The importance of timely ophthalmologic examination in preterm infants at risk of retinopathy occurrence

Abstract

Background/Aim. Retinopathy of prematurity (ROP) is a multifactorial disease in premature infants. The aim of this study was to determine the incidence of ROP in children treated at the Center of Neonatology, Pediatric Clinic, Clinical Center in Kragujevac, Serbia. Methods. The study covered all children with birth weight below 2,000 g and/or gestational age below the 37th week, who from June 2006 to December 2009 underwent ophthalmological examination for ROP. The results of fundoscopy were classified in accordance with the International Classification of ROP. The treatment of infants and those with ROP was conducted in accordance with the early treatment of ROP study recommendations. We analyzed gestational age, birth weight and postconceptional age in two groups: healthy infants and those with severe form of ROP. Statistical analysis was performed using the SPSS 16. Results. A total of 478 children met the criteria of screening for ROP. Severe stage of ROP, which required laser treatment, had 102 (21.3%) children. Out of the infants with severe ROP 14 (13.7%) of the infants with APD had aggressive posterior disease, while two (0.4%) remained blind. The differences in the mean values of gestational age between the healthy and the children with severe form of the disease were statistically significant (p < 0.0005). The mean value of gestational age for the healthy children was 33.33 ? 2.28 weeks and for the seek infants 30.66 ? 2.79 weeks. The mean value of the weight in healthy children was 1.981 ? 407 g, and in sick children 1.535 ? 434 g which was statistically significant (p < 0.0005). Multivariate binary logistic regression showed that the occurrence of the disease depends on body weight and gestational age. Conclusion. The incidence of severe forms of ROP was 21.3%. Aggressive form of ROP was present in 13.7% of the children. The cut-off value for body weight was 1.740 g, and for gestational age 32.5 weeks.Uvod/Cilj. Retinopatija prematuriteta (ROP) je multifaktorijalna bolest prevremeno rodjene dece. Cilj ove studije bio je da se utvrdi incidencija retinopatije prematuriteta kod lecenih u Centru za neonatologiju Klinike za pedijatriju, Klinickog centra u Kragujevcu. Metode. Kod sve dece telesne mase na rodjenju ispod 2 000 g i/ili gestacione starosti ispod 37 nedelja, u periodu od juna 2006. do decembra 2009. godine, uradjen je oftalmoloski pregled na retinopatiju prematuriteta. Rezultati oftalmoloskog pregleda su klasifikovani prema Internacionalnoj klasifikaciji za retinopatiju prematuriteta. Lecenje dece sa retinopatijom vrseno je laserom prema preporukama studija za rano lecenje. Analizirali smo gestacionu starost, telesnu masu na rodjenju i postkoncepcijsku starost dve grupe: zdrava deca i deca sa teskom formom retinopatije. Statisticka analiza radjena je koriscenjem programa SPSS 16. Rezultati. Ukupno 478 dece je ispunilo kriterijume skrininga za retinopatiju prematuriteta. Tesku formu retinopatije koja je zahtevala lecenje laserom imalo je 102 (21,3%) dece. Od dece sa teskom formom ROP, 14 (13,7) je imalo agresivnu formu, dok je dvoje (0,4%) dece sa agresivnom formom ostalo slepo. Razlika srednjih vrednosti gestacione starosti izmedju zdrave dece i dece sa teskom formom retinopatije bila je statisticki znacajna (p < 0,0005). Srednja vrednost gestacione starosti zdrave dece bila je 33,33 ? 2,28 nedelje, a bolesne 30,66 ? 2,79 nedelje. Srednja vrednost telesne mase zdrave dece bila je 1 981 ? 407 g, a bolesne 1 535 ? 434 g, sto je bilo statisticki znacajno (p < 0,0005). Multivarijantna binarna logisticka regresija pokazala je da na pojavu bolesti veliki uticaj ima telesna masa i gestaciona starost dece. Zakljucak. Incidencija teske forme ROP iznosila je 21,3%. Agresivan oblik ROP imalo je 13,7% dece. Granicna vrednost za telesnu masu iznosila je 1 740 g, a za gestacionu starost 32,5 nedelja.