Incidence and risk factors of retinopathy of prematurity
Keywords:
retinopathy of prematurity, risk factor, incidence
Abstract
Background Retinopathy of prematurity (ROP) is one of themain causes of visual impairment in premature infants.
Objective To determine the incidence and risk factors for ROP
in premature infants.
Methods This retrospective study included premature infants
born in Stella Maris Women's and Children's Hospital and admitted
to the neonatal intensive care unit (NICU) and Neonatology
Department from November 2009 to May 2012. We included all
premature infants with body weight (BW) < 1500 g or gestational
age (GA) < 32 weeks, and selected infants with BW 1500 - 2000
g or GA > 32 weeks with unstable clinical courses who had been
screened for ROP. Data was analyzed with Fisher's exact test and
independent t test.
Results Of the 48 premature infants in the study, ROP was
detected in 6 (12.5%) of the subjects. Stages ofROPwere classified
according to the International Classification ofRetinopathy
of Prematurity. Stage 1 ROP was detected in 1 (2.1 %) subject;
stage 2 ROP was detected in 3 (6.25%) subjects; and stage 3
ROP was found in 2 ( 4.2%) subjects. The 2 infants with stage
3 ROP required surgery. No ROP was detected in infants with
GA ~30 weeks or BW > 1250 g. Respiratory distress syndrome
(RDS), sepsis, blood transfusion, and apnea were found to be
associated with development ofROP. Duration of oxygen therapy
was found to be a significant risk factor for ROP in a comparison
of the no ROP group to the ROP group: 14.0 (SD 9.508) days
vs. 3.81 (SD 5 .218) days, respectively (P<0.05). In addition,
the duration of continuous positive airway pressure (CPAP)
usage was also a significant risk factor for ROP, with 1.83 (SD
1.329) days in the ROP group vs. 0.76 (SD 1.122) days in the
no ROP group (P<0.05).
Conclusions The incidence of ROP in the premature infants in
our study is 12.5%. Retinopathy of prematurity is associated with
lower BW, lower GA, lower Apgar score at the 5th minute, RDS, sepsis, apnea, blood transfusion, aminophylline usage, as well as
longer duration of oxygen therapy and CPAP usages.
References
1. Scott E. Disorders of the retina and vitreous. In: Kliegman
RM, Stanton BM, St Geme JW, Schor NF, Behrman RE,
editors. Nelson textbook of pediatrics. 19'h ed. Philadelphia:
Elseviers Saunders; 2012. p. 2174-81.
2. Gong A, Anday E, Boros S, Bucciarelli R, Burchfield
D, Zucker J, er al. One year follow-up evaluation of 260
premature infants with respiratory distress syndrome and
birth weights of700 to 1350 grams randomized to two rescue
doses of synthetic surfactant or air placebo. American Exosurf
Neonatal Study group I. J Pediatr. l 995 ;126:S68-74.
3. Valentine PH, Jackson JC, Kalina RE, Woodrum DE.
Increased survival of low birth weight infants: impact on
the incidence of retinopathy of prematurity. Pediatrics.
1989;84:442-5.
4. Gibson DL, Sheps SB, Uh SH, Schechter MT, McCormick
AQ. Retinopathy of prematurity-induced blindness: birth
weight-specific survival and the new epidemic. Pediatrics.
1990;86:405-12.
5. Schalij-Delfos NE, Cats BP. Retinopathy of prematurity:
the continuing threat to vision in preterm infants. Acta
Ophthalmol Scand. 1997;75:72-5.
6. Rudanko SL, Fellman V, Laatikainen L. Visual impairment
in children born prematurely from 1972 through 1989.
Ophthalmology. 2003; 110: 1639-45.
7. Gomalla TL. Eye disorders of the newborn and retinopathy
of prematurity. In: Gomalla Tl, Cunningham MD, Eyal FG,
Tuttle D, editors. Neonatology. 6th ed. New york: McGrawHill;
2009. p. 454-62.
8. International Committee for the Classification of Retinopathy
of Prematurity. The international classification of
retinopathy of prematurity revisited. Arch Ophthalmol.
2005; 123 :99 1-9.
9. Clemett R, Darlow B. Results of screening low-birthweight
infants for retinopathy of prematurity. Curr Opin
Ophthalmol. 1999;10:155-63.
10. Shah VA, Yeo CL, Ling YLF, Ho LY. Incidence, risk factors
of retinopathy of prematurity among very low birth weight
infants in Singapore. Ann Acad Med Singapore. 2005;34:
169-78.
11. Li ML, Hsu SM, Chang YS, Shih MH, Lin YC, Lin CH, er
al. Retinopathy of prematurity in southern Taiwan: a tertiary
medical center 10-year study. J Fla Med Assoc. 2010;20: 1-
9.
12. Palmer EA, Flynn JT, Hardy RJ. Incidence and course of
retinopathy of prematurity. Ophthalmology. 1991;98:1628-
40.
13. Maheshwari R, Kumar H, Paul VK, Sing M, Deorari AK,
Tiwari HK. Incidence and risk factors of retinopathy of
prematurity in a tertiary care newborn unit in New Delhi,
1996. Natl Med J India. 1996;9:211-4.
14. Haugen OH, Markestad T. Incidence of retinopathy of
prematurity (ROP) in the western part of Norway. A
population-based retrospective study. Acta Ophthalmol
Scand. l 997;75:305-7.
15. Lappi M. Retinopathy of prematurity in southern Finland.
Acta Ophthalmol Suppl. 1993;210:56-8.
16. Smith J, Spurrier N, Goggin M. Retinopathy of prematurity
in South Australian neonatal intensive care unit. Aust N Z
J Ophthalmol. 1995;23:49-54.
17. Hussain N, Clive J, Bhandari V. Current incid ence
of retinopathy of prematurity, 1989-1997. Pediatrics.
l 999;104:26-41.
18. Mathew MRK, Fern A, Hill R. Retinopathy of prematurity:
are we screening too many babies? Eye. 2002;16:538-42.
19. Zin AA, Moreira MEL, Bunce C, Darlow BA, Gilbert CE.
Retinopathy of prematurity in 7 neonatal units in Rio
de Janeiro: screening criteria and workload implications.
Pediatrics. 2010:410-7.
20. Cryotherapy for retinopathy of prematurity cooperate
group. Multicenter trial of cryotherapy for retinopathy of
prematurity. One year outcome-structure and function. Arch
Ophthalmol. 1990;108: 1408-16.
21. Early Treatment for Retinopathy of Prematurity Cooperative
Group. Revised indications for the treatment of retinopathy
of prematurity: results of the early treatment for retinopathy
of prematurity randomized trial. Arch Opthalmol. 2003; 121:
1684-96.
22. Darlow B, Hutchinson J, Henderson, Donoghue D, Simpson
J, Evans N. Prenatal risk factors for severe retinopathy of
prematurity among very preterm infants of the Australian and New Zealand neonatal network. Pediatrics. 2005;115:990-
6.
23. Blair BM, O'Halloran HS, Pauly TH, Stevens JL. Decreased
incidence of retinopathy of prematurity, 1995-1997. J
AAPOS. 2001;5:118-22.
24. Filho JB, Costa Mc, Eckert GU, Santos PGB, Silveira RC,
82 • Paediatr Indones, Vol. 53, No. 2, March 2013
Procianoy RS. Maternal preeclampsia protects preterm
infants against severe retinopathy of prematurity. J Pediatr.
2011;158:373-6.
25. Bassiouny MR. Risk factors associated with retinopathy of
prematurity: a study from Oman. J Trop Pediatr. 1996;42:355-
8.
RM, Stanton BM, St Geme JW, Schor NF, Behrman RE,
editors. Nelson textbook of pediatrics. 19'h ed. Philadelphia:
Elseviers Saunders; 2012. p. 2174-81.
2. Gong A, Anday E, Boros S, Bucciarelli R, Burchfield
D, Zucker J, er al. One year follow-up evaluation of 260
premature infants with respiratory distress syndrome and
birth weights of700 to 1350 grams randomized to two rescue
doses of synthetic surfactant or air placebo. American Exosurf
Neonatal Study group I. J Pediatr. l 995 ;126:S68-74.
3. Valentine PH, Jackson JC, Kalina RE, Woodrum DE.
Increased survival of low birth weight infants: impact on
the incidence of retinopathy of prematurity. Pediatrics.
1989;84:442-5.
4. Gibson DL, Sheps SB, Uh SH, Schechter MT, McCormick
AQ. Retinopathy of prematurity-induced blindness: birth
weight-specific survival and the new epidemic. Pediatrics.
1990;86:405-12.
5. Schalij-Delfos NE, Cats BP. Retinopathy of prematurity:
the continuing threat to vision in preterm infants. Acta
Ophthalmol Scand. 1997;75:72-5.
6. Rudanko SL, Fellman V, Laatikainen L. Visual impairment
in children born prematurely from 1972 through 1989.
Ophthalmology. 2003; 110: 1639-45.
7. Gomalla TL. Eye disorders of the newborn and retinopathy
of prematurity. In: Gomalla Tl, Cunningham MD, Eyal FG,
Tuttle D, editors. Neonatology. 6th ed. New york: McGrawHill;
2009. p. 454-62.
8. International Committee for the Classification of Retinopathy
of Prematurity. The international classification of
retinopathy of prematurity revisited. Arch Ophthalmol.
2005; 123 :99 1-9.
9. Clemett R, Darlow B. Results of screening low-birthweight
infants for retinopathy of prematurity. Curr Opin
Ophthalmol. 1999;10:155-63.
10. Shah VA, Yeo CL, Ling YLF, Ho LY. Incidence, risk factors
of retinopathy of prematurity among very low birth weight
infants in Singapore. Ann Acad Med Singapore. 2005;34:
169-78.
11. Li ML, Hsu SM, Chang YS, Shih MH, Lin YC, Lin CH, er
al. Retinopathy of prematurity in southern Taiwan: a tertiary
medical center 10-year study. J Fla Med Assoc. 2010;20: 1-
9.
12. Palmer EA, Flynn JT, Hardy RJ. Incidence and course of
retinopathy of prematurity. Ophthalmology. 1991;98:1628-
40.
13. Maheshwari R, Kumar H, Paul VK, Sing M, Deorari AK,
Tiwari HK. Incidence and risk factors of retinopathy of
prematurity in a tertiary care newborn unit in New Delhi,
1996. Natl Med J India. 1996;9:211-4.
14. Haugen OH, Markestad T. Incidence of retinopathy of
prematurity (ROP) in the western part of Norway. A
population-based retrospective study. Acta Ophthalmol
Scand. l 997;75:305-7.
15. Lappi M. Retinopathy of prematurity in southern Finland.
Acta Ophthalmol Suppl. 1993;210:56-8.
16. Smith J, Spurrier N, Goggin M. Retinopathy of prematurity
in South Australian neonatal intensive care unit. Aust N Z
J Ophthalmol. 1995;23:49-54.
17. Hussain N, Clive J, Bhandari V. Current incid ence
of retinopathy of prematurity, 1989-1997. Pediatrics.
l 999;104:26-41.
18. Mathew MRK, Fern A, Hill R. Retinopathy of prematurity:
are we screening too many babies? Eye. 2002;16:538-42.
19. Zin AA, Moreira MEL, Bunce C, Darlow BA, Gilbert CE.
Retinopathy of prematurity in 7 neonatal units in Rio
de Janeiro: screening criteria and workload implications.
Pediatrics. 2010:410-7.
20. Cryotherapy for retinopathy of prematurity cooperate
group. Multicenter trial of cryotherapy for retinopathy of
prematurity. One year outcome-structure and function. Arch
Ophthalmol. 1990;108: 1408-16.
21. Early Treatment for Retinopathy of Prematurity Cooperative
Group. Revised indications for the treatment of retinopathy
of prematurity: results of the early treatment for retinopathy
of prematurity randomized trial. Arch Opthalmol. 2003; 121:
1684-96.
22. Darlow B, Hutchinson J, Henderson, Donoghue D, Simpson
J, Evans N. Prenatal risk factors for severe retinopathy of
prematurity among very preterm infants of the Australian and New Zealand neonatal network. Pediatrics. 2005;115:990-
6.
23. Blair BM, O'Halloran HS, Pauly TH, Stevens JL. Decreased
incidence of retinopathy of prematurity, 1995-1997. J
AAPOS. 2001;5:118-22.
24. Filho JB, Costa Mc, Eckert GU, Santos PGB, Silveira RC,
82 • Paediatr Indones, Vol. 53, No. 2, March 2013
Procianoy RS. Maternal preeclampsia protects preterm
infants against severe retinopathy of prematurity. J Pediatr.
2011;158:373-6.
25. Bassiouny MR. Risk factors associated with retinopathy of
prematurity: a study from Oman. J Trop Pediatr. 1996;42:355-
8.
Published
2013-04-30
How to Cite
1.
Rasyidah R, Fing S. Incidence and risk factors of retinopathy of prematurity. PI [Internet]. 30Apr.2013 [cited 26Apr.2024];53(2):76-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/255
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Received 2016-08-19
Accepted 2016-08-19
Published 2013-04-30
Accepted 2016-08-19
Published 2013-04-30
