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      Incidence of retinopathy of prematurity at two tertiary centers in Jeddah, Saudi Arabia

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          Abstract

          Purpose

          To review the incidence and risk factors for retinopathy of prematurity (ROP) King Faisal Specialist Hospital and King Abdulaziz University Hospital in Jeddah, Saudi Arabia.

          Material and methods

          In this prospective cohort study, preterm infants who were admitted to a neonatal intensive care unit from 2012 to 2013 were evaluated for ROP. Inclusion criteria were, preterm infants with gestational age <32 weeks and/or birth weight <1500 g. The risk factors that were assessed were intraventricular hemorrhage, patent ductus arteriosus (PDA), sepsis and hydrocephalus. The relative risk was used to measure the risk and logistic regression was used to adjust for confounding factors. Statistical significance was indicated by p < 0.05.

          Results

          Thirty-one of 92 (33.7%) preterm infants had unilateral or bilateral ROP. The mean gestational age was 26.7 weeks (range, 24–29 weeks) and mean birth weight was 0.843 kg (range, 0.606–1.450 kg). There were 7 infants with stage 1 ROP, 10 infants with stage 2, 14 infants with stage 3 and no cases of stage 4 or 5. Twelve (13%) infants had plus disease and received laser therapy within 72 h of diagnosis. Statistically significant risk factors for ROP were PDA ( p = 0.0005) and intraventricular hemorrhage ( p = 0.0005).

          Conclusion

          The incidence of ROP was 33.7% and risk factors were PDA and intraventricular hemorrhage. Laser therapy was very effective for the treatment of plus disease and preventing progression of ROP. Clinicians should assess for potential risk factors when monitoring premature infants.

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          Retinopathy of prematurity in Saudi Arabia: incidence, risk factors, and the applicability of current screening criteria.

          A Binkhathlan, S Srungeri, M Saleh … (2008)
          To study the risk factors for Retinopathy of Prematurity (ROP) and the applicability of the current ROP screening criteria in Saudi Arabia. A retrospective study of ROP incidence was conducted in patients of a neonatal intensive care unit in Riyadh from July 2003 until July 2004. Infants born at <36 weeks of gestation, and/or weighing <2000 g at birth, had their charts reviewed for ROP diagnosis and risk factors for ROP. The sensitivity and specificity of current screening criteria were assessed. One hundred and seventy-four infants were examined. Retinopathy of prematurity was diagnosed in 93 infants (56%); 15% of those patients were in stage 3 of the disease (severe ROP). The mean gestational age (GA) was 30 weeks for the ROP-positive group. At
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            Risk factors for severe retinopathy of prematurity in preterm low birth weight neonates.

            Vinod K. Paul, Ramesh Agarwal, Parijat Chandra … (2011)
            To evaluate the risk factors predisposing to severe retinopathy of prematurity (ROP) in a level III neonatal unit. This retrospective study was conducted in a tertiary care neonatal and ophthalmic center. The authors retrospectively analyzed data of preterm infants who were born from January 2003 through December 2008 and were screened for ROP. Data were collected from prospectively filled ROP screening forms. All the neonates with gestation ≤ 32 wks or birth weight ≤ 1500 g were screened. In addition, infants with birth weight of 1501-1800 g or gestation of 33-34 wks were also screened in the presence of additional risk factors like need for oxygen or mechanical ventilation. Primary outcome was severe ROP defined as treatable ROP as per type I ETROP guidelines (after year 2005) or threshold disease (before 2005). A total of 704 neonates were screened during the study period, of whom 84 (11.9%) and 33 (4.7%) infants developed any ROP and severe ROP, respectively. The mean birth weight and gestation of infants with severe ROP were 1113 ± 438 g and 29 ± 3 wks, respectively. The following risk factors were found to be significant for severe ROP on univariate analysis: gestation ≤ 30 wks, birth weight < 1000 g, respiratory distress syndrome, use of surfactant, apnea, hypotension, patent ductus arteriosus (PDA), sepsis, necrotizing enterocolitis, pneumonia, meningitis, intraventricular hemorrhage, packed cell transfusion, and use of oxygen, continuous positive airway pressure and positive pressure ventilation. On multivariate analysis by stepwise logistic regression, respiratory distress syndrome (adjusted OR: 8.1 (95% CI 2.6-25.1); p < 0.001), PDA requiring medical or surgical management (adjusted OR: 3.2 (95% CI 1.1-8.9); p = 0.03), and meningitis (adjusted OR: 6.7 (95% CI 1.9-23.0); p = 0.002) were found to be independently associated with severe ROP. All infants with severe ROP had regression of the disease after laser therapy. Respiratory distress syndrome, PDA requiring medical or surgical management and meningitis were found to be associated with severe ROP. Outcomes were good after laser therapy with all followed-up infants having regression of the disease.
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              Retinopathy of prematurity at a University Hospital in Riyadh, Saudi Arabia.

              Abdulla A Thabit, Bazdawi Al-Riyami, Fatma Al-Oweisi (2003)
              To prospectively study the incidence and nature of retinopathy of prematurity (ROP) at a University Hospital in Riyadh, Kingdom of Saudi Arabia. This study was carried out the Neonatal Intensive Care Unit of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia. One hundred and ninety-five consecutive preterm infants with a birth weight of 2000 g or less were screened for ROP. The first examination was performed at 4-7 weeks of postnatal age. Mean gestational age of all premature infants was 28.4 2.4 weeks (range 22-34), mean birth weight was 1103 302 g (range 520-1960), and mean duration of oxygen therapy was 24.0 32.2 days (range 0-210). Seventy-three children developed acute ROP, giving an overall incidence of 37.4%. The incidence in preterms with birth weight of 1500 g developed ROP. Nineteen of the 73 children with ROP (26% or 9.7% of all infants studied) reached threshold ROP, and needed laser treatment or cryotherapy which induced regression in all of patients. Incidence of ROP in our patients in comparable to other reports. Screening for ROP should be carried out for all preterms of <1500 g birth weight. Such screening programs will identify those requiring retinal ablative surgery in order to induce regression of the acute ROP and prevent cicatrizing sequelae with subsequent traction retinal detachment and blindness.
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                Author and article information

                Contributors
                Khalid Alshehri
                Journal
                Journal ID (nlm-ta): Saudi J Ophthalmol
                Journal ID (iso-abbrev): Saudi J Ophthalmol
                Title: Saudi Journal of Ophthalmology
                Publisher: Elsevier
                ISSN (Print): 1319-4534
                Publication date PMC-release: 08 March 2016
                Publication date (Print): Apr-Jun 2016
                Publication date (Electronic): 08 March 2016
                Volume: 30
                Issue: 2
                Pages: 109-112
                Affiliations
                [a ]Ophthalmology Department, King Faisal Specialist Hospital, Jeddah, Saudi Arabia
                [b ]Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
                Author notes
                [* ]Corresponding author. Tel.: +966 503359760. dr.khalid_alshehri@ 123456hotmail.com
                Article
                Publisher ID: S1319-4534(16)00029-1
                DOI: 10.1016/j.sjopt.2016.02.006
                PMC ID: 4908068
                PubMed ID: 27330386
                SO-VID: e9a5c3dc-9375-48c0-8d8b-7a6e1cd1663a
                Copyright © © 2016 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 28 April 2015
                Date revision received : 27 February 2016
                Date accepted : 28 February 2016
                Categories
                Subject: Original Article

                Keywords: retinopathy of prematurity (rop),plus disease,threshold disease,patent ductus arteriosus,hydrocephalus,intraventricular hemorrhage
                Data availability:
                Keywords: retinopathy of prematurity (rop), plus disease, threshold disease, patent ductus arteriosus, hydrocephalus, intraventricular hemorrhage

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