Sagarmatha Choudhary Eye Hospital, Siraha, Lahan, Nepal.
Nepal J Ophthalmol. 2020 Jan;12(23):32-38. doi: 10.3126/nepjoph.v12i1.28625.
Retinopathy of prematurity (ROP) is emerging as a leading cause of childhood blindness. The incidence of ROP is likely to increase after improvement in neonatal care unit in premature neonates. This study is conducted to determine the perinatal risk factors for ROP in preterm and low birth weight neonates.
This is a prospective, descriptive and clinical; hospital based study. A total of 92 preterm neonates with gestational age of 36 weeks or less and birth weight of 2000 grams or less admitted in Neonatal Intensive Care Unit (NICU) were screened. Detailed antenatal, perinatal and neonatal history; birth asphyxia and subsequent oxygen support records were noted. All the neonates underwent detailed anterior and posterior segment eye examination with indirect binocular ophthalmoscope after pupil dilatation within 4 weeks of life. Retinal vascular changes were classified according to the International Classification of Retinopathy of Prematurity. The Chi-square test with odds ratio was performed to derive the association between ROP and antenatal, perinatal and neonatal factors. A p-value was considered significant at 0.05.
Out of 92 neonates, 21(22.8%) developed ROP. Twelve neonates (13%) had stage-1 ROP, 6(6.5%) had stage-2 and 3(3.3%) had stage-3 ROP. Birth weight (OR=2.9; p=0.04; 95% CI=1.0-8.3), gestational age (OR=3.9; p=0.01; 95% CI=1.3-11.8) and time span of oxygen exposure (OR=2.9; p=0.05; 95% CI=1.0-8.4) had a strong association with ROP.
The incidence of ROP is significantly high among preterm low birth weight neonates. The risk of developing ROP becomes even greater with lower gestational age and more duration of oxygen exposure.
早产儿视网膜病变（ROP）正在成为儿童失明的主要原因。随着新生儿重症监护病房中早产儿护理的改善，ROP 的发病率可能会增加。本研究旨在确定早产儿和低出生体重儿 ROP 的围产期危险因素。
这是一项前瞻性、描述性和临床的基于医院的研究。共筛查了 92 名胎龄 36 周或以下、出生体重 2000 克或以下的早产儿，记录了详细的产前、围产期和新生儿病史；出生窒息和随后的氧支持记录。所有新生儿在生命后 4 周内瞳孔扩大后，均用间接双目检眼镜进行详细的眼前段和后段眼部检查。视网膜血管变化根据国际早产儿视网膜病变分类进行分类。采用卡方检验和优势比得出 ROP 与产前、围产期和新生儿因素之间的关联。p 值<0.05 认为差异有统计学意义。
92 例新生儿中，21 例（22.8%）发生 ROP。12 例新生儿（13%）为 1 期 ROP，6 例（6.5%）为 2 期，3 例（3.3%）为 3 期。出生体重（OR=2.9；p=0.04；95%CI=1.0-8.3）、胎龄（OR=3.9；p=0.01；95%CI=1.3-11.8）和吸氧时间（OR=2.9；p=0.05；95%CI=1.0-8.4）与 ROP 有很强的关联。
早产儿和低出生体重儿 ROP 的发病率明显较高。胎龄越小、吸氧时间越长，发生 ROP 的风险越大。
