Retinopathy of prematurity in high risk preterm: incidence, risk factors and type and time of intervention with outcomes at western regional institute of ophthalmology in India

Purpose: To study the outcomes of various intervention in high risk preterm with retinopathy of prematurity along with its incidence and risk factors. Materials and Methods: High risk preterm infants with gestational age ≤ 34 weeks and birth weight ranging from 500 grams to 2.0 kg were examined for ROP. Neonates having unstable neonatal course along with risk factors were referred to ophthalmology department for screening and appropriate interventions were undertaken. Results: Amongst 208 high risk babies(102 female child, 106 male child) ROP was detected in 77.88% of babies. 29.62% had ROP with Zone I vascularization, 62.96% had ROP with Zone II vascularization and 07.40% had ROP with Zone III vascularization. After grouping and staging, 114 were kept under observation, 22 needed anti-VEGF (Vascular Endothelial Growth Factors) agents, 22 needed intervention with laser photocoagulation and 4 were referred after explaining the nil visual prognosis. Timing of intervention for anti-VEGFs: 12 of 22 were treated on presentation, 10 of 22 within 1 week. For laser treatment, 8 of 22 were treated on presentation, 4 of 22 between 1 to 2 weeks, 2 of 22 between 2 to 4 weeks and 8 of 22 after 4 weeks. Conclusion: Major risk factor in our study which contributed to high risk preterm were oxygen therapy, NICU admission with ventilation and multiple pregnancy which predisposed these babies to ROP. Favourable outcomes: Were noted in 87/114 babies under observation, 21/22 babies in anti VEGF treatment group and 18/22 in laser photocoagulation treated babies.