Characteristic and risk factors of retinopathy of prematurity in Sanglah Hospital Denpasar: 3-years retrospective study

Introduction: Retinopathy of prematurity (ROP) is one of the important causes of blindness in children. ROP is characterized by abnormal retinal neovascularization of premature infants. Purpose: This study aimed to estimate the prevalence of ROP in preterm infants at Sanglah Hospital Bali from 2015-2017 and identify the risk factors predisposing them to ROP. Methods: This was a retrospective study, observational analysis on premature infants diagnosed as ROP at Sanglah Hospital Bali from January 2015 to December 2017, with a gestational age of 30 weeks or less at birth and a birth weight of 1500 grams or less. Infants whose gestational age was >30 weeks or whose birth weight was >1500 grams were also included. The ophthalmological examinations were initiated between the fourth and sixth weeks of chronological age or 34 weeks of corrected age, whichever was earlier, and were repeated weekly or biweekly as per Indonesian guidelines for ROP screening, until full vascularization of the retina reached zone 3. Results: Out of 31 infants diagnosed as ROP, 3 (9.7%) cases developed ROP in one eye, and 28 (90,3%) cases in both eyes. They were classified as 23 (74.2%) cases stage 1, and 8 (25,8%) cases stage 2. None of the studied infants presented ROP at stage 3, 4, or 5. The risk for ROP was not significantly associated with birth weight (OR 0.375; 95% CI 0.030 – 4.635), gestational age (OR 0.897; 95% CI 0.792 – 1.015), sepsis (OR 1.111; 95% CI 0.089 – 13.835), blood transfusion (OR 1.111; 95% CI 0.089 – 13.835), and HMD (OR 1.118; 95% CI 0.977 – 1.443). Conclusions: The data of this study showed that low gestational age, low birth weight, sepsis, oxygen therapy, and blood transfusion may be contribute to the development of ROP, but not significant statistically. Clinicians should be aware of the presence of the additional risk factors when monitoring preterm infants,especially when giving supplemental oxygen therapy.