Epidemic of Retinopathy of Prematurity in Regions Affected by War

Abstract

Purpose: : To determine the prevalence of Retinopathy of Prematurity (ROP) among children attending the school for the blind and visually impaired who were born prior to 1989 compared to children born between 1989 and 2000 (years of active war in regions of former Yugoslavia).

Methods: : The data were collected in 2005, in a boarding school for visually impaired children in Zemun (Belgrade), Serbia. Using the modified WHO/PBL protocol we examined 325 eyes of 166 students, aged 4 to 22, to determine the cause of visual impairment. Each child’s previous ophthalmological and medical records were reviewed for relevant perinatal ocular and medical history. Data were grouped in two categories: (a) that pertaining to children born prior to the war (before 1989; 16–22 years old) and (b) those born during the war (1989–2000; less than 16 years old). The following parameters were obtained through data analysis: (i) primary anatomical site of vision loss (ii) most common causes of vision loss (iii) categories of visual impairment (iv) causes of vision loss in different age groups and (v) war related visual impairment.

Results: : Retina was identified as the primary anatomical site of vision loss. Retinopathy of Prematurity (ROP) was the most common etiology of visual impairment and blindness (48% of males and 52% of females). 21% of children under 16 years of age (born between 1989 and 2000), compared to 7% of children in the 16–22 year old group (born prior to 1989), had ROP as the primary cause of visual impairment. Among all causes of visual impairment, 29% of eyes examined had NLP. 34% of students with NLP were born during the war years, whereas 19% of students with NLP were born prior to the war. Five out of seven prosthetic eyes resulted from war related injury.

Conclusions: : The incidence of Retinopathy of Prematurity (ROP) in Serbia was greater in the years of war, compared to pre–war years. We further conclude that (i)during the years of active war there was an added contribution to visual disablity through war related injury and (ii) children born during the war years had a more severe visual disability from all causes.

Keywords: retinopathy of prematurity • clinical (human) or epidemiologic studies: prevalence/incidence