Retinopathy of prematurity : are we screening enough babies in Jordan ?

Abstract EN

Objectives: To assess the efficacy of the screening program for retinopathy of prematurity in Jordan and to determine the appropriate upper limits for screening in terms of gestational age and birth weight in premature babies in Jordan.

Methods: A prospective study conducted at the ophthalmology and neonatal department of Queen Rania Al Abdullah children’s hospital between January and July 2017.

All premature babies scheduled for retinopathy of prematurity screening exam which is performed at four to six weeks of age or at 31 week estimated gestational age were included in the study.

Infants who died or were discharged against medical advice prior to the ROP screening were excluded from the study.

Data were initially collected regarding the patient’s gender, gestational age, birth weight, duration of admission to neonatal unit and oxygen therapy.

The stage of ROP was determined through binocular ophthalmoscope and the RetCam.

The type of treatment offered was reported.

Results was analyzed and then compared to those in previous studies.

Results: One hundred and thirty- six (17%) out of 800 premature infants had ROP.

The birth weight ranged between 0.8 and 2.4 kg (mean 1.4±0.6) and the Gestational age (GA) ranged from 27 to 34 weeks (mean 31±1.5).

The rate of retinopathy of prematurity in infants with gestational age between 27 and 29 was (45.5%) compared to 21.0% and 7.1% in preterm infants of (28-30) weeks and infants above 30 weeks respectively.

The rate of retinopathy was 37.1%, 18.4% and 13% in patients with birth weight less than 1 kg, (1-1.5) kg and above 1.5 kg respectively.

Stage I, II, III, and IV were found in 36.0%, 18.4%, 44.1%, and 1.5% respectively.

No patient in this study was reported to have stage V disease.

Sixty-two patients (10.3%) required treatment.

Conclusion: The rate of Retinopathy of Prematurity among Jordanian premature infants at Queen Rania Al Abdullah children hospital was 17%.

The rate and severity of Retinopathy of prematurity were higher in patients with low birth weight and low gestational age.

Some premature infants of birth weight of more than 1.5 kg developed retinopathy requiring treatment.

It is recommended to extend the upper limit of retinopathy of prematurity screening program in Jordan to include preterm infants with a birth weight up to 2 Kgs.

Where the screening program was more effective in detecting retinopathy and the more appropriate management was able to be presented to the patients.