First Author: R.Ellakkany EGYPT
Co Author(s): R. Bassiouny S. Aboelkhair T. Mohsen I. Othman
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To study the incidence and risk factors of retinopathy of prematurity (ROP) in preterm babies at neonatal intensive care units (NICU) in Mansoura University hospital, Egypt. Outcomes of intravitreal injection of anti-VEGF (ranibizumab) for those stages required treatment were evaluated.
Mansoura University Hospital, Mansoura, Egypt
This study included 402 preterm infants admitted to NICU in Mansoura University hospital in the period from March 2013 to March 2015. Fundus examinations were done using indirect ophthalmoscopy and a 28D lens and fundus images were captured using wide field digital fundus camera (Retcam 3). Demographic data was collected, risk factors and incidence of the disease were analyzed. Those cases required treatment were treated by intravitreal injection using single dose of anti-VEGF (ranibizumab). Follow up of all ROP cases were done until full retinal vascularization and outcomes after treatment were evaluated.
Out of the 402-screened preterm babies, 237 cases (59%) had ROP; in which 101 (42.6%) stage 1, 114 (48.1%) stage 2, 12 (5.1%) stage 3, 10 (4.2%) had aggressive posterior retinopathy and 24 (10.1%) presented with plus disease. Twenty-four (10.1%) patients were indicated for treatment. Forty-eight eyes received single dose of intravitreal injection of anti-VEGF (ranibizumab); 42 eyes (87.5%) showed regression with complete retinal vascularization at mean PMA of 53.6 ± 5.1 wk, 2 eyes (4.2%) regressed with cicatrization in the form of epiretinal fibrosis and optic disc dragging, 4 eyes (8.3%) progressed; one eye to stage 5 and the remaining 3 eyes to stage 4a. Gestational age (GA), birth weight (BW), oxygen therapy, sepsis, multiple birth and cesarean section (CS) were factors found to be significantly associated with the disease.
ROP occurred in 59% of all screened preterm babies. The main risk factors associated with the disease were GA, BW, oxygen therapy, sepsis, CS and multiple birth, (10.1%) of ROP cases required treatment and received single dose of intravitreal injection of ranibizumab, (87.5%) showed regression. This denotes that early intravitreal injection with anti-VEGF in ROP cases required treatment is effective and safe in management of such cases.