Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study

Abstract

Background and objectives: World Health Organization's vision 20/20 programme has recognized retinopathy of prematurity (ROP) as an important cause of childhood blindness in industrialized and middle-income countries. While ROP is virtually nonexistent in many African countries, ROP is seen in urban areas where facilities for neonatal care exist. The aim of this study is to establish the frequency of ROP in a cohort of patients screened for ROP and to establish if current screening criteria apply to our patients.

Patients and methods: Infants with birth weight (BW) of 1500 g or less and/or gestational age of 32 weeks or less were screened for ROP over a 2(1/2)-year period by a single examiner.

Results: ROP was observed in 84 of 514 (16.3%) of infants included for analysis. Threshold disease (tROP) was noted in 1.6% of the total cohort although 41/84 babies with ROP were lost prior to regression or progression to tROP. Of the 43/84 adequately followed up, eight (18.6%) developed tROP. An estimated frequency of tROP was more likely to be 2.9%. There was no tROP noted in babies of BW greater than 1250 g. Gestational age was an unreliable risk parameter in our population.

Conclusion: The projected occurrence rate of tROP is similar to that found in black population in the Multicentre Cryotherapy for ROP Trial. Our data suggest that the screening criterion based on BW can safely be lowered to 1250 g in our population.