Simon Skalicky, Frank Billson
Purpose: To determine the prevalence and predictors of retinopathy of prematurity (ROP) in premature hos-pitalised infants.
Methods: A prospective consecutive series of infants <32 weeks corrected gestational age (CGA) and <1250 g birth weight were screened for retinopathy. The following were collected: CGA at birth, sex, the presence and stage of ROP, postnatal dexamethasone use, microbial-positive cultures, clinical infective epi-sodes, chronic lung disease (CLD), mechanical ventila-tion and oxygen support. Age-adjusted and unadjusted generalised linear models and independent t-tests were used to compare infants with and without ROP and to find suspected ROP risk factors. Results: Of 448 infants <32 weeks CGA and <1250 g birth weight, 289 were screened for ROP as inpatients, 109 were screened as outpatients and 50 were screened elsewhere or lost to follow up. 82 (28.4%) of 289 infants had ROP (21 had stage one, 35 stage two, 26 stage three) and 11 had threshold disease treated with laser. Infants with ROP were born earlier than those without ROP (26.6 v 28.2 weeks), were more likely to have CLD (47.6 v 18.9%), infective episodes (2.2 v 1.0 per infant) and receive dexamethasone (45.1 v 11.7%). Dexamethasone use (OR 3.1 p = 0.001), CGA (OR 1.5 p < 0.0001) and infective episodes (OR 1.4 p < 0.005) were independently predictive of ROP. Conclusions: ROP affects a large proportion of pre-mature infants. Dexamethasone use, early gestational age and neonatal sepsis are important risk factors for ROP more so than supplemental oxygen therapy and mechanical ventilation.