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R. Sharma, P. Sharma, U. Dhaliwal; Retinopathy of Prematurity Screening Study in a Tertiary Level Neonatal Intensive Care Unit . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4125.
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Purpose: This hospital–based, prospective cohort study was undertaken to study the incidence,screening criteria and risk factors of retinopathy of prematurity(ROP) in our neonatal unit. METHODS: Neonates with gestational age under 35 weeks and/or birth weight under 1500 gm born over a one–year period were examined by indirect ophthalmoscopy between 2 to 4 weeks after birth, and followed up till retinal vascularisation was complete.Detected disease was classified as per ICROP classification and followed up. Maternal, neonatal and other risk factors were noted and data analyzed by statistical package SPSS–10.0. RESULTS: The incidence of retinopathy was 21.7% in the study cohort of sixty babies, 33.3% in babies under 32 weeks gestation and 36.4% in babies weighing under 1250 gm.Out of cases with the disease, stage 1 was seen in 23.1%, stage 2 in 46.2%, stage 3 in 15.3% and stage 5 in 15.3%.The onset correlated better with postnatal age than postconceptional age.On univariate analysis, ROP was associated with lower birth weight(p=0.036), lower gestational age(p=0.018), septicemia(p=0.04), apneic spells(p=0.008), oxygen administration(p=0.002), hyaline membrane disease(p=0.02) and exchange transfusion(p=0.03). On multivariate analysis, ROP was associated with oxygen administration, sepsis and apneic spells. No association was found with other risk factors like hypertension, bleeding per vaginum, meconium aspiration, placenta previa, abruptio placentae, gender, apgar score, multiple birth, seizure, congenital abnormalities, intraventricular hemorrhage, icterus, phototherapy, anemia, cyanosis, parenteral nutrition, ventilation, respiratory distress syndrome and chronic lung disease.Conclusions: A good screening programme adapted to the specific requirements of the nursery is essential for timely detection of ROP,which remains a serious problem in newborns.Screening should be performed with a high index of suspicion in the presence of risk factors like oxygen administration, apneic spells , septicemia ,exchange transfusion and hyaline membrane disease .
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