Retinopathy of Prematurity: Risk Factors, Recent Trends of Screening and Outcome of Treatment in a Tertiary Care Eye Hospital of Bangladesh

Abstract

Objectives: To determine the associated risk factors, current methods of screening and treatment outcome of ROP in a tertiarylevel eye hospital in Bangladesh. Methods: A prospective longitudinal study was conducted in the OPD, Pediatric care unit of a tertiary eye hospital, among 167 babies from October 2014 to June 2019. The initial examination was done either at four weeks of birth or 31 weeks post-conceptually, whichever was earlier. After taking consent, a detailed history was taken. Before the fundus examination, mydriasis was achieved, and indirect ophthalmoscopy was done under topical anesthesia. In favorable cases, staging of ROP was done with subsequent follow-up. As per ETROP indication, either laser photocoagulation or anti-vascular endothelial growth factor (anti-VEGF) injection or both were given for treatment. Later these babies were followed up to see the outcome. Results: Out of 167 babies, we had two groups after the 1st screening; 76 babies (45.5%) fell in the ROP group and 91 babies in the No ROP group. On subsequent screening, 28 babies had spontaneously regressed ROP, leaving 48 in the ROP group who required treatment. The male gender was predominant in both groups (52.6% and 56.04%, respectively). Type 1 ROP was the most prevalent. Oxygen therapy (93.4%) of variable duration and neonatal jaundice (52.6%) were the top two risk factors of ROP in this study. Sixty-five babies (38.9%) fell into a group of birth weight 1000-1500 grams, and 81 (48.5%) had a gestational age of 28-32 weeks. As a treatment, the majority with ROP (21 cases) received laser therapy. In the final follow-up, refractive errors are the most common outcome after treatment of ROP. Conclusion: The available care for ROP varies, and visual disability is mainly preventable when detected and treated in time. With limited resources and expertise, the screening and treatment of ROP implemented in Bangladesh showed some satisfactory outcomes; a longer follow-up would give a more detailed evaluation of the impact of this treatment on the visual status.