Thrombocytopenia as a Clinical Biomarker of Retinopathy of Prematurity: A Systematic Review

Highlights: This is the first systematic review investigating thrombocytopenia and its association with retinopathy of prematurity The findings suggest that thrombocytopenia could serve as a potential clinical biomarker for screening ROP, considering its quick, affordable, and widespread availability for examination purposes.   Abstract Retinopathy of prematurity (ROP) is the leading cause of childhood blindness and occurs due to the underdevelopment of retinal blood vessels in premature infants. Platelets are essential in the regulation of angiogenesis. Hence, thrombocytopenia might aid in the progression of ROP. This systematic review aims to look into the relationship between thrombocytopenia and retinopathy of prematurity. The PubMed and Cochrane Library databases were accessed to include retrospective case-control and cross-sectional studies, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In our review, 9 records were analyzed. All research was done in the period between 2017 and 2022 . Seven studies have reported the prevalence of thrombocytopenia in infants with retinopathy of prematurity (ROP), ranging from 18.37% to 71%. In preterm children without ROP, the occurrence of thrombocytopenia is between 5.71% and 21%. Seven studies have significantly identified thrombocytopenia as a risk factor for ROP, with the Odd Ratio (OR) for thrombocytopenia ranging from 2.8 to 6.69 . Therefore, thrombocytopenia in premature infants could be thought of as a potential clinical biomarker for Type-1 ROP screening. Additionally, this discovery implied that thrombocytopenia can contribute to the pathophysiology of ROP. The crucial platelet count threshold in ROP requires additional investigations.