A study of clinical profile and treatment outcome in pre term babies with retinopathy of prematurity

Context: Study of disease and treatment pattern is a key to developing database of Retinopathy of Prematurity (ROP) in India. Aim: To evaluate the pattern of ROP, timing of laser and immediate post laser complications at a tertiary care referral hospital. Study Design: A retrospective analysis of medical records of preterm babies, screened for ROP from 2008- to 2013 was performed. Materials and Methods: International classification of ROP was adopted to stage the disease. Information on various parameters including BW, GA, and stage of ROP, treatment details, chronological and post menstrual age (CA and PMA) at laser, number of sittings and immediate complications following laser were collected. Result: In total records of 233 preterm infants were reviewed. Among the babies screened, 64 (27.8%) had ROP, out of these 36 babies underwent laser ablation. In one baby with rigid pupil, intravitreal anti Vascular Endothelial Growth factor (VEGF) was given prior to laser. PMA at laser was 30- 48 weeks and the chronological age was 4-18 weeks. PMA at laser of APROP babies was 30 to 32 weeks and the CA at laser was 4 weeks. Post laser complications were recorded in 6 APROP babies. All treated eyes had a favourable outcome except in one eye disease progressed to stage 4B ROP requiring lens sparing vitrectomy. Conclusion: The study reaffirms the role of GA as the most critical factor in determining the number and severity of ROP. The study validates the need for early screening at 2 weeks. Immediate post laser complications the characteristic of APROP supports single sitting as the most convenient approach to laser.