1
|
García H, Villasis-Keever MA, Zavala-Vargas G, Bravo-Ortiz JC, Pérez-Méndez A, Escamilla-Núñez A. Global Prevalence and Severity of Retinopathy of Prematurity over the Last Four Decades (1985-2021): A Systematic Review and Meta-Analysis. Arch Med Res 2024; 55:102967. [PMID: 38364488 DOI: 10.1016/j.arcmed.2024.102967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/01/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is a vasoproliferative disease of the retina that occurs in premature infants. The prevalence of ROP reported so far is inconsistent. AIM To conduct a systematic review to describe the trend of ROP prevalence between 1985 and 2021, and to determine the influence of countries' economic conditions on ROP prevalence. METHODS We searched PubMed, Embase, and Google Scholar for studies published between January 1985 and December 2021 using the following MeSH terms: "retinopathy of prematurity", "ROP", "incidence", and "prevalence". Two independent reviewers examined the articles to select studies that met the selection criteria and performed data extraction and study quality assessment. For the meta-analysis, the pooled prevalence was calculated using a random-effects model and R software. RESULTS Of 5,250 titles and abstracts, 139 original studies met the inclusion criteria; a total of 121,618 premature infants were included in these studies. The pooled prevalence of ROP was 31.9% (95% confidence interval [CI] 29.0-34.8) and that of severe ROP was 7.5% (6.5-8.7). In general, no significant differences in prevalence were found over the four decades; however, we found a higher prevalence in premature infants ≤28 weeks of gestational age. In addition, the highest ROP prevalence was found in lower-middle-income countries with high mortality rates. In contrast, the highest severe ROP prevalence was found in high-income countries. CONCLUSION ROP remains a common cause of morbidity in premature infants worldwide. Therefore, it seems necessary to maintain early identification strategies for patients at higher risk, particularly in low- and middle-income countries.
Collapse
Affiliation(s)
- Heladia García
- Research Unit in Analysis and Synthesis of Evidence, Pediatrics Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
| | - Miguel Angel Villasis-Keever
- Research Unit in Analysis and Synthesis of Evidence, Pediatrics Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Georgina Zavala-Vargas
- Research Unit in Analysis and Synthesis of Evidence, Pediatrics Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Juan Carlos Bravo-Ortiz
- Pediatric Ophthalmology Service, Pediatrics Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Ayari Pérez-Méndez
- Research Unit in Analysis and Synthesis of Evidence, Pediatrics Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Alberto Escamilla-Núñez
- Research Unit in Analysis and Synthesis of Evidence, Pediatrics Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| |
Collapse
|
2
|
Raffa LH, Fatani M, Alghamdi R. Insights into Risk: Exploring Retinopathy of Prematurity and Short-term Comorbidities in Moderate-to-Late Preterm Infants. Niger J Clin Pract 2024; 27:124-130. [PMID: 38317045 DOI: 10.4103/njcp.njcp_576_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/08/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) and short-term comorbidity data moderate-to-late preterm (MLP) infants in Saudi Arabia are limited. AIM The present study mainly aimed to identify ROP incidence and severity in MLP infants. The secondary objective was to explore whether moderate preterm infants are more prone to systemic short-term comorbidities compared to late preterm infants. MATERIALS AND METHODS This retrospective study was conducted at King Abdulaziz University Hospital, a tertiary center in Jeddah, Saudi Arabia. Two-hundred and sixty-eight MLP infants born with gestational ages (GAs) of 32 to 36 + 6 weeks were included. Births were classified as moderate preterm (GA 32 to 33 + 6 weeks) and late preterm (GA 34 to 36 + 6 weeks) and the two groups were compared with an independent t-test. RESULTS ROP incidence was 1.5%; all cases were stage 1 and involved zone II or III. No patient had type 1 ROP requiring treatment. The short-term comorbidity incidence was high (76.1%) and included hyperbilirubinemia (n = 206, 76.7%), respiratory distress syndrome (n = 178, 66.4%), hypoglycemia (n = 32, 11.9%,), and transient tachypnea of newborn (n = 25, 9.3%). Moderate preterm infants were more likely to have lower birth weight (P < 0.001), any-stage ROP (P = 0.032), respiratory distress syndrome (P = 0.031), intraventricular hemorrhage (P = 0.038), and hyperbilirubinemia (P < 0.001) compared to the late preterm infants. CONCLUSIONS Any-stage ROP incidence among MLP infants was low, with no type 1 ROP cases requiring treatment. Short-term comorbidity incidence was relatively high among the moderate preterm infants. Despite the low non-type 1 ROP incidence at our center, MLP infants require proper surveillance of systemic short-term comorbidities.
Collapse
Affiliation(s)
- L H Raffa
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - M Fatani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - R Alghamdi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
3
|
Yu CW, Popovic MM, Dhoot AS, Arjmand P, Muni RH, Tehrani NN, Mireskandari K, Kertes PJ. Demographic Risk Factors of Retinopathy of Prematurity: A Systematic Review of Population-Based Studies. Neonatology 2022; 119:151-163. [PMID: 35124682 DOI: 10.1159/000519635] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Current national guidelines use gestational age (GA) and birth weight (BW) as their basis for retinopathy of prematurity (ROP) screening. The strength of association of these and other demographic risk factors is inconsistent across studies. This review aims to evaluate the strength of association of documented risk factors for ROP in large sample, population-based studies. METHODS MEDLINE, EMBASE, and Cochrane Library were searched from January 2010 to May 2020. Original studies reporting the risk of ROP in a region and demographic risk factors were included. RESULTS Eighteen studies comprising 342,005 infants were included. The overall risk of ROP in preterm infants was 18.8%. For every week decrease in GA, there was a median adjusted odds ratio (aOR) of 1.4 times (range 1.2-1.9) of developing ROP. For every 100-g decrease in BW, the median aOR was 1.8 times (range 1.2-2.7). Higher risk was found in infants with neonatal sepsis and bronchopulmonary dysplasia. The risk of any, severe, and treatment-requiring ROP was highest for 23 weeks GA, which was 66.5, 40.3, and 39.4%, respectively. Regions with higher neonatal mortality rates had the highest mean GA of infants with ROP. CONCLUSION For every week decrease in GA and every 100-g decrease in BW, there was a median of 1.4 times and 1.8 times the odds of developing ROP, respectively. Further research is required to clarify the role of additional risk factors.
Collapse
Affiliation(s)
- Caberry W Yu
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Arjan S Dhoot
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Parnian Arjmand
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nasrin N Tehrani
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kamiar Mireskandari
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| |
Collapse
|
4
|
Varol F, Ogreten T, Ozdogan T, Cömert S, Samancı N. A Retrospective Analysis of Retinopathy of Prematurity (ROP) in a Tertiary Newborn Intensive Care Unit: Incidence and Risk Factors of ROP. JOURNAL OF CHILD SCIENCE 2022. [DOI: 10.1055/s-0042-1751270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Background Retinopathy of prematurity (ROP) is the most frequent problem which causes blindness in preterm babies. In our study we evaluate the frequency of retinopathy, the risk factors, and their effects on disease development in premature newborns admitted to our neonatal intensive care unit (NICU).
Methods A total of 139 premature infants with gestational ages less than 34 weeks followed in our NICU between January 1, 2008 and January 1, 2011. The infants were divided into two groups as group 1 (no ROP/mild ROP) and as group 2 (severe ROP).
Results The demographics of 139 patients were as follows: 79 (56.83%) were female and 60 (43.17%) were male. Overall, 104 (74.8%) patients were found to have no or mild ROP and 35 (25.2%) had severe ROP. Among the patients in the severe ROP group, 25 of them had plus disease. With logistic regression analysis, lower gestational age (odds ratio [OR]: 4.1, confidence interval [CI]: 1.9–9.2), the central catheter usage (OR: 13.4, CI: 1.2–146.6), hypotension (OR: 7.5, CI: 1.1–49.6), perinatal asphyxia (OR: 261.3, CI: 8.8–7725.4), apnea (OR: 18.1, CI: 1.6–202.6), and high FiO2 (OR: 1.2 CI: 1.0–1.5) were found to be related to severe ROP.
Conclusion Among the preterms with very low body weight included in our study, we found that the frequency of severe ROP requiring treatment was low. The most important factors related to severe ROP were found to be low gestational age and birth weight. Being aware of the risk factors related to severe ROP in addition to screening every preterm infant carrying these risk factors is extremely important for the early diagnosis and treatment to prevent blindness due to severe retinopathy.
Collapse
Affiliation(s)
- Fatih Varol
- Department of Pediatrics, Suleymaniye Obstetrics and Child Health Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tulin Ogreten
- Division of Ophthalmology, Department of Pediatrics, Suleymaniye Obstetrics and Child Health Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tutku Ozdogan
- Division of NICU, Department of Pediatrics, Suleymaniye Obstetrics and Child Health Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serdar Cömert
- Division of NICU, Department of Pediatrics, Suleymaniye Obstetrics and Child Health Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nedim Samancı
- Division of NICU, Department of Pediatrics, Suleymaniye Obstetrics and Child Health Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
5
|
Çömez A, Çelemler P, Özmen MC, Yurttutan S, Akkececi NS, Güngör K, Saygılı O. Retinopathy of prematurity incidence and treatment modalities in moderate and late preterm infants: a study from two tertiary centers. Can J Ophthalmol 2021; 57:195-200. [PMID: 33887261 DOI: 10.1016/j.jcjo.2021.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/19/2021] [Accepted: 03/18/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the incidence, severity, and treatment modalities of retinopathy of prematurity (ROP) in moderate and late preterm infants with a gestational age (GA) >31 + 6 weeks. METHODS ROP screening results of preterm infants with GA >31 + 6 weeks to 36 + 6 weeks between March 2013 and January 2019 were evaluated retrospectively. Infants were divided into 2 groups according to GA as 32-33 + 6 weeks (moderate preterm) and 34-36 + 6 weeks (late preterm). In these groups, any ROP and severe ROP (requiring treatment) development rates and ROP types and treatment modalities were evaluated. RESULTS A total of 4156 preterm infants, 1875 (45.1%) female and 2281 (54.9%) male, were included. Overall, 1466 (35.2%) of the infants were moderate preterm and 2690 (64.8%) were late preterm. The incidences of any ROP and severe ROP were 22% and 2.5%, respectively. The rate of severe ROP was 5.3% in moderate preterm infants and 0.9% in late preterm infants. Significant correlations were determined between duration of hospital stay, birth weight (BW), and GA with ROP development (r = +0.415, r = -0.258, r = -0.199, respectively; p < 0.001 for all). Of 102 patients (2.5%) requiring treatment, 64 (62.7%) had laser, 34 (33.3%) had intravitreal bevacizumab (IVB), 2 (1.9%) had sequential IVB and laser, and 2 (1.9%) had vitreoretinal surgery. CONCLUSION ROP seems to still be an important health problem in moderate and late preterm infants in our country according to data from screening high-risk preterm infants with a GA >31 + 6 weeks. In this cohort, ROP development correlates with GA, BW, and duration of hospitalization significantly.
Collapse
Affiliation(s)
- Ayşegül Çömez
- Sutcu Imam University Faculty of Medicine, Department of Ophthalmology, Kahramanmaras, Turkey.
| | - Pelin Çelemler
- Gaziantep Children's Hospital, Department of Ophthalmology, Gaziantep, Turkey
| | - Mehmet Cüneyt Özmen
- Gazi University School of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Sadık Yurttutan
- Sutcu Imam University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kahramanmaras, Turkey
| | | | - Kıvanç Güngör
- Gaziantep University Faculty of Medicine, Department of Ophthalmology, Gaziantep, Turkey
| | - Oğuzhan Saygılı
- Gaziantep University Faculty of Medicine, Department of Ophthalmology, Gaziantep, Turkey
| |
Collapse
|
6
|
Şahinoğlu Keşkek N, Gülcan H, Yılmaz G, Akkoyun İ. Impact of Platelet Count in Retinopathy of Prematurity. Turk J Ophthalmol 2020; 50:351-355. [PMID: 33389935 PMCID: PMC7802096 DOI: 10.4274/tjo.galenos.2020.01058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/11/2020] [Indexed: 12/01/2022] Open
Abstract
Objectives The aim of the study was to investigate the risk factors for retinopathy of prematurity (ROP), including platelet count. Materials and Methods This retrospective study analyzed 137 infants in 3 subgroups: no ROP; mild ROP, and severe ROP requiring laser treatment (type 1 ROP). A retrospective review of records was performed and statistical analysis of possible risk factors for ROP including platelet count was evaluated by using logistic regression. Results Birth weight (BW), gestational age (GA), and low platelet count in the first week after birth were significant risk factors for developing ROP (p=0.038, 0.02, and 0.004, respectively). BW, GA, ventilation, and lower platelet count were associated with progression to type 1 ROP (p=0.004; 0.027, and 0.021, respectively). Conclusion Lower platelet count in the first week after birth is a risk factor for ROP development in addition to the previously established factors of ventilation need, low BW, and low GA.
Collapse
Affiliation(s)
- Nedime Şahinoğlu Keşkek
- Başkent University Faculty of Medicine, Adana Research and Training Center, Department of Ophthalmology, Adana, Turkey
| | - Hande Gülcan
- Başkent University Faculty of Medicine, Adana Research and Training Center, Department of Pediatrics, Division of Neonatology, Adana, Turkey
| | - Gürsel Yılmaz
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - İmren Akkoyun
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| |
Collapse
|
7
|
Retinopathy of prematurity occurrence and evaluation of screening policy in a large tertiary Greek cohort. Int Ophthalmol 2019; 40:385-391. [PMID: 31641909 DOI: 10.1007/s10792-019-01195-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 10/10/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE To assess the frequency of retinopathy of prematurity (ROP) and evaluate the appropriateness of screening guidelines in a tertiary hospital in Thessaloniki, Greece. METHODS Retrospective review of consecutive infants admitted to the IInd Department of the Neonatal Care Unit of Aristotle University in the period April 2004-2015. ROP screening took place according to the Royal College of Paediatrics and Child Health and Royal College of Ophthalmologists (UK) guidelines [i.e. gestational age < 32 weeks and/or birth weight < 1501 g)], plus a few additional cases due to comorbidity. RESULTS 1178 out of the 8782 admitted infants underwent ROP screening. ROP was detected in 232 (19.7%) infants of whom 87 developed severe form of the disease (i.e. ≥ stage 3). Treatment was required in 30 (2.5%) infants, all of whom fulfilled the screening criteria. Two of the 206 infants who were additionally screened due to comorbidity developed severe ROP which regressed spontaneously. Disease regression was achieved in 27/29 (93%) treated infants who survived. CONCLUSIONS The frequency of ROP observed in this cohort was as low as that reported in other developed countries. The currently used screening criteria permitted identification of all infants who were at risk and, therefore, need not be changed.
Collapse
|
8
|
Silva JC, Zin A, Gilbert C. Retinopathy of prematurity prevention, screening and treatment programmes: Progress in South America. Semin Perinatol 2019; 43:348-351. [PMID: 31182224 DOI: 10.1053/j.semperi.2019.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Retinopathy of prematurity (ROP) is the main cause of blindness and visual impairment in Latin America and prevention, detection and treatment have been a priority in the Region in the last two decades. There is progress in the number of eligible babies screened and treated in at least half of the countries with strong regulations on ROP, but screening is not yet available in all provinces in most. More effort is needed to increase national protocols and legislation, strengthening of services and human resources to cover all national provinces; telemedicine might be a promising strategy.
Collapse
Affiliation(s)
- Juan Carlos Silva
- Pan-American Health Organization-PAHO, Calle 66 # 11 - 50, Bogotá, Colombia.
| | - Andrea Zin
- Clinical Research Unit, Fernandes Figueira Institute, Av Rui Barbosa 716, Flamengo, Rio de Janeiro 22250-020, Brazil
| | - Clare Gilbert
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| |
Collapse
|
9
|
Pastro J, Toso BRGDO. Influence of oxygen in the development of retinopathy of prematurity. Rev Bras Enferm 2019; 72:592-599. [DOI: 10.1590/0034-7167-2018-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 03/08/2019] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to describe the influence of oxygen in retinopathy of prematurity (ROP) in premature newborns (PTNB) hospitalized in neonatal units of intensive care and undergoing ophthalmological follow-up procedures after hospital discharge. Method: retrospective cohort study, from January 2014 to June 2016, whose data collection totaled 181 charts. Descriptive and inferential statistical analysis. Results: when using oxygen (O2) in 148 PTNB (81.7%), both mask (n=141; 77.9%; p-value <0.001) and the tracheal tube predominated (n=100; 55.25; p-value <0.001) for 15 days in average. The time of use and O2 concentration of the tracheal tube (p-value <0.001), the time of mask use (p-value <0.001) and the time and concentration of O2 of the continuous positive airway pressure (CPAP) (p-value <0.001) were significant to cause ROP in 50 PTNB (11.31%). Conclusion: the oxygen therapy has influenced the development and severity of ROP, indicating the need to adopt protocols for its use.
Collapse
|
10
|
Chaves-Samaniego MJ, Gómez Cabrera C, Chaves-Samaniego MC, Escudero Gómez J, García Campos JM, Muñoz Hoyos A, García Serrano JL. Multicenter validation study of the WINROP algorithm as a method for detecting retinopathy of prematurity. J Matern Fetal Neonatal Med 2018; 33:1302-1306. [DOI: 10.1080/14767058.2018.1517325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- María J. Chaves-Samaniego
- Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
- Department of Ophthalmology, San Cecilio University Hospital, Granada, Spain
| | | | | | - Julia Escudero Gómez
- Department of Paediatric Ophthalmology, Regional University Hospital of Málaga, Málaga, Spain
| | | | | | | |
Collapse
|
11
|
Azami M, Jaafari Z, Rahmati S, Farahani AD, Badfar G. Prevalence and risk factors of retinopathy of prematurity in Iran: a systematic review and meta-analysis. BMC Ophthalmol 2018; 18:83. [PMID: 29606108 PMCID: PMC5879798 DOI: 10.1186/s12886-018-0732-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/26/2018] [Indexed: 01/12/2023] Open
Abstract
Background Retinopathy of prematurity (ROP) refers to the developmental disorder of the retina in premature infants and is one of the most serious and most dangerous complications in premature infants. The prevalence of ROP in Iran is different in various parts of Iran and its prevalence is reported to be 1–70% in different regions. This study aims to determine the prevalence and risk factors of ROP in Iran. Methods This review article was conducted based on the preferred reporting items for systematic review and meta-analysis (PRISMA) protocols. To find literature about ROP in Iran, a comprehensive search was done using MeSH keywords in several online databases such as PubMed, Ovid, Science Direct, EMBASE, Web of Science, CINAHL, EBSCO, Magiran, Iranmedex, SID, Medlib, IranDoc, as well as the Google Scholar search engine until May 2017. Comprehensive Meta-analysis Software (CMA) Version 2 was used for data analysis. Results According to 42 studies including 18,000 premature infants, the prevalence of ROP was reported to be 23.5% (95% CI: 20.4–26.8) in Iran. The prevalence of ROP stages 1, 2, 3, 4 and 5 was 7.9% (95% CI: 5.3–11.5), 9.7% (95% CI: 6.1–15.3), 2.8% (95% CI: 1.6–4.9), 2.9% (95% CI: 1.9–4.5) and 3.6% (95% CI: 2.4–5.2), respectively. The prevalence of ROP in Iranian girls and boys premature infants was 18.3% (95% CI: 12.8–25.4) and 18.9% (95% CI: 11.9–28.5), respectively. The lowest prevalence of ROP was in the West of Iran (12.3% [95% CI: 7.6–19.1]), while the highest prevalence was associated with the Center of Iran (24.9% [95% CI: 21.8–28.4]). The prevalence of ROP is increasing according to the year of study, and this relationship is not significant (p = 0.181). The significant risk factors for ROP were small gestational age (p < 0.001), low birth weight (p < 0.001), septicemia (p = 0.021), respiratory distress syndrome (p = 0.036), intraventricular hemorrhage (p = 0.005), continuous positive pressure ventilation (p = 0.023), saturation above 50% (p = 0.023), apnea (p = 0.002), frequency and duration of blood transfusion, oxygen therapy and phototherapy (p < 0.05), whereas pre-eclampsia decreased the prevalence of ROP (p = 0.014). Conclusion Considering the high prevalence of ROP in Iran, screening and close supervision by experienced ophthalmologists to diagnose and treat the common complications of pre-maturity and prevent visual impairment or blindness is necessary.
Collapse
Affiliation(s)
- Milad Azami
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Zahra Jaafari
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Shoboo Rahmati
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Gholamreza Badfar
- Department of Pediatrics, Behbahan Faculty of Medical Sciences, Behbahan, Iran.
| |
Collapse
|
12
|
Bas AY, Demirel N, Koc E, Ulubas Isik D, Hirfanoglu İM, Tunc T. Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units. Br J Ophthalmol 2018. [PMID: 29519879 PMCID: PMC6287567 DOI: 10.1136/bjophthalmol-2017-311789] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. Methods A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses. Results The TR-ROP study included 6115 infants: 4964 (81%) with a GA≤32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW≤1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW≤1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment. Conclusions Screening of infants with a GA≤34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs. Trial registration number NCT02814929, Results.
Collapse
Affiliation(s)
- Ahmet Yagmur Bas
- Department of Neonatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Nihal Demirel
- Department of Neonatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Esin Koc
- Department of Neonatology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Dilek Ulubas Isik
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Turan Tunc
- Neonatology Division, Memorial Hospital, Istanbul, Turkey
| | | |
Collapse
|