Retinopathy of Prematurity in Extreme Preterm and Extreme Low-birth-weight Infants: Incidence, Course, and Risk Factors.

Purpose: The purpose of this study was to analyze the incidence of retinopathy of prematurity (ROP), treatment requiring ROP (TROP), course, and systemic risk factors in extreme preterm or extreme low-birth-weight babies.

Methods: A retrospective analysis of neonatal intensive care unit-based ROP screening from January to December 2021 in a tier-2 city in Kerala, India, was done. Inclusion criteria were gestational age (GA) ≤28 weeks or birth weight ≤1000 g. ROP screening and treatment were done according to the International Classification of ROP guidelines. Treatment was indicated in babies with type 1 ROP or aggressive ROP. Details of ROP screening, treatment, and neonatal risk factors were collected from the records. The results were statistically analyzed, and P < 0.05 was considered statistically significant.

Results: The study included 54 babies with a mean GA of 27.47 ± 1.76 weeks and a mean BW of 847.43 ± 189.22 g. ROP was detected at an average postmenstrual age of 33.8 ± 1.7 weeks. The incidence of any ROP and TROP was 87% and 19.14%, respectively. All babies with TROP were managed with laser or intravitreal antivascular endothelial growth factor injection or both. ROP resolved spontaneously in 60%, but those with Zone 2 disease had delayed regression. Inotropic support and anemia were found to increase the risk for ROP.

Conclusion: The incidence and outcome of any ROP and TROP in this study are comparable to the rates reported globally, and this reflects the improvement in neonatal care. The use of inotropes and anemia may increase the risk for ROP and needs to be managed judiciously.