A study on role of thrombocytopenia in retinopathy of prematurity

Authors

  • Aswathy Benedict Department of Paediatrics, Father Muller Medical College, Mangalore, Karnataka, India
  • Mario Joseph Bukelo Department of Paediatrics, Father Muller Medical College, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20200106

Keywords:

Oxygen exposure, Retinopathy of prematurity, Risk factors, Thrombocytopenia, Vascular endothelial growth factor

Abstract

Background: Retinopathy of Prematurity (ROP) is one of the causes of avoidable blindness in India. Globally ROP is estimated to affect more than 50,000 infants annually and in India, every year, 500 children are estimated to become blind from ROP. Many a times, lack of trained professionals and lack of timely referral are found to be setbacks in ROP diagnosis and treatment in developing nations. The aim of the study was to study if thrombocytopenia is a risk factor for retinopathy of prematurity and does supplemental oxygen with thrombocytopenia increases the risk of ROP.

Methods: It was a retrospective case control study done in a tertiary care hospital. Data was collected from 177 preterm admitted to NICU over a period of 3 years from March 2015-2018.

Results: A total of 177 preterm admitted to the NICU was included in this study. 77 had ROP and were taken as cases, while 100 were controls. Out of the cases, 55.6% had thrombocytopenia (OR-2.47, p value: 0.003). 89% (n =69) of cases had significant oxygen exposure (OR-8.65, p value 0.0001; 95% CI: 2.00-10.75). Oxygen exposure and thrombocytopenia coexisted in 57% of cases, with 4 times increased risk of ROP (OR-4.51, p value: 0.0001).

Conclusions: Thrombocytopenia is a significant risk factor for retinopathy of prematurity in preterm. The presence of thrombocytopenia with significant oxygen exposure tends to accentuate the risk further. Future prospective studies with long term follow up are warranted to establish other risk factors.

References

Azad R. Prevention of Blindness Due to Retinopathy of Prematurity: A National Movement. Ind J Pediatr. 2014;81:1373-5.

Smith LEH. Pathogenesis of retinopathy of prematurity. Seminars Neonatol. 2003;8:469-73.

Jensen AK, Ying GS, Huang J, Karp K, Quinn GE, Binenbaum G. Thrombocytopenia and retinopathy of prematurity. J AAPOS. 2011;15(5):447-50.

Dutta S, Raghuveer T, Vinekar A, Dogra MR. Can We Stop the Current Epidemic of Blindness From Retinopathy of Prematurity? Ind Pediatr. 2016;53 Suppl 2:S80-4.

Fierson WM, Capone A. Telemedicine for Evaluation of Retinopathy of Prematurity. Pediatr. 2015;135(1):e238-54.

Casteels I, Cassiman C, Van Calster J, Allegaert K. Educational paper: Retinopathy of prematurity. Eur J Pediatr. 2012;171(6):887-93.

Hartnett ME, Penn JS. Mechanisms and management of retinopathy of prematurity. N Engl J Med. 2012;367(26):2515-26.

Port A, Chan R, Ostmo S, Choi D, Chiang MF. Risk factors for retinopathy of prematurity insights from outlier infants. Graefes Arch Clin Exp Ophthalmol. 2014;252(10):1669-77.

Bas AY, Demirel N, Koc E, on behalf of the TR-ROP Study Group, et al. incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units. Bri J Ophthalmol. 2018;102:1711-6.

Downloads

Published

2020-01-23

Issue

Section

Original Research Articles