Retinopathy of Prematurity

BACKGROUND Retinopathy of Prematurity is a leading cause of blindness among premature infants. It is a disorder of retinal blood vessels due to abnormal response of premature infants� retinal vasculature to prematurity and therapy for its management. Present study was undertaken to develop effective screening program in order to screen such premature infants especially those with risk factors for this disease and to study the characteristics and grading of this disease in them. OBJECTIVES 1. To identify neonates who are at risk of developing Retinopathy of Prematurity and screen them for the same 2. To study the risk factors associated with Retinopathy of Prematurity.3. To study the morphological characteristics and grading of this disease. METHODS A total of 90 neonates of birth weight less than 2000gms and gestational age less than 36 weeks were screened and these neonates were followed up for the presence or retinopathy of prematurity. Risk factors in these infants were noted and if present morphological characteristics of this disease were recorded and graded. . Eye examination was done using an indirect ophthalmoscope and a +20 dioptre lens after dilating the pupils with tropicamide 0.5 % and phenlyephrine 2.5 % which was instilled twice at 5 minute intervals, in both eyes. RESULTS Overall Incidence of this disease was calculated in addition to incidence in neonates of various categories of birth weights and gestational ages and stage specific incidence. Chi square test and P value was calculated to check the statistical correlation between various risk factors and the presence of this disease in the infants screened. A table of comparison was drawn up to compare results of this study with the Palmer et al (Cryo-ROP study). In our study 17 of the 90 infants screened were found to have the disease thus the incidence was found to be 18.88 % for any stage of the disease. Of the 17 infants 11 (64.7 %) were in stage 1, 2 (23.5 %) were in stage 2, l (5.88 %) were in stage 3 and 1 (5.88 %) were in stage 4. The incidence of ROP in various gestational age groups were as follows 28-30 weeks (33 %), 30-32 weeks (37.5 %), 32-34 wks (12.5 %) and 34-36wks (6.2 %). The incidence of ROP with respect to various birth weights was as follows 1000 grams. As inferred from previous studies this study also showed that lower gestational age and lesser birth weight make independent contributions to the overall incidence of ROP. Anemia, blood transfusion, hyperbillirubinaemia and phototherapy were not found to be significantly associated with ROP in our study. Other factors like septicaemia, apnoea, RDS, and maternal factors like infection, diabetes and hypertension were not significantly associated with ROP in this study