Original research: Blindness in infants presenting with advanced and untreated ROP: a single-centre study in Pakistan

BMJ Open Ophthalmology

article

Muhammad Moin¹  Lubna Siddiq Mian¹  Clare Gilbert²  Abdullah Irfan¹  Umar K Mian³ 

[1] Ophthalmology, Ameer-ud-Din Medical College , Post Graduate Medical Institute;Clinical Research Unit, ITD , London School of Hygiene & Tropical Medicine;Ophthalmology , Montefiore Medical Center;Montefiore Medical Center / Albert Einstein College of Medicine, Department of Ophthalmology and Visual Science

关键词: retina;    vision;    child health (paediatrics);   

DOI  :  10.1136/bmjophth-2021-000911

学科分类：工业工程学

来源: BMJ Publishing Group

【 摘 要 】

Purpose To describe the ocular features andcharacteristics of young children presenting withadvanced, untreated retinopathy of prematurity and todetermine appropriate screening guidelines for retinopathyof prematurity (ROP) in Pakistan.Material and methods A retrospective case series ofyoung children with stage5A or 5B or cicatricial changes(4B or 4A ROP) was undertaken in the Department ofOphthalmology, Lahore General Hospital, Lahore, Pakistan,from August 2017 to July 2019. Information was obtainedfrom interviewing parents and from neonatal caredischarge summaries, if available. An assessment of visualfunction and a dilated fundus examination were performed.Results 51 children presented at mean age of 9.7 (1.5–36) months. Their mean gestational age (GA) was 28.84(26–38) weeks, and mean birth weight (BW) was 1229(800–2100) g. Four children (7.8%) had a GA of >31 weeksplus a BW of >1501 g. 40 (76.4%) children were blind and11 (23.6%) had impaired vision. Sixty-five eyes (63.7%)had stage 5B; 13 (12.7%) eyes had stage 5A; 18 (17.6%)had falciform macular folds (4B ROP) and 6 eyes (5.9%)had macular dragging (4A ROP). 39 (76.5%) children hadbilateral stage 5A/5B. Half (47%) of the children livedoutside the capital city of Lahore, and 15 came from smallcities (population <1million).Conclusion The third epidemic of blindness due to ROPhas arrived in Pakistan, and premature babies are goingblind even in smaller cities. Initial screening guidelines ofa GA of ≤35 weeks and BW of ≤2000 g seem reasonable.There is an urgent need to improve the quality of neonatalcare and to increase the coverage of ROP screening andtreatment services across the country.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND