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LETTER TO EDITOR
Year : 2017  |  Volume : 5  |  Issue : 2  |  Page : 107

Retinopathy of prematurity: Incidence, prevalence, risk factors, and outcomes at a tertiary care center in Telangana


Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Date of Web Publication25-Apr-2017

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al.Kindy College of Medicine, Baghdad University, P.O. Box. 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcor.jcor_90_16

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How to cite this article:
Al-Mendalawi MD. Retinopathy of prematurity: Incidence, prevalence, risk factors, and outcomes at a tertiary care center in Telangana. J Clin Ophthalmol Res 2017;5:107

How to cite this URL:
Al-Mendalawi MD. Retinopathy of prematurity: Incidence, prevalence, risk factors, and outcomes at a tertiary care center in Telangana. J Clin Ophthalmol Res [serial online] 2017 [cited 2020 Jul 11];5:107. Available from: http://www.jcor.in/text.asp?2017/5/2/107/205187

Sir,

I read with interest the study by Le et al. on the retinopathy of prematurity (ROP) at a tertiary care center in Telangana.[1] It is obvious that ROP, one of the most common causes of preventable blindness in preterm neonates, is emerging as a “third epidemic” in the developing countries, including India. This is due to the increasing survival of preterm neonates, insufficient monitoring of oxygen saturation in most centers, and lack of an ROP screening guideline in most Neonatal Intensive Care Units (NICUs).[2] The authors mentioned that the incidence of ROP was 2.3% in their studied cohort and they emphasized the importance of neonatal screening.[1] I presume that the clinical implication of that recommendation ought to be cautiously interpreted. This is based on the following three points.

First, a health problem to be screened in a given community must be sizable to merit screening. I presume that the reported incidence of ROP in the studied population was low (2.3%) and, therefore, did not justify screening.

Second, the prevailing practices for proper screening and referral scheme among Indian pediatricians for ROP are not yet optimum. Only 14.5% of total pediatricians surveyed in a pilot study were following the international recommendations for ROP referral. Screening for ROP was dismal as observed in that pilot survey. This might be the consequence of nonavailability of trained ophthalmologists as well as inconsistent screening guidelines.[3]

Third, the cost of including the screening and treatment of ROP into NICUs is substantial and adequate financial resource must be available to cover it. It has been found that the unit costs per newborn were US$ 18 for each examination, US$ 398 per treatment, and US$ 29 for training. The estimated cost of ROP diagnosis and treatment for all at-risk infants NICUs was US$ 80 per infant. The additional cost to the Unified Health System for 1 year would be US$ 556,640 for a ROP program with 52% coverage, increasing to US$ 856,320 for 80% coverage, and US$ 1.07 million or 100% coverage.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Le C, Basani LB, Zurakowski D, Ayyala RS, Agraharam SG. Retinopathy of prematurity: Incidence, prevalence, risk factors, and outcomes at a tertiary care center in Telangana. J Clin Ophthalmol Res 2016;4:119-22.  Back to cited text no. 1
  [Full text]  
2.
Visser L, Singh R, Young M, Lewis H, McKerrow N. Guideline for the prevention, screening and treatment of retinopathy of prematurity (ROP). S Afr Med J 2012;103:116-25.  Back to cited text no. 2
    
3.
Patwardhan SD, Azad R, Gogia V, Chandra P, Gupta S. Prevailing clinical practices regarding screening for retinopathy of prematurity among pediatricians in India: A pilot survey. Indian J Ophthalmol 2011;59:427-30.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Zin AA, Magluta C, Pinto MF, Entringer AP, Mendes-Gomes MA, Moreira ME, et al. Retinopathy of prematurity screening and treatment cost in Brazil. Rev Panam Salud Publica 2014;36:37-43.  Back to cited text no. 4
    




 

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