targets, Screening Criteria

Retinopathy of Prematurity (ROP) is a disease of immature retinal tissue that is strongly associated with prematurity, low birth weight, and prolonged oxygen exposure. The purpose of this review is to evaluate published literature to determine which factors can be linked to the development of ROP, which factors are protective against ROP, and which factors are still unclear. It also sought to review the major oxygenation trials in premature infants to establish the recommended oxygen saturation targets in premature babies and what criteria are useful in evaluating infants for ROP. Databases (PubMed, Medline, PubMed Central, and Google Scholar) were used to obtain relevant literary articles. Key findings suggested that major risk factors for ROP were prematurity, low birth weight, and prolonged oxygen exposure. Evidence suggests that maternal diabetes, maternal smoking, prolonged rupture of membranes, lack of antenatal steroids, ethnicity, multiple births, low Apgar scores, and sepsis are risk factors for the development of ROP. Evidence suggests that maternal hypertensive disorders, mode of birth, and chorioamionitis are not associated with ROP. Recommendations of oxygen saturations in the neonate include targets of 90-95% and 90-94%. Screening for ROP is dependent on birth weight, gestational age, and risk factors, with recommendations varying according to pediatric societies.

Incidence and Risk Factors for Retinopathy of Prematurity in a Portuguese Cohort.

To evaluate the incidence and risk factors for retinopathy of prematurity (ROP) in two Portuguese neonatal units with a sub-analysis of infants with a gestational age (GA) of 28 weeks or older. This was a retrospective case series of all infants who underwent ROP screening from 2012 to 2020. Demographic, clinical, and laboratory data were collected. Univariate logistic regression was used to examine the risk factors for ROP followed by multivariate regression. A total of 475 infants were included with a median GA of 30 weeks (range: 23 to 36 weeks) and a median birth weight of 1,229 grams (range: 408 to 2,620 grams). ROP was diagnosed in 113 infants (23.8%) and 29 (6.1%) were treated. In the multivariate analysis, GA and hyperglycemia were significantly associated with severe ROP (P < .001). In the subgroup analysis of infants with a GA of 28 weeks or older, bronchopulmonary dysplasia, late-onset sepsis, and hyperglycemia were linked to severe ROP. The incidence of ROP in the cohort falls within the range of other high-income countries. Hyperglycemia overpowered all of the other risk factors. Although rare, more mature infants are also at risk for severe ROP. Infants with older GA share the same group of risk factors, but bronchopulmonary dysplasia seems to play a greater role. [J Pediatr Ophthalmol Strabismus. 2022;59(4):254-260.].

Dysregulated genomic and coding-transcriptomic factors in retinopathy of prematurity

Retinopathy of prematurity (ROP) is a type of vitreous retinopathy in premature children that leads to visual impairment and blindness at early ages. ROP is a lifetime disease that can impose a tremendous economic and psychological burden on the government and society. ROP is characterized by abnormal neovascularization in the retina. ROP is a multifactorial disease that means many factors are involved in the pathogenesis of ROP, such as low birth weight, short gestational age as a primary risk factor for ROP, anemia, intraventricular hemorrhage, inflammation, sepsis, underlying diseases, maternal preeclampsia, and other factors. Some studies suggest that genetic factors play an essential role in ROP pathogenesis and development. In addition, monitoring genetic factors such as genetic polymorphism may pave the way for diagnosis and prognosis ROP, leading to prevention and stopping disease progression in time. Understanding the genomics of diseases opened a new door for treatment. Genetic-based therapeutic approaches are preventive strategies that can effectively prevent the progression of ROP and improve infants' lives. In this study, we reviewed some genetic factors involved in ROP pathogenesis and development, and in the following, we survey some new genetic-based therapeutic approaches for treating ROP in preterm infants.

Risk Factors for Retinopathy of Prematurity with Specific Emphasis on Postnatal Weight Gain: An Observational Study

Introduction: Retinopathy Of Prematurity (ROP) is a vasoproliferative disorder that affects premature infants with multiple risk factors. Timely screening and treatment can help decrease this preventable cause of blindness. Aim: To assess the risk factors for development of ROP, and to study its association with postnatal weight gain. Materials and Methods: This was an observational study with both prospective and retrospective arms. In the retrospective component, the case files and ROP screening records of the infants were screened, in the duration of July 2019 to February 2020. The prospective data was collected from the ongoing screening sessions, during March 2020 to November 2020. The risk factors for ROP, and postnatal weight gain was observed during the ROP screening programme conducted at the intramural Neonatal Intensive Care Unit (NICU) of Sir Sayajirao Hospital, Vadodara, Gujarat, India. Infants with Birth Weight (BW) &lt;2000 g and Gestational Age (GA) &lt;34 weeks and those with high risk factors {prolonged oxygen exposure, mechanical ventilation, anaemia requiring blood transfusion, Intraventricular Haemorrhage (IVH), Respiratory Distress Syndrome (RDS), Bronchopulmonary Dysplasia (BPD), recurrent apnea, hypotension requiring inotropes, surgery during first week of life, sepsis and hypoglycaemia} were included in the study. Subjects were followed-up till 44 weeks Post-Menstrual Age (PMA), or till complete vascularisation of retina or regression of ROP on retinal examination whichever was earlier. Risk factors were studied using univariate analysis and multivariate regression. Weight gain was studied using independent sample t-test. Results: A total of 486 neonates were enrolled, who underwent serial ophthalmological examinations. Out of these, 375 infants (198 (52.8%) male and 177 (42.7%) females) underwent examinations until 44 weeks of PMA or till complete retinal vascularisation, or till complete regression of ROP with or without treatment. Out of these, 173 patients had no ROP, 120 patients developed ROP which got spontaneously regressed over time and 82 patients developed severe ROP which required treatment. Mean Gestational Age (GA) in the study population was 34.35 week (±2.64 wk), and mean Birth Weight (BW) was 1.67 kg (±0.45 kg). In the group of severe ROP, mean GA was 32.03 week (±1.33 wk) and mean BW was 1.33 kg (±0.35 kg); and the mean number of positive risk factors were 5.93 (±1.77). Poor postnatal weight gain was associated with more risk of severe ROP. GA &lt;34 week (p-value &lt;0.0001), BW &lt;1750 g (p-value &lt;0.0001), oxygen exposure (p-value &lt;0.0001), IVH (p-value &lt;0.0001), RDS (p-value=0.0111), BPD (p-value=0.0058), hypotension requiring inotropes (p-value=0.0001) and sepsis (p-value &lt;0.0001) were significant risk factors. On multivariate logistic regression, BW &lt;1750 g, GA &lt;34 week, sepsis and hypotension requiring inotropes were most important risk factors for ROP, along with poor postnatal weight gain. Conclusion: Poor postnatal weight gain is associated with increased risk of severe ROP.

A Retrospective Analysis of Retinopathy of Prematurity (ROP) in a Tertiary Newborn Intensive Care Unit: Incidence and Risk Factors of ROP

AbstractBackground Retinopathy of prematurity (ROP) is the most frequent problem which causes blindness in preterm babies. In our study we evaluate the frequency of retinopathy, the risk factors, and their effects on disease development in premature newborns admitted to our neonatal intensive care unit (NICU).Methods A total of 139 premature infants with gestational ages less than 34 weeks followed in our NICU between January 1, 2008 and January 1, 2011. The infants were divided into two groups as group 1 (no ROP/mild ROP) and as group 2 (severe ROP).Results The demographics of 139 patients were as follows: 79 (56.83%) were female and 60 (43.17%) were male. Overall, 104 (74.8%) patients were found to have no or mild ROP and 35 (25.2%) had severe ROP. Among the patients in the severe ROP group, 25 of them had plus disease. With logistic regression analysis, lower gestational age (odds ratio [OR]: 4.1, confidence interval [CI]: 1.9–9.2), the central catheter usage (OR: 13.4, CI: 1.2–146.6), hypotension (OR: 7.5, CI: 1.1–49.6), perinatal asphyxia (OR: 261.3, CI: 8.8–7725.4), apnea (OR: 18.1, CI: 1.6–202.6), and high FiO2 (OR: 1.2 CI: 1.0–1.5) were found to be related to severe ROP.Conclusion Among the preterms with very low body weight included in our study, we found that the frequency of severe ROP requiring treatment was low. The most important factors related to severe ROP were found to be low gestational age and birth weight. Being aware of the risk factors related to severe ROP in addition to screening every preterm infant carrying these risk factors is extremely important for the early diagnosis and treatment to prevent blindness due to severe retinopathy.

Incidence, clinical characteristics, and treatment outcomes of retinopathy of prematurity: a single-center retrospective study

Background: Retinopathy of prematurity (ROP) is one of the primary causes of infant blindness worldwide. This study aimed to estimate the incidence of ROP among neonates admitted to a neonatal intensive care unit (NICU) and analyze the clinical characteristics, therapeutic outcomes, and associated factors. Methods: This single-center retrospective cohort study included 1,551 premature babies admitted to the NICU and screened for ROP at a tertiary hospital in Central Saudi Arabia from January to August 2021. Clinical charts were reviewed to collect data on gestational age (GA) at birth, birth weight, GA at diagnosis, age at diagnosis, sex, ROP laterality, severity assessment (stage, zone, and plus), treatment procedures and number of sessions, and outcomes (regression or stationary). Results: The ROP incidence was 8.7% (male ratio, 0.85). The monthly incidence showed a small peak in spring and a higher peak in summer. Among all patients with ROP, 10.8% required treatment. Anti-vascular endothelial growth factor injection was administered in 85% of the pooled treatment and retreatment sessions, yielding a 66.7% success rate, while laser therapy, which was administered in the remaining 15% of the sessions, resulted in a 100% success rate. The treatment efficacy was relatively lower in more severe cases, although this trend showed no statistical significance. Conclusion: Nationwide studies should be conducted to understand the incidence and risk factors of ROP which are essential to design evidence-based screening criteria specific to the local population and to implement evidence-based guidelines for the management of ROP, notably for the selection of the best therapeutic approach.

Clinical Study on Pathogenic Factors and Screening Strategies of Retinopathy of Prematurity

Objective: To investigate the incidence of retinopathy of prematurity (ROP), analyze the risk factors of ROP, and put forward effective screening strategies, to reduce its incidence. Background: Retinopathy of prematurity (ROP) is an eye disease that can happen in new born premature (born early) babies or have weigh less than 3 pounds at birth. ROP happens when abnormal blood vessels grow in the retina. There are multiple risk factors, which are causing the ROP. In our study we will analyses the risk factors of ROP. Methods: From February 2016 to August 2021, 190 premature infants in the neonatal intensive care unit (NICU) who received inpatient care and ophthalmic screening was selected as study subjects. ROP group (n = 32) and non-ROP group (n = 158) were selected, and the clinical data of the two groups were compared. Including oxygen concentration, mechanical ventilation, broncho pulmonic dysplasia, delivery mode (cesarean section, vaginal delivery), blood transfusion, anemia, gestational diabetes, gestational hypertension, fetal distress, preterm birth weight, gestation age, etc. Women were divided into two groups according to whether they had gestational diabetes mellitus (GDM) or not: gestational diabetic (n = 38) and non-gestational diabetics (n = 152). Age, pregnancy times, birth times, oxygen inhalation, birth weight, and gestational age were compared between the two groups. The X2 test for counting data and the t-test for measuring data are then conducted according to the distribution characteristics of the data, The correlation analysis between ROP and a single risk factor was performed by chi-square test, and the analysis of the correlation between many risk factors and ROP was conducted by Logistic regression analysis. Results: 1) The incidence of ROP in the GDM group was higher than that in the non-GDM group (P P > 0.05). 3) Univariate analysis showed that oxygen use, birth weight, gestational age, bronchopulmonary dysplasia, pregnancy-induced hypertension, and fetal distress in the ROP group and non-ROP group were statistically significant (P P > 0.05). 4) Logistic multivariate analysis showed that oxygen use, gestational hypertension, diabetes mellitus during pregnancy, fetal distress, bronchopulmonary dysplasia, birth weight, and gestational age were the main risk factors for ROP. Conclusion: 1) Gestational diabetes mellitus is a high-risk factor for ROP. 2) Oxygen inhalation, birth weight, and gestational age are related to the occurrence and development of ROP. 3) In determining the initial screening time for ROP.

Postnatal administration of systemic steroids increases severity of retinopathy in premature infants

Postnatal systemic steroids are known to increase the risk of developing retinopathy of prematurity (ROP). However, whether the total dosage and type of postnatal systemic steroids are related to the development and severity of ROP in premature infants remains unclear. This study was conducted to identify the risk factors for ROP and investigate the relationship between photocoagulation (PC)-demanding severe ROP and the postnatal dosage of any type of systemic steroids. A total of 75 infants born at <28 weeks of postmenstrual age (PMA) were enrolled. The number of PC procedures for ROP was evaluated as the objective variable. This study analyzed the following independent variables: gestational age; birth weight; sex; Apgar scores; duration of mechanical ventilation; duration of nasal intermittent positive pressure ventilation; mean saturation and mean oxygen concentration administration until 36 weeks of PMA; total accumulation dosage of hydrocortisone, dexamethasone, and systemic steroids; dosage number of times of erythropoietin; total dosage of red cell concentrates (RCC); incidence of necrotizing enterocolitis (NEC) and focal intestinal perforation; sepsis; bronchopulmonary dysplasia (BPD); and intraventricular hemorrhage (IVH). Logistic regression was used to estimate the relative risk (odds ratio (OR)) associated with risk factors for PC-demanding severe ROP. Compared with infants in the non-PC group, PC-treated infants had younger gestational age, longer mechanical ventilation periods, and higher dosage of systemic steroids and dexamethasone. Multivariate logistic regression analysis revealed total dosage of systemic steroids as the only risk factor for PC-demanding severe ROP. Based on receiver operating characteristic (ROC) curve analysis, a cutoff value of 8.95mg/kg of postnatal systemic steroid administration was identified as a useful marker to predict PC-demanding severe ROP. By focusing on the method of systemic steroid administration and avoiding excessive doses for infants born at <28 weeks of PMA, preventing the development of severe ROP is possible.

Correlation between hyperglycemia and glycated albumin with retinopathy of prematurity

To determine the association between hyperglycemia, glycated albumin (GlyA) and retinopathy of prematurity (ROP). Prospective study of all infants under ROP screening from March 2017 to July 2019. All demographic, clinical and laboratory data were collected. Glucose was measured at birth and every 8 h for the first week and serum GlyA was evaluated at birth, 1st, 2nd and 4th weeks after birth. Reference range for GlyA was obtained. Univariate logistic regression was used to examine risk factors for ROP followed by multivariate regression. A total of 152 infants were included in the study. Median gestational age was 30 weeks and median birth weight 1240 g. Thirty-three infants (21.7%) had ROP. Hyperglycemia was present in 24 (72.7%) infants diagnosed with any ROP versus 6 (0.05%) in those without ROP. Median GlyA at birth, 1st, 2nd and 4th and respective reference ranges were 8.50% (6.00–12.65), 8.20% (5.32–11.67), 8.00% (5.32–10.00) and 7.90% (5.30–9.00) respectively. After multivariate logistic regression, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors (Exp (B) 28.062, 95% CI for Exp(B) 7.881–99.924 p < 0.001). In our cohort, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors.

Retinopathy of prematurity in Ardabil, North West of Iran: Prevalence and risk factors.

Retinopathy of prematurity (ROP), which affects the retina of premature infants, is a leading cause of blindness in premature infants worldwide. The aim of this study was to evaluate the frequency and risk factors of retinopathy of prematurity infants referred to Alavi hospital between October 2018 and October 2019. In the present study, 400 infants with gestational age less than 34 weeks and or birth weight of 2000 g or less were enrolled in the study. Required information including sex, gestational age, maternal age, birth weight, type of delivery, oxygen therapy, septicemia, multiple gestations, consanguineous marriage, respiratory problem, and blood exchange were extracted from their hospital records and then included in the data collection form. These infants were also examined for ROP, stage and area of involvement by an experienced ophthalmologist and then classified into two groups including retinopathy and healthy group. Finally, the data were analyzed in SPSS 25 software using chi-square, fisher exact test, t-test, binary logistic regression, and ROC curve analysis. Of the 400 preterm infants studied (57.2% male and 42.8% female), 107 (26.8%) infants had ROP of whom 23 (21.5%) needed treatment (i.e. 5.8% of all infants need treatment). There were 4 (3.7%), 29 (27.1%), and 74 (69.2%) infants with zone I, II, and III, respectively. There were 91 (85%), 11 (10.3%), and 5 (4.7%) infants with stage I, II, and III, respectively. Multivariate logistic regression analysis showed that parental consanguinity (OR=2.263, 95%CI: 1.240-4.130, P=0.008), gestational age less than 32.5 weeks (OR=4.067, 95%CI: 2.340-7.069, P<0.001), and birth weight less than 1725 g (OR=4.522, 95%CI: 2.677-7.637, P<0.001) were associated with a 2.3-fold, 4.1-fold, and 4.5-fold increased risk of ROP, respectively. ROP had no significant relationship with other variables. In summary, the findings of the present study showed that one quarter of the premature infants had ROP. Furthermore, birth weight less than 1725 g, gestational age less than 32.5 weeks, and parental consanguinity were risk factors for ROP, in addition, one-fifth of the infants with ROP needed treatment.

Prevalence and Risk Factors of Retinopathy of Prematurity (ROP): A Cross-Sectional Study

Background and Aim: Despite considerable progress made in the treatment of Retinopathy of prematurity (ROP), it is still a common cause of reduced vision in children in developed countries, and its prevalence is increasing. This is a preventable disease and responds to treatments appropriately if diagnosed at early stages, but in case of delayed diagnosis and treatment, it may lead to blindness. The aim of the present study is to describe the incidence, severity, and risk factors of ROP in a tertiary healthcare center.&#x0D; Material and Methods: This was a prospective, observational, nonrandomized study conducted in a tertiary-level neonatal intensive care unit (NICU) of a teaching hospital in Gujarat. A total of 130 preterm neonates admitted in the NICU during the study period were screened for ROP as per the guidelines of NNF of India. Screening was done under topical anesthesia, and findings were documented according to the International Classification for Retinopathy of Prematurity recommendations. The data were analyzed for gestational age, birth weight, and systemic factors predisposing to ROP.&#x0D; Results: Of the 130 neonates, 37 neonates were found to have ROP, with the incidence of ROP being 28.4%. The mean birth weight (1388 ± 312 g) and the mean gestational age (32.21 ± 2.50 wk) Out of the 37 neonates with ROP, 14 had a gestational age of &gt; 32 weeks and/or birth weight of &gt; 1500 g. ROP was classified into type 1 and type 2 as per the ETROP study, 14 (39.39%) neonates had type 1 or treatable ROP; there were no cases of APROP in our study; ROP regressed without any intervention in 13 neonates; 7 neonates were defaulters; and 11 neonates were treated with laser.&#x0D; Conclusion: ROP is strongly associated with smaller, more immature, and sicker neonates. However, in our study, about 40% of neonates who developed ROP were of higher gestation (&gt; 32 wk) and birth weight (&gt; 1500 g). The analysis of risk factors for ROP development will help to understand and predict it in severe preterm infants.

Retinopathy of prematurity: Postnatal weight gain and risk factors profile; a hospital-based study from a tertiary care center

Background: Premature infants often develop blindness in one or both eyes due to disparity in retinal growth. This condition is termed as retinopathy of prematurity (ROP). Aim: The aim of the study is to study the postnatal weight gain pattern of preterm infants (Age &lt; 32 weeks) and risk factors of ROP in a tertiary care center and to validate the lower birth weight and gestational age (GA) for ROP. Methods: Hospital-based study on 110 preterm neonates admitted in the neonatal intensive care unit (NICU) who fulfilled the criteria for ROP screening. On screening, 55 neonates were identified to have ROP and 55 neonates identified to have no ROP. The profiles of ROP and risk factors were documented according to the International Classification for ROP recommendations. The data were analyzed for GA, birth weight, and risk factors predisposing to ROP. Results: A total of 110 preterm neonates were screened, out of which, 55 had ROP. The mean GA (P = 0.002), Apnea (P = 0.001), ventilation (P = 0.001), and surfactant (P = 0.001) were observed a significant difference. Further, a significant difference in weight gain pattern in the two groups (P &lt; 0.05) was also observed. The group without ROP had a better weight gain pattern than the group with ROP. Conclusion: Our study revealed prematurity, low birth weight, and birth weight increasing patterns were found to be strong predictors of ROP. GA, apnea, ventilation, and surfactant were found to be statistically significant factors associated with ROP.

INCIDENCE AND RISK FACTORS OF RETINOPATHY OF PREMATURITY (ROP): A SINGLE CENTER STUDY IN A TERTIARY CENTER IN INDONESIA

Background: Retinopathy of prematurity (ROP) is an abnormal proliferative retinal blood vessel in premature infants. ROP is known as one of the causes of blindness in children in developed countries. Objectives: We conducted this study to report the incidence and identify the potential risk factors associated with ROP. Methods: This study was a hospital-based retrospective cohort study of preterm infants in the tertiary neonatal intensive care unit from May 2009 to April 2011. The ROP was identified by an ophthalmologist with binocular indirect ophthalmoscope (BIO). Potential risk factors such as gestational age, birth weight, oxygen therapy, sepsis, small for gestational age, blood transfusion, asphyxia, and respiratory distress syndrome were analyzed using the bivariate and multivariate analysis. Results: There were 248 preterm infants enrolled in this study. Thirty-two (12.9%) patients were diagnosed with various ROP stages, and 43.7% patients suffer from severe ROP requiring treatment for severe ROP. Gestational age and birth weight were not independent risk factors of ROP. In contrast, oxygen therapy (OR 36.93, CI 4.73-288.02), sepsis (OR 4.86, CI 1.85-12.82), and small for gestational age (OR 3.99, CI 1.47-10.82) include as independent risk factors. Conclusions: Incidence of ROP were 12.9%, while the independent risk factors were oxygen therapy, sepsis, and small for gestational age.

The possible effect of pentoxifylline on development and severity of retinopathy of prematurity

Background and aim Retinopathy of prematurity (ROP) is the major ocular problem of preterm infants that occurs with abnormal proliferation of immature retinal vessels. Although pentoxifylline (PTX) was reported to inhibit vasculogenesis and neovascularization in experimental studies, there is no clinical data about the effects of PTX treatment on the development and severity of ROP. This clinical study aimed to investigate the possible effects of PTX on the development of ROP. Materials and methods A single-centre retrospective study was conducted including preterm infants who were hospitalised in the neonatal intensive care unit between 2015–2017 years. Infants were divided into two groups in terms of PTX administration for adjuvant therapy, as PTX and non-PTX groups. Results A total of 211 infants were included in the study [gestational age 29 (27–31) weeks, birth weight 1140 (960–1340) g]. From these, 97 infants (46%) were given PTX treatment. The two groups were similar in terms of demographic data and baseline clinical characteristics. Any stage of ROP was detected in 47.4% of infants in the PTX group, which was significantly higher than those in the non-PTX group (27.2%) (p = 0.002). The incidence of advanced-stage ROP in the PTX group (10.3%) was also higher than in the non-PTX group (2.6%) (p = 0.021). Repeated usage of PTX was not found to be related to the development of ROP (p = 0.059). The time of PTX administration was similar between the ROP and no-ROP groups (median; one vs one week, p = 0.825). Surfactant therapy, duration of hospital stay, and PTX treatment were found as significant risk factors for ROP in the logistic regression analysis. Conclusions In contrast to the experimental studies and also promising results of PTX treatment in some neonatal morbidities, it may be associated with increased incidence and stage of ROP.

Incidence of retinopathy of prematurity treatment in extremely preterm infants in China.

Retinopathy of prematurity (ROP) continues to be a major cause of visual impairment and blindness in premature infants and children. To investigate the incidence of severe ROP receiving treatment in extremely preterm (EP) infants in China over time. The risk factors for ROP treatment were also assessed. This was a multicentre retrospective study and a subanalysis of baseline data from the "Outcomes of EP infants in China 2010-2019" study. This study was conducted in 68 tertiary neonatal care centres from 31 provinces of China. Infants with a gestational age of 230 -276 weeks and admitted to a neonatal unit within the first 72h of life between 2010 and 2019 were enrolled. Incidence of ROP was analysed in infants who survived to 32weeks postmenstrual age and screened for ROP. Multivariable modified Poisson regression models were used to identify risk factors for ROP treatment. Among 7295 eligible infants, 4701 (64.5%) survived to 32weeks postmenstrual age and met ROP screening criteria. Of the 3756 infants who screened and with ROP data, 2320 (61.8%) developed ROP of any stage. The overall incidence of ROP treatment was 12.6%, decreasing from 45.5% at 23weeks to 8.3% at 27weeks. During the 10-year period, the incidence of ROP treatment did not change, although the incidence of any ROP increased over time. Independent risk factors associated with ROP treatment included lower gestational age, small for gestational age, multiple birth, severe intraventricular haemorrhage, patent ductus arteriosus and supplemental oxygen duration. The incidence of EP infants receiving ROP treatment showed no change during this 10-year period in China. Prevention of prematurity and foetal growth restriction, judicious use of oxygen and reducing comorbidities are promising factors that may reduce the incidence of ROP needing treatment in these high-risk infants.

RETINOPATHY OF PREMATURITY, AN IMPORTANT PUBLIC HEALTH PROBLEM IN PAKISTAN: A REVIEW

Introduction: Retinopathy of Prematurity (ROP) is the significant cause of blindness in children globally. Although the incidence of ROP is greater in premature infants worldwide, statistics show that it is more common in low-middle-income countries. Multiple causes and complications of ROP in low middle-income countries have been reported therefore the purpose of this literature review was to review the findings from literature about the burden, causes, outcomes, and important preventive measures of ROP for low middle-income countries, especially in Pakistan. Methods: A comprehensive review of the literature was conducted from published articles. Research studies were selected that included risk factors of ROP, screening, and diagnosis of ROP, treatment of ROP, and prevention of ROP.Results The cause of the high rate of ROP in Low-middle income countries (LMICs) includes a high rate of preterm babies, lack of awareness regarding ROP, financial instability, and insufficient treatment and screening programs at the newborn units. ROP is found to be the significant cause of preventable blindness in South Asia. There are three different levels of prevention aimed at reducing the burden of ROP in LMICs. Primary prevention aims at reduction in preterm births, secondary prevention aims at early diagnosis of the disease and tertiary prevention aims at reducing deterioration of conditions due to disease. Conclusion: The emphasis on preventive measures especially primary and secondary level prevention can help in decreasing the burden of ROP. This requires a multidisciplinary approach at all levels including at the level of policymaking, program implementation, health care providers, and community level.

A descriptive survey on knowledge gap related to retinopathy of prematurity and its prevention and management among nurses in a tertiary care hospital

Purpose:Retinopathy of prematurity (ROP) is a leading cause of severe visual impairment of childhood affecting preterm babies. The disease is sensitive to the quality of neonatal nursing care provided to preterm neonates in any neonatal intensive care unit. (NICU). The aim of this study was to assess the knowledge gap among nurses related to ROP and its prevention and management working in NICU in a tertiary care hospital.Methods:In a cross-sectional descriptive survey, 53 nurses working in a selected NICU of a tertiary care hospital were enrolled. A pretested and validated self-administered questionnaire was used to assess the knowledge of nurses related to ROP. The questionnaire consisted of two main parts namely the demographic information and the knowledge questionnaire related to ROP related to risk factors of ROP, screening procedure, and nursing care to babies with ROP before, during, and after the procedure.Results:The majority of nurses were female with a mean age of 33.48 ± 5.85 years, having a median of 5 years of experience in NICU. Most of the nurses (38, 68%) had overall poor knowledge, followed by fair knowledge (21%) with the mean knowledge scores of 14.07 ± 2.06. No significant association between the overall knowledge scores and age, total professional experience in NICU, designation, and educational qualification of the nurses could be observed (P ≥ 0.05).Conclusion:Most of the nurses working in the NICU had poor knowledge regarding ROP, necessitating the need for updating the knowledge of nurses related to ROP, its prevention, and management by disseminating information about the disease through seminars, and workshops and arranging in-house educational sessions on ROP.

Risk Factors for Retinopathy of Prematurity in the Netherlands: A Comparison of Two Cohorts

Introduction: Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP. Methods: Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians. Ophthalmologists provided data of screened infants, which were combined with risk factors from the national perinatal database (Perined). Clinical data and potential risk factors were compared to the first national ROP inventory (NEDROP-1, 2009). During the second period, more strict risk factor-based screening inclusion criteria were applied. Results: Of 1,287 eligible infants, 933 (72.5%) were screened for ROP and matched with the Perined data. Any ROP was found in 264 infants (28.3% of screened population, 2009: 21.9%) and severe ROP (sROP) (stage ≥3) in 41 infants (4.4%, 2009: 2.1%). The risk for any ROP is decreased with a higher GA (odds ratio [OR] 0.59 and 95% confidence interval [CI] 0.54–0.66) and increased for small for GA (SGA) (1.73, 1.11–2.62), mechanical ventilation >7 days (2.13, 1.35–3.37) and postnatal corticosteroids (2.57, 1.44–4.66). For sROP, significant factors were GA (OR 0.37 and CI 0.27–0.50), SGA (OR 5.65 and CI 2.17–14.92), postnatal corticosteroids (OR 3.81 and CI 1.72–8.40), and perforated necrotizing enterocolitis (OR 7.55 and CI 2.29–24.48). Conclusion: In the Netherlands, sROP was diagnosed more frequently since 2009. No new risk factors for ROP were determined in the present study, apart from those already included in the current screening guideline.

Retinopathy of Prematurity in the University of Calabar Teaching Hospital, Calabar, Nigeria: An Early Report of a Screening Service.

Background:Retinopathy of prematurity (ROP) is an important cause of childhood blindness worldwide. This blindness is avoidable through regular screening of preterm infants and prompt intervention for those with the condition.Aims/Objectives:This study aimed to determine the pattern of presentation of ROP and the risk factors for its development among preterm infants in the Neonatal Unit of the University of Calabar Teaching Hospital, Calabar, Nigeria.Design of Study:This study is a prospective, longitudinal study.Settings:The study was carried out in the Special Care Baby Unit, Sick Baby Unit, and Neonatal Clinic of the Department of Paediatrics and Child Health, University of Calabar Teaching Hospital, Calabar, Nigeria.Materials and Methods:All preterm infants whose mothers had given informed consent to participate were enrolled. Ocular examination was performed by a trained ophthalmologist. ROP was staged and documented using the revised version of the International Classification of ROP. Data were entered into a questionnaire and analysed using IBM SPSS version 22.Results:Of the 53 neonates recruited into the study, ROP was detected in 11 (21%) neonates, of which 9 (82%) had stage 1 disease, 2 (18%) had stage 2, and none had stage 3. ROP was more common in females, 7 (63.6%), than their male counterparts 4 (36.4%). ROP was higher among those with gestational age (GA) ≤30 weeks [9 (81.8%)] when compared with those with GA >30 weeks [2 (18.2%)] (P = 0.016). Other risk factors for ROP assessed by this study were found not to be significantly associated with the occurrence of ROP.Conclusion:ROP was present in 21% of the neonates, and the majority had stage 1 disease. This finding emphasizes the need for screening of all preterm neonates for ROP in order to forestall avoidable blindness which could result from this condition.

A Good Way to Reduce Screening for Retinopathy of Prematurity: Development of the ROP Model in a China Preterm Population.

Importance: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. Without treatment, more than 45% of eyes may suffer permanent vision loss. Current ROP screening guidelines, which include a range of birth weights (BWs) and gestational ages (GAs), may require screening many low-risk preemies who might develop severe ROP.Method: All high-risk infants in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Zhengzhou University from 2017 to 2021 were included in this retrospective cohort study. Each of the 27 candidate risk factors was evaluated in univariate analysis and adjusted for known risk factors (i.e., GA and BW). The significant results were analyzed in a backward selection multivariate logistic regression model. Receiver operating characteristic (ROC) curves and a nomogram were drawn.Results: The study included 2,040 infants who underwent ROP screening. The weight gain rate [OR, 2.65; 95% confidence interval (CI), 1.49–1.21 ≤ 12 g/d vs. > 18 g/d; P = 0.001], blood transfusion (OR, 2.03; 95% CI, 1.14–3.64; P = 0.017), invasive mechanical ventilation (OR, 1.74; 95% CI, 1.15–2.66; P = 0.009) and N-terminal segment of pro-B-type natriuretic peptide (NT-proBNP) ≥ 25,000 ng/L (OR, 1.51; 95% CI, 1.00–2.28; P = 0.048) were four new statistically independent risk factors in addition to GA and BW. The area under the curve (AUC) of the final multivariate model was 0.90 (95% CI, 0.88–0.92; P < 0.001).Conclusions and Relevance: These findings add to our understanding of ROP screening because they include all eligible infants rather than only high-risk infants, as in previous studies. Under the control of BW and GA, low weight gain rate, increased number of blood transfusion, invasive mechanical ventilation and NT-proBNP ≥ 25,000 ng/L were “new” statistically independent risk factors for ROP. The ROP risk can be calculated manually or represented by a nomogram for clinical use.