Screening ROP in the University Hospital Ostrava

Objective: to analyze the group of premature infants who were examined by an ophthalmologist in screening for ROP (retinopathy of prematurity) at the University Hospital in Ostrava.
Methods: A retrospective observational case series. We reviewed and analyzed clinical records of all the premature infants born before the 32nd gestational week examined by ophthalmologist in ROP screening at the University Hospital in Ostrava in the period from 1. 9. 2011 to 31. 8. 2012. Children’s gestational age at birth, birth weight, postconceptional age (PCA) of the child at the time of the first ocular inspection, at the time of diagnosis ROP and at the time of any intervention, possible risk factors of ROP (Apgar score in the 1st minute, duration of oxygen therapy, FiO2 (%) (percentage fraction of oxygen in the inspired gas mixture), duration of mechanical ventilation, transfusion of erythrocytes (resuspended leukodepleted), presence of sepsis / infection in the perinatal period and duration of phototherapy) were evaluated. Eye examination was performed in local anesthesia with the use of an eyelid retractor, in artificial mydriasis, using an indirect ophthalmoscope and digital imaging system RetCam 3.
Results: 138 premature infants with an average gestational age at birth of 29.8 weeks, average birth weight 1385 g, were included in this study. Thirty-four children (24.6 %) were diagnosed with ROP, in all cases 1st stage at the time of diagnosis. An ophthalmologist indicated and subsequently implemented intervention (cryotherapy / laser treatment) in the case of five children (14.7 %) with ROP under general anesthesia. Average duration of oxygen therapy at infants with ROP was 371 hours, in the group without ROP 84 hours. The difference between the average values was statistically significant [t (37) = -3.69, P <= 0.0007]. Average time of mechanical ventilation in the case of children with ROP were 229 hours, in the group without ROP 41 hours [t (35) = -2.99, P <0.005]. In the case of children with ROP, we noticed on average 3 transfusions of erythrocytes, in the group without ROP 1 transfusion [t (40) = -3.94, P <= 0.0003]. The average value of the Apgar score in the 1st minute of children with ROP group was 6.3 and children without ROP 7.8. The difference between the average values of Apgar score in the 1st minute was between both groups statistically significant [t (136) = 4.06, P <= 0.00008]. Sepsis / infection in the perinatal period occurred in 30 (88.2 %) children with ROP, in comparison with 46 (44.2 %) children with sepsis / infection without ROP. Average duration of phototherapy in infants with ROP was 42.4 hours, in the group without ROP 53.6 hours [t(136) = 1,21, P<= 0,2]. Conclusion: This study demonstrated statistically significant correlation of Apgar score in the 1st minute, duration of oxygen therapy, duration of mechanical ventilation, transfusion of erythrocytes and presence of sepsis / infection on the onset and progression of ROP at premature infants in our group. No effect of FiO2 (%) and duration of phototherapy on the onset and progression of ROP was demonstrated.