Incidence and risk factors for retinopathy of prematurity

Session Details

Session Title: Free Paper Session 2: Vascular Diseases & Diabetic Retinopathy I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:42

Venue: Room 117

First Author: : N.Sahinoglu Keskek TURKEY

Co Author(s): :    I. Akkoyun   C. Sariturk   G. Yilmaz                       

Abstract Details

Purpose:

Retinopathy of prematurity (ROP) is a multifactorial and rapidly progressive disease involving the abnormal development of the retinal vasculature that causes blindness. Short gestational age(GA) and low birth weight(BW) are common risk factors of ROP . In addition oxygen therapy, respiratory distress syndrome (RDS), sepsis, intraventricular haemhorrage and postnatal blood transfusion contribute to development of ROP. The characteristics of infants with ROP differs among countries depending on their level of development. The aim of the study was to determine pre and postnatal risk factors associated with the development of ROP in our neonatal intensive care unit conditions.

Setting:

Baskent University, Faculty of Medicine, Department of Ophthalmology, Adana, Turkey

Methods:

All infants (n=57) screened for ROP at a neonatal intensive care unit over a 2-year period with gestational age 34 weeks and follow-up of 43 weeks postconception were included. The findings were classified in accordance with the International Classification of Retinopathy of Prematurity. The babies were classified in two groups: group A included patients without retinopathy; group B included patients with retinopathy. Group B was studied in two subgroups; Group B1 included the babies with stage 1 or 2 (mild-ROP); and group B2 included patients who progressed to moderate or severe stage 3 (severe-ROP) and were treated. A retrospective review of records was performed. The incidence of retinopathy and risk factors for ROP are evaluated. Eight possible risk factors for ROP was analyzed consisting of body weight (BW), gestational age (GA), apnea, respiratory distress syndrome (RDS), ventilation, transfusion, corticosteroid treatment, and surfactant.

Results:

Fifty seven babies were included in the study. Forty three babies (75.4%) did not have ROP (Group A) and 14 babies (24.6%) had retinopathy (Group B). Nine babies (15.7%) had mild ROP which regressed spontaneously (Group B1). Five babies (8.7%) had severe ROP and necessitated laser photocoagulation. One of the babies (1.7%) in Group B2 had agressive posterior retinopathy of prematurity (AP-ROP). The mean BW for group A and group B were 1647,91 ± 411,81 gr; 1086,43 ± 319,10 gr respectively. The mean GA for group A and group B were 31,72 ± 2,20 and 29 ± 2 weeks respectively. No eyes progressed to Grade 4 or 5. Asymmetric ROP was not seen in among the study group. There was statistical significant differences in GA and BW, between group A and group B(p˂0.001). Group B were smaller for age and had less birth weight. Existence of RDS, transfusion and apnea was more in group A than group B. This difference was statistically significant (p=0.03; 0.001; 0.01). Furthermore existence of RDS, sepsis and ventilation was more in group B2 than group B1. This difference was statistically significant (p<0.001).

Conclusions:

In conclusion, low BW and short GA are the most important risk factors for developing ROP. Also transfusion, RDS and apnea were shown to precipitate ROP development. Sepsis and ventilation were found to be important factors for developing severe ROP.

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