Hanif Muhammad, Ariff Shabina, Ansar Aisha, Ahmed Khabir, Hussain Ali Shabbir
Department of Pediatrics and Child Health.
Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2020 Apr-Jun;32(2):174-178.
Retinopathy of prematurity (ROP) is a preventable and treatable vasoproliferative disorder of the retina which develops mostly in preterm babies. It is a leading cause of childhood blindness and more common in under developed countries. Prevalence of the severe ROP is 7.7% in Pakistan. We reviewed the characteristics of preterm babies with severe ROP to evaluate the predictors of sight threatening ROP.
Our study was conducted at the NICU of Aga Khan University Hospital which is a tertiary care private sector hospital in Karachi. Ninety-seven cases of severe ROP were found out of which 83 cases were enrolled. Data on determinants for ROP were collected including gestational age, birth weight, weight gain at two and four weeks, h/o blood transfusion, supplementary oxygen, presence of PDA and its treatment. Data analysis was done by using SPSS version 20.0.
Frequency of severe ROP in our cohort was 5.95%. Mean gestational age for severe ROP was 28.27±1.79 and mean birth weight was 1069.16±271.71 grams. The overall mean weight gain per week in these babies was 94.62±75.64 grams. Supplementary oxygen was provided in almost 100% (82/83 cases) of cases. Surfactant was given to 56.6 % babies. PDA was found in 23 cases out of which 19 were treated by medical therapy whereas surgical treatment was done in 4 cases.
Severe Retinopathy of prematurity was directly correlated with low birth weight, and gestational age. An average, weight gain in four weeks was lower in ROP babies (94.62±75.64 grams) than the recommended weight gain (WHO recommended 140-210 gm per week). This could be associated with the development and severity of ROP requiring treatment. Therefore, a prospective case control study is required to further identify risk factors associated with the above cohort. Screening and follow up of all such babies according to the international criteria is the need of the day.
早产儿视网膜病变（ROP）是一种可预防和治疗的视网膜血管增生性疾病，主要发生在早产儿中。它是儿童失明的主要原因，在欠发达国家更为常见。在巴基斯坦，严重ROP的患病率为7.7%。我们回顾了患有严重ROP的早产儿的特征，以评估威胁视力的ROP的预测因素。
我们的研究在阿迦汗大学医院的新生儿重症监护病房进行，该医院是卡拉奇一家三级护理私立医院。共发现97例严重ROP病例，其中83例被纳入研究。收集了ROP的相关决定因素数据，包括胎龄、出生体重、两周和四周时的体重增加、输血史、补充氧气、动脉导管未闭（PDA）的存在及其治疗情况。使用SPSS 20.0版进行数据分析。
我们队列中严重ROP的发生率为5.95%。严重ROP的平均胎龄为28.27±1.79周，平均出生体重为1069.16±271.71克。这些婴儿每周的总体平均体重增加为94.62±75.64克。几乎100%（82/83例）的病例接受了补充氧气治疗。56.6%的婴儿使用了表面活性剂。23例发现有PDA，其中19例接受药物治疗，4例接受手术治疗。
严重早产儿视网膜病变与低出生体重和胎龄直接相关。平均而言，ROP婴儿四周内的体重增加（94.62±75.64克）低于推荐的体重增加量（世界卫生组织推荐每周140 - 210克）。这可能与需要治疗的ROP 的发生和严重程度有关。因此，需要进行一项前瞻性病例对照研究，以进一步确定与上述队列相关的危险因素。按照国际标准对所有此类婴儿进行筛查和随访是当务之急。
