Retinopathy of Prematurity –Recent Screening Status in a Tertiary Care Hospital of Bangladesh

Pharmaceutical Science-Pediatrics for Better Child Health

Abstract

Retinopathy of prematurity (ROP) results in severe visual impairment and blindness in newborns. In the recent days with development of the technology  to save  preterm  infants,  it’s incidence  is increasing  in both  developed  and developing  countries.  Only  appropriate  and timely  screening program can prevent ROP and reduce the functional impairment of eyes. The aim of this study was to see the recent screening status of the hospital so that  future  plan  of ROP  treatment  and prevention  can  be taken  more  appropriately.  This  prospective  study  was  conducted  from January  2018  to December 2018 in neonatology  department  of Dhaka Shishu (Children) Hospital. Neonates with gestational age < 34wks or  birth weight, <1800gms were  screened  for  ROP.  First  screening  was  done  at 4 wks chronological  age  or  32  wks  postmenstrual  age  of neonate  which  comes  later.  Then subsequent screening was done according to the findings upto 45 wks of postmenstrual age. The findings regarding incidence of ROP, types of ROP and treatment modalities of ROP along with other variables were recorded. Data were analyzed with SPSS version 17. Total 116 cases were screened for ROP. Mean gestational age was 30.7±2.4 wks and mean weight was 1420.9±313.8 gms. According to gestational age, 14 (12%) neonates with gestational age < 28 wks had ROP.  Nine (7.8%) cases had ROP in both gestational age groups of 29-30wks and 31-32wks. Only 5(4.3%) cases with gestational age

33-34wks had ROP. According to birth weight, neonates with birth weight <1000 gms had ROP in 1(0.9%). Twenty four (20.7%) and 12(10.3%) cases had ROP in weight groups of 1000-1499gms and 1500-1800 gms consequently. Thirty one (26.8%) cases   were found ROP in their first visit. In 6(5.1%) cases ROP were found in 2nd  and subsequent visits. Among the neonates, A-P ROP was present in 15(12.9%) cases, type -1 in 9 (7.7%),  type- 2 in 11 (9.6%) and RD in 2(1.7%) cases. Three (2.6%) cases of type 2 ROP turned into type- 1 ROP in subsequent visits. Among the ROP cases, total 29(78%) needed treatment. Laser therapy was given in 7(24%) cases, both laser and intravitreal bivacizumab in 17 (59%) cases, only intravitreal bivacizumab in 2(7%) cases and surgery along with medical treatment  was advised for  3(10%) cases. Thirty four (92%) cases had good outcome and 3 (8%) infant had no vision.The incidence of ROP was 31.9% in this study. Most of cases were A-P ROP then Z2S3 ROP. Laser plus intravitreal bivacizumab were given in most of the cases with ROP. The more number of advanced stages of ROP and a large number of babies required treatment indicates that these babies came to us in advanced stages due to irregularity and missing of follow-up.