A clinical audit on the screening program and outcome of retinopathy of prematurity at a neonatal intensive care unit & special care baby unit at a tertiary care centre in Sri Lanka

Introduction

Retinopathy of prematurity (ROP) has become one of the leading causes of preventable childhood blindness worldwide with the increase in survival of preterm babies. Screening for ROP is very important as early detection and timely treatment will help to significantly reduce the incidence, severity and burden of childhood blindness. This study was done to ascertain the effectiveness of a screening program at a tertiary care hospital and its outcome.

 

Method

The study population comprised of 112 babies selected retrospectively, from January 2018 to June 2018, for screening using a pre-existing data collection tool adapted at SCBU/NICU. Collected data was compared with national guidelines and audit standards to ascertain the effectiveness of screening.

 

Results

The average birth weight of the babies was 1445g, ranging from 577g to 2550g. The first screening was done by 3 weeks postnatal life in 92.9% and by 4 weeks of postnatal life 94.6%. The main risk factor detected at screening was oxygen therapy (91.3%). Ninety five percent (95.3%) of babies did not develop ROP and were only observed until discharge. 4.7% developed ROP, where 3.8% required intravitreal Bevacizumab and 0.9% required laser treatment; 2.8% had Zone II ROP, 0.9% had Zone II Stage II plus disease and 0.9% had Stage IVa. The average period of post screening follow up was 34 days.

 

Conclusions

The majority of babies included in the study met the national screening indications and underwent timely screening and subsequent follow up until discharge criteria were met. Five babies required treatment and all of them met the ETROP criteria for early treatment