Screening for Retinopathy of Prematurity in Neonatal Unit – An Experience of A Tertiary Care Hospital in Bangladesh

Liton Chandra Saha1, Dipak K Nag 2, Md. Mahbubul Hoque 3, MAK Azad Chowdhury 4

 

Abstract
Background: Retinopathy of prematurity (ROP) is a leading cause of childhood
preventable blindness. Improved survival of preterm neonates has increased the
incidence of retinopathy of prematurity (ROP).
Objective: To determine the incidence of retinopathy of prematurity (ROP) in
Neonatal Unit of a Dhaka Shishu (Children) Hospital (DSH) and assess the treatment
requirements of these cases.
Methods: A ROP prospective screening survey was performed enrolling preterm
neonates with a gestational age of 34 weeks or less and a birth weight of 1800 gram or
less admitted to the SCABU and NICU of Dhaka (Shishu) Children Hospital from
July 2013 to July 2014. Retinal evaluation was done by indirect ophthalmoscopy and
ROP was classified as type 1, type 2, APROP (Aggressive posterior ROP) and retinal
detachment (RD) groups. Infants who were found type 1 ROP, APROP and RD were
assigned for treatment.
Results: A total of 100 babies retinal evaluation were done. Among them 35 babies
70 eyes (35%) were found to have ROP (27 eyes 13.5% type1, 4 eyes 2.0% APROP, 5
eyes 2.5% retinal detachment and 34 eyes 17.0% were type 2). During the first screening
9 eyes had type 1, 52 eyes had type2, 4 eyes had APROP and 5 eyes were found to
have retinal detachment. In the subsequent follow up another 18 eyes progressed to
type 1 ROP from the type 2 group. In regards to treatment, 19 (52.8%) eye received
laser, 10 (27.8%) eyes had received both laser and intra vitreal avastin, 2 eyes (2.6%)
has got only intra vitreal avastin and 5 (13.9%) were advised for surgery.
Conclusion: The incidence of ROP is high in premature infants and more common
in babies with gestational age less than 30 wks. Management of treatable ROP is also
a time demanding issue.
Key words: Retinopathy of prematurity, ROP, prematurity, incidence, treatment, Bangladesh

 

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