# Pervasiveness and Frequency of Retinopathy of Prematurity in a Tertiary Care Centre and Its Correlation With Birth Weight and Gestational Age: A Retrospective Study

## TL;DR

This study finds that 5.1% of preterm infants in a South Indian hospital had retinopathy of prematurity, with lower birth weight and earlier gestational age strongly linked to retinal immaturity.

## Contribution

The study provides center-specific data on ROP prevalence and its correlation with birth weight and gestational age in a South Indian tertiary hospital.

## Key findings

- ROP prevalence was 5.1% among screened preterm infants.
- Lower birth weight and earlier gestational age were significantly associated with immature retinal vascularization.
- Most infants had retinal vascularization in Zone III, indicating significant retinal immaturity.

## Abstract

Introduction

Retinopathy of prematurity (ROP) is a vasoproliferative retinal disorder affecting incompletely vascularized retina of preterm infants. It remains one of the leading preventable causes of childhood blindness worldwide. The incidence and severity of ROP vary with neonatal care standards, oxygen regulation, and demographic factors. Birth weight (BW) and gestational age (GA) are the most important predictors of disease, though other perinatal and systemic factors may contribute. In India, wide variation in reported prevalence underlines the importance of centre-specific data to guide screening protocols.

Aim

To determine the prevalence and severity of ROP in a tertiary-level hospital and to analyse its association with BW, GA, and retinal vascularization patterns.

Methods

This retrospective observational study was conducted at a tertiary hospital in South India from January 2022 to December 2024. Infants with GA ≤32 weeks and/or BW <2000 g, and those with GA 32-36 weeks with additional risk factors, were screened as per national guidelines. Data on maternal history, GA, BW, oxygen therapy, laboratory findings, retinal zone at first examination, and ROP stage were collected. Statistical analysis was performed using Microsoft Excel (Microsoft Corp., Redmond, WA) and IBM SPSS v29 (IBM Corp., Armonk, NY). Descriptive statistics and Pearson chi-square tests were applied, with p < 0.05 considered significant.

Results

A total of 375 infants were screened. A total of 50 infants (13.3%) had extremely low birth weight (ELBW), 171 (45.6%) had very low birth weight (VLBW), and 154 (41.1%) had low birth weight (LBW). Regarding gestational age (GA), 43 (11.5%) were extremely preterm, 156 (41.6%) were very preterm, and 176 (46.9%) were late preterm. A total of 12 (3.2%) had immature retinal vascularization in Zone I, 154 (41.1%) in Zone II, and 182 (48.5%) in Zone III, while 27 (7.2%) had a mature retina.

ROP was present in 19 infants (5.1%): Stage I in 11 (2.9%), Stage II in 8 (2.1%); plus disease was seen in one infant (0.3%). Retinal immaturity was significantly associated with lower BW (χ² = 104.387, df = 6, p = 0.0005) and earlier GA (χ² = 132.535, df = 6, p = 0.0005).

Conclusion

Prevalence of ROP in this tertiary hospital was 5.1%, with lower BW and earlier GA strongly associated with immature retinal vascularization. These findings underscore the importance of targeted screening and meticulous neonatal care to prevent sight-threatening ROP.