Characteristics of babies referred to a tertiary eye hospital of Bangladesh for retinopathy of prematurity screening and management, a database analysis

Abstract

Background: IspahaniIslamia Eye Institute and Hospital (IIEIH) is a not for profit hospital and a leading Retinopathy
of Prematurity (ROP) screening center in Bangladesh.
Objective: The study had an aim to analyze the characteristics of referred babies and identify possible bottlenecks
in the referral system.
Methods: Electronic records of babies referred to IIEIH for a period of three years (2016-2018) were analyzed
retrospectively. All the babies registered in the electronic file were screened by any of the three consultants with
a keen interest in ROP. Variables of interest were ROP stage, gestational age, birth weight, time to screening, referring
institution and treatment modalities (laser, Anti-VEGF, retina surgery or combination). Data was exported
to SPSS version 23 for Mac for descriptive and correlation analysis. A P-value of less than 0.05 was considered
statistically significant.
Results: Eight hundred and eighty seven babies with ROP stage 1 or above were registered over the 3 years
period, a large majority were referred mostly by neighbouring private institutions (75%), 60% of babies were
moderate pre-terms according to WHO classification, the mean birth weight was 1563±397.1 grams. ROP stage
2 was dominant (37%) and 61% of any stage ROP babies had at least one treatment modality. There was an obvious
delay in screening since only 55% of babies were screened within a period of less than 8 weeks. The younger
the gestational age and the lower the birth weight, the higher the risk of presenting with ROP with advanced
stage. (P-value<0.001).
Conclusions: The majority of babies with ROP came from private institutions and more than half of them needed
at least one treatment modality. The delay in screening was a key bottleneck and needs to be addressed. We
recommend more NICUS and more ROP services in public hospitals