HYDERABAD: A once less-known condition that causes blindness among premature babies, known as Retinopathy of Prematurity (RoP), is now being considered an epidemic by ophthalmologists. A 12-fold increase has been reported in babies requiring treatment for RoP, in a span of 18 years from 2000 to 2017, in a study conducted by researchers from LV Prasad Eye Institute, published in the Indian Journal Of Ophthalmology just this month.
The researchers in their study point out that the problem of RoP has reached ‘epidemic proportions’. The study titled ‘Changing patterns of early childhood blinding conditions presenting to a tertiary eye centre: The epidemic of retinopathy of prematurity in India’, also reports that there was a 19-fold increase in babies requiring RoP screening during the same period.
For the study, the researchers went through the medical records of 6.39 lakh children examined in the outpatient department of LVPEI, in the 18-year study period. In this period, they observed an increasing trend in the number of premature babies requiring evaluation and treatment for RoP at the institute. In the year 2000, premature babies constituted only 4.5 per thousand children screened for RoP at the institute’s outpatient department. This number increased to 25.8 per thousand in 2017.
The researchers report that the number of babies requiring treatment for RoP increased from 38 in the year 2000 to 489 in 2017 which is almost a 12-fold increase, whereas the number of babies who had to be evaluated for RoP increased from 87 to 1,727. They also found that more than 8,277 children did not undergo any treatment for RoP after evaluation, one of the reasons being that it was too late for the condition to be treated.
The four main causes of childhood blindness are Vitamin A deficiency, Congenital cataract, Congenital glaucoma and RoP. Why the researchers refer to RoP as an epidemic is because the percent of children with RoP at the institute’s outpatient department increased from 9.8 percent in the period 2000-2005 to 23.43 percent in the period 2012-2017.
In case of Vitamin A deficiency and Congenital cataract, the percentage of cases decreased between the time periods 2000-2005 and 2012-2017, from 0.61 percent to 0.1 percent and 6.3 percent to 4.3 percent respectively. The cases of Congenital glaucoma remained almost same from 3.6 percent to 3.2 percent.
These findings are of concern because India has the highest number of premature births in the country, according to the World Health Organization (WHO), which pegged the number at 35.19 lakh premature births in a year. Premature babies are highly prone to RoP, which can later result not just in blindness, but even the detachment of retina.
Premature babies do not have fully-developed blood vessels in their retina, which continue to develop even after one month of delivery. When a baby is delivered prematurely before the nine-month period, it does not have properly-developed blood vessels in retina. Moreover, as such babies are often put in incubators and stand the risk of developing RoP, if proper flow of oxygen is not maintained.
As per the National Health Portal, oxygen affects vascular endothelial growth factor (VEGF) which constricts or delays the development of blood vessels in the retina. However, if your baby is born premature, it is not the end of the road. “Early detection of Retinopathy of Prematurity can help prevent blindness in the baby. There are treatments like Laser therapy or surgery available to treat the condition. It is necessary that the disease be detected early, soon after the delivery so that it can be treated. The best way to prevent RoP is to ensure that the pregnant woman is healthy, and receives proper medical attention to avoid premature delivery,” said Dr Ravinder Goud, Superintendent of Sarojini Devi Eye Hospital.
Why India should be concerned
The findings from the study are of concern because India has the highest number of premature births in the country, according to the World Health Organization. The WHO has pegged the number of premature births in India in a year at 35.19 lakhs. Premature babies are highly prone to Retinopathy of Prematurity (RoP), which can result not just in blindness but even the detachment of retina
489 babies required treatment for RoP in 2017, find researchers, as opposed to the 38 babies who faced the same condition in the year 2000
Risk of RoP high if the baby is...
Born in 34 weeks or less 2,000 gor less in terms of weight
Born in normal time period, but with some kind of health risk
Flow of oxygen It should be ensures that the oxygen saturation value is kept at 83-93% during baby’s incubation
8,277or more children have not undergone any treatment for RoP, even after evaluation