• Muhammad Hanif Aga Khan University hospital
  • Shabina Ariff Aga Khan University
  • Aisha Ansar Aga Khan University
  • Khabir Ahmed Aga Khan University
  • Ali Shabbir Hussain Aga Khan University


Background: Retinopathy of prematurity (ROP) is a preventable and treatable vaso-proliferative disorder of the retina which develops mostly in preterm babies. It is a leading cause of childhood blindness and more common in under developed countries. Prevalence of the severe ROP is 7.7% in Pakistan. We reviewed the characteristics of preterm babies with severe ROP to evaluate the predictors of sight threatening ROP. Methods: Our study was conducted at the NICU of Aga Khan University Hospital which is a tertiary care private sector hospital in Karachi. Ninety-seven cases of severe ROP were found out of which 83 cases were enrolled. Data on determinants for ROP were collected including gestational age, birth weight, weight gain at two and four weeks, h/o blood transfusion, supplementary oxygen, presence of PDA and its treatment. Data analysis was done by using SPSS version 20.0 Results: Frequency of severe ROP in our cohort was 5.95%. Mean gestational age for severe ROP was 28.27±1.79 and mean birth weight was 1069.16±271.71 grams. The overall mean weight gain per week in these babies was 94.62±75.64 grams. Supplementary oxygen was provided in almost 100% (82/83 cases) of cases. Surfactant was given to 56.6 % babies. PDA was found in 23 cases out of which 19 were treated by medical therapy whereas surgical treatment was done in 4 cases. Conclusion: Severe Retinopathy of prematurity was directly correlated with low birth weight, and gestational age. An average, weight gain in four weeks was lower in ROP babies (94.62±75.64 grams) than the recommended weight gain (WHO recommended 140–210 gm per week). This could be associated with the development and severity of ROP requiring treatment. Therefore, a prospective case control study is required to further identify risk factors associated with the above cohort. Screening and follow up of all such babies according to the international criteria is the need of the day.Keywords: Child health; Retinopathy of prematurity; Low birth weight; Gestational age; Childhood blindness; Risk factors; weight gain

Author Biographies

Muhammad Hanif, Aga Khan University hospital

Fellow Pediatric neonatology, Department of Pediatrics and Child Health

Shabina Ariff, Aga Khan University

Associate Professor, Department of Pediatrics and Child Health

Aisha Ansar, Aga Khan University

Medical Student

Khabir Ahmed, Aga Khan University

Associate Professor, Department of Surgery

Ali Shabbir Hussain, Aga Khan University

Assisstant Professor, Department of Pediatrics and Child Health


Shah PK, Prabhu V, Karandikar SS, Ranjan R, Narendran V, Kalpana N. Retinopathy of prematurity: Past, present and future. World J Clin Pediatr 2016;5(1):35–46.

Jamil AZ, Tahir MY, Ayub MH, Mirza KA. Features of retinopathy of prematurity in a tertiary care hospital in Lahore. J Pak Med Assoc 2015;65(2):156–8.

Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet 2012;379(9832):2162–72.

Dogra MR, Katoch D. Retinopathy of Prematurity: An emerging and evolving challenge. Indian J Ophthalmol 2017;65(9):782–4.

Brown BA, Thach AB, Song JC, Marx JL, Kwun RC, Frambach DA. Retinopathy of prematurity: evaluation of risk factors. Int Ophthalmol 1998;22(5):279–83.

Lynch AM, Wagner BD, Hodges JK, Thevarajah TS, McCourt EA, Cerda AM, et al. The relationship of the subtypes of preterm birth with retinopathy of prematurity. Am J Obstet Gynecol 2017;217(3):354.e1–354.e8.

Chen Y, Li X. Characteristics of severe retinopathy of prematurity patients in China: a repeat of the first epidemic. Br J Ophthalmol 2006;90(3):268–71.

Hakeem AH, Mohamed GB, Othman MF. Retinopathy of prematurity: A study of prevalence and risk factors. Middle East Afr J Ophthalmol 2012;19(3):289–94.

Vinekar A, Dogra MR, Sangtam T, Narang A, Gupta A. Retinopathy of prematurity in Asian Indian babies weighing greater than 1250 grams at birth: Ten year data from a tertiary care center in a developing country. Indian J Ophthalmol 2007;55(5):331–6.

Shah PK, Narendran V, Kalpana N. Aggressive posterior retinopathy of prematurity in large preterm babies in South India. Arch Dis Child Fetal Neonatal Ed 2012;97(5):F371–5.

Sanghi G, Dogra MR, Katoch D, Gupta A. Demographic profile of infants with stage 5 retinopathy of prematurity in North India: Implications for screening. Ophthalmic Epidemiol 2011;18(2):72–4.

Vinekar A, Gilbert C, Dogra M, Kurian M, Shainesh G, Shetty B, et al. The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting. Indian J Ophthalmol 2014;62(1):41–9.

Chaudhry TA, Hashmi FK, Salat MS, Khan QA, Ahad A, Taqui AM, et al, Retinopathy of prematurity: an evaluation of existing screening criteria in Pakistan. Br J Ophthalmol 2014;98(3):298–301.

Fortes Filho JB, Bonomo PP, Maia M, Procianoy RS. Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies. Graefes Arch Clin Exp Ophthalmo 2009;247(6):831–6.



Most read articles by the same author(s)