Aggressive Posterior Retinopathy Of Prematurity(APROP) In Heavier Babies In Asia: Demographic Trends, Risk Factors And Treatment Outcome.

1. Anusha Venkataraman
2. Rajvardhan Azad
3. Saurabh Dileep Patwardhan
4. Parijat chandra

Dr.R.P.Centre for Ophthalmic Sciences, A.I.I.M.S., New Delhi, India

Purpose: To study the treatment outcomes of APROP in heavier Asian babies with birth weight > 1500 grams.

Methods: This is a retrospective review of 18 eyes of 10 infants with birth weight > 1500 grams, who were diagnosed with APROP between Jan 2003 and July 2007, at a tertiary care hospital in India. Statistical tests involve the chi-square test for and paired and unpaired t tests.

Results: The mean gestational age was 32 weeks (28-34 weeks). The mean birth weight was 1825 grams (1500-2300 grams). The systemic risk factors were oxygen administration in 6 of 10 infants (60%), blood transfusion in 6 of 10 infants (60%), sepsis in 5 of 10 infants (50%) and apnea in 4 of 10 infants (40%). 44.44% of the eyes (8 of 18) had zone 1 disease and the remaining 55.56% (10 of 18 eyes) had zone 2 posterior disease. At a mean post conceptual age of 40.3 weeks (34-54 weeks), all eyes were treated with confluent laser photocoagulation. At a mean follow up period of 13 months (6-15 months), 77.77% (14 of 18 eyes) developed regression APROP. 2 eyes (11.11%) developed disc and macular drag and 2 eyes (11.11%) progressed to stage 5 retinal detachment.

Conclusions: Screening of heavier babies, even with gestational age > 28 weeks, should be performed especially in the presence of systemic risk factors , as APROP is not limited to very low birth weight babies. Prompt diagnosis and laser photocoagulation can prevent vision threatening complications and blindness.