Various Conditions, Social Factors Influence Retinopathy of Prematurity

Premature Baby Retinopathy
Retinopathy In Premature Infant. Retinal Fluorescein Angiogram Showing Hypoxia Of The Retinal Periphery. Recolorized, Black And White Image. (Photo By BSIP/UIG Via Getty Images)
Respiratory distress syndrome, intraventricular hemorrhage, necrotising enterocolitis and barriers to regular follow-up are all linked with disease development and progression.

In addition to low birth weight and gestational age, a study published in Clinical Ophthalmology shows that respiratory distress syndrome (RDS), intraventricular hemorrhage (IVM), necrotising enterocolitis (NEC), and oxygen exposure all contribute to retinopathy of prematurity (ROP). The incidence of the condition in a Western Indian (where this study was conducted) population of preterm infants is 26.9%, similar to that of other regions, according to the research.

ROP was diagnosed according to the International Classification of Retinopathy of Prematurity (ICROP) and zone, stage, plus, pre-plus were calculated and recorded. Analysis was completed to identify associations between ROP characteristics and birth weight (BW), gestational age (GA), and other factors.

Researchers screened a total of 167 neonates for ROP (80 girls). The patients’ mean GA was 31.89±2.824 weeks (18.7% >34 weeks, 81.3% <34 weeks). Mean BW was 1538.11±530.84 g. Nine of the patients (20%) were diagnosed with stage 1 ROP, 15 (33.3%) with stage 2, 13 (28.9%) with stage 3, 1 (2.2%) with stage 4, and 4 (8.9%) with stage 5. One participant had ROP in zone 1 (8.9%), 18 in zone 2 (40%), and 24 in zone 3 (53.3%). 5 neonates (11.11%) had plus disease, 7 (15.6%) had pre-plus, and 9 (20%) had aggressive posterior ROP. 

The researchers found significantly lower mean BWs and GAs for neonates with ROP compared with those without (1296.98 gm vs 1626.35 gm, P <.001; 30.67 weeks vs 32.33 weeks, P <.001, respectively). Risk factors found to be correlated to ROP were O2 supplementation, RDS< IVH, and NEC (P <.001). 

“More evaluation needs to be done to see an actual rate of regression in the Eastern part of the world,” the study says. However, researchers say that “babies having stages 4 and 5 were referred babies, suggesting an unmet need for ROP screening in peripheral rural areas.” An additional factor in this rate could be that 31.4% of patients did not return for follow-up visits, which is significant because ROP can progress rapidly, and is more difficult to treat later.

Reference

Meena S, Bhatnagar K, Sheemar A, Gupta N, Tandon M, Agrawal N. Unmet need for ROP screening gin peripheral rural areasClin Ophthalmol. 2022;16:1963-1969. doi:10.2147/OPTH.S357591