Profile of Retinopathy of Prematurity in Outborn and Inborn Babies at a Tertiary Eye Care Hospital
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Profile of Retinopathy of Prematurity in Outborn and Inborn Babies at a Tertiary Eye Care Hospital ANUSHA SACHAN,1 PARIJAT CHANDRA,1 RAMESH AGARWAL,2 RAJPAL VOHRA,1 ROHAN CHAWLA,1 M JEEVA SANKAR,2 DEVESH KUMAWAT1 AND ATUL KUMAR1 From 1Dr. Rajendra Prasad Centre for Ophthalmic Sciences and 2Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. Correspondence to: Dr Parijat Chandra, Professor, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110 029, India. [email protected] Submitted: April 22, 2019; Initial review: August 05, 2019; Accepted: April 07, 2020.
Objective: To study the profile of retinopathy of prematurity (ROP) among outborn and inborn babies at a tertiary-care centre. Methodology: In a prospective observational study from 2015-2016, outborn and inborn babies eligible for ROP screening were evaluated for ROP profile and treatment results. Results: 532 outborns and 38 inborns had ROP. Respiratory distress, sepsis and apnea were present in 81.3%, 51.5% and 36.2% of outborns with ROP and 68.4%, 39.4% and 36.8% of inborns with ROP. Type 1 ROP was noted in 49.2% eyes of outborns with ROP and 36.8% eyes of inborns with ROP. Type 1 ROP regressed with laser in 97.3% and 100% eyes of outborn and inborn with ROP, respectively. Stage 4, 5 and sequelae were noted in 5.2%, 22.8% and 4.6% eyes of outborns with ROP, respectively, but none in inborns. Conclusions: Quality neonatal care and timely screening ensured lesser ROP-related morbidity in inborns as compared to outborns. Keywords: Blindness, Referral, Screening, Surgery. Published Online: June 12, 2020; PII: S097475591600196
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mproved neonatal care of preterm babies has led to a reduction in mortality, but due to unrestricted use of supplemental oxygen there is a significant increase in retinopathy of prematurity (ROP), the socalled third epidemic in middle income countries [1]. The quality of neonatal care, neonatologistophthalmologist coordination, timely ROP screening and management may prevent advanced ROP, with recent studies showing lower rates of ROP ranging from 20% to 30% [2-4]. This study was conducted to determine the difference in ROP profile of inborn and outborn babies with respect to risk factors, diagnosis at presentation, treatment given and outcomes. METHODS The study was conducted at our tertiary eye-care centre and Neonatal intensive care unit (NICU) associated with the same hospital, from May, 2015 to May, 2016. The study was approved from the Institutional review board and adhered to the Declaration of Helsinki guidelines. Informed written consent was taken from the parents to participate in the study. We studied the risk factors for ROP, demographics and screening referrals of ROP from the discharge summary or by interviewing the caregivers. Records were requested from the NICU, if unavailable. Outborn babies (referred from INDIAN PEDIATRICS
other health facilities to our centre) were screened for ROP as per the Nat
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