Follow-Up Compliance in Retinopathy of Prematurity Care: A Bangladeshi Perspective

Authors

  • Tariq Reza Ali
  • Nuzhat Choudhury
  • Ferdous Akhter Jolly
  • Nadia Sultana
  • Tanjela Bushra

Keywords:

Retinopathy of prematurity, Treatment, Post-treatment follow-up, Compliance

Abstract

Background: Retinopathy of Prematurity (ROP) is a vaso-proliferative disorder that can lead to irreversible vision loss without timely treatment. Moreover, regular follow-up after treatment is crucial for successful outcomes. However, follow-up compliance in Bangladesh remains suboptimal. This study aimed to assess adherence to treatment and follow-up in ROP care. Methods: A retrospective study was conducted at Bangabandhu Sheikh Mujib Medical University to assess compliance with treatment and follow-up among infants with Retinopathy of Prematurity (ROP) who received intravitreal anti-VEGF injection (Avastin), laser photocoagulation, or a combination of both between January 2021 and December 2023. Result: A total of 950 preterm babies were screened. Intravitreal Avastin was required in 127 (13.4%), laser therapy in 118 (12.4%), and both treatments in 43 (4.5%). Surgical intervention was needed in 27 (2.8%) babies. Type 1 ROP occurred in 295 (31.1%), aggressive ROP in 130, stage 3 (zone II/III) in 50, stage 4 (A+B) in 19, and stage 5 in 14 babies. Mean gestational age was 33.4 ± 2.8 weeks and mean birth weight 1795 ± 300 g. Compliance with intravitreal injection was 100% initially, declining to 31.4% by 16 weeks, while laser follow-up ranged from 97.6% at week 1 to 61.6% at week 12. Rescue laser was required in 43 babies initially treated with intravitreal injection. Conclusion: Compliance with ROP treatment follow-up was satisfactory in both groups during the first month but declined thereafter. Follow-up was not maintained for all infants up to six months of age, which is the protocol recommended by most ROP specialists

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References

Gilbert C, Fielder A, Gordillo L, Quinn G, Semiglia R, Visintin P, et al. Characteristics of Infants With Severe Retinopathy of Prematurity in Countries With Low, Moderate, and High Levels of Development: Implications for Screening Programs. Pediatrics 2005;115(5):e518–25.

Czeszyk A, Hautz W, Bulsiewicz D, Jaworski M, Czech-Kowalska J. The long-term influence of perinatal factors on macular morphology and vessel density in preterm children. Early Human Development 2024;192:105993.

Dai Y, Zhu L, Zhou Y, Chen C, Zhang S. Ten-Year Trend of Retinopathy of Prematurity Among Extremely Preterm Infants in One Neonatal Intensive Care Unit in China. Front Pediatr 2021;9:717090.

Sapieha P, Joyal JS, Rivera JC, Kermorvant-Duchemin E, Sennlaub F, Hardy P, et al. Retinopathy of prematurity: understanding ischemic retinal vasculopathies at an extreme of life. J Clin Invest 2010;120(9):3022–32.

Sen P, Wu WC, Chandra P, Vinekar A, Manchegowda PT, Bhende P. Retinopathy of prematurity treatment: Asian perspectives. Eye (Lond) 2020;34(4):632–42.

Akter S, Hossain M, Shirin M, Khalil I, Anwar K. Blood Transfusion: A Risk Factor in Retinopathy of Prematurity. Bangladesh Journal of Child Health 2012;34.

Ahmed ASMNU, Muslima H, Anwar KS, Khan NZ, Chowdhury MAKA, Saha SK, et al. Retinopathy of Prematurity in Bangladeshi Neonates. J Trop Pediatr 2008;54(5):333–9.

Shahidullah M, Dey AC, Ahmed F, Jahan I, Dey SK, Choudhury N, et al. Retinopathy of prematurity and its association with neonatal factors. Bangabandhu Sheikh Mujib Medical University Journal 2017;10(1):1–4.

Hong EH, Shin YU, Cho H. Retinopathy of prematurity: a review of epidemiology and current treatment strategies. Clin Exp Pediatr 2022;65(3):115–26.

Jang JH. Characteristics of retinal vascularization in reactivated retinopathy of prematurity requiring treatment and clinical outcome after reinjection of ranibizumab. Sci Rep 2024;14(1):15647.

Strawbridge J, Cheng JY, Gundlach BS, Gillespie T, Karmouta R, Khitri M, et al. Short-term reactivation of retinopathy of prematurity following primary ranibizumab treatment. Retina [Internet] 2024 [cited 2024 Sep 14];Available from: https://journals.lww.com/10.1097/IAE.0000000000004206

Yildirim M. Clinical Approach and Anatomical Results in the Treatment of Retinopathy of Prematurity. The Eurasian Journal of Medicine 2024;56(1):52–5.

Thang LH, Evgenievich SE, Ivanovich SE, Igorevich KA, Andreevna KO, Vladimirovich MD, et al. Special features of postoperative long-term follow-up patients with retinopathy of prematurity. Tradit Med Mod Med 2024;1–10.

Berrocal AM, Fan KC, Al-Khersan H, Negron CI, Murray T. Retinopathy of Prematurity: Advances in the Screening and Treatment of Retinopathy of Prematurity Using a Single Center Approach. Am J Ophthalmol 2022;233:189–215.

Akter S, Hossain MM, Shirin M, Anwar KS. Retinopathy of Prematurity - Neonatologists’ Experience. Journal of Bangladesh College of Physicians and Surgeons 2013;31(4):181–8.

Ahmed ASMNU, Muslima H, Anwar KS, Khan NZ, Chowdhury MAKA, Saha SK, et al. Retinopathy of Prematurity in Bangladeshi Neonates. Journal of Tropical Pediatrics 2008;54(5):333–9.

García H, Villasis-Keever MA, Zavala-Vargas G, Bravo-Ortiz JC, Pérez-Méndez A, Escamilla-Núñez A. Global Prevalence and Severity of Retinopathy of Prematurity over the Last Four Decades (1985–2021): A Systematic Review and Meta-Analysis. Archives of Medical Research 2024;55(2):102967.

Dalai R, Das K, Nayak D, Murmu M, Nanda P. A clinical study on retinopathy of prematurity in a tertiary care centre. International Journal of Research in Medical Sciences 2019;7:4181.

Rahman S, Shanta NF, Morshed M, Mili SL, Khan M, Sarkar A. Frequency and Problems Associated With Retinopathy of Prematurity (ROP) in A Tertiary Care Hospital. Journal of Dhaka Medical College 2022;31(2):237–42.

Sanghi G, Dogra MR, Das P, Vinekar A, Gupta A, Dutta S. Aggressive posterior retinopathy of prematurity in Asian Indian babies: spectrum of disease and outcome after laser treatment. Retina 2009;29(9):1335–9.

Sanghi G, Dogra MR, Katoch D, Gupta A. Aggressive posterior retinopathy of prematurity in infants ≥ 1500 g birth weight. Indian J Ophthalmol 2014;62(2):254–7.

Shah PK, Subramanian P, Venkatapathy N, Chan RVP, Chiang MF, Campbell JP. Aggressive posterior retinopathy of prematurity in two cohorts of patients in South India: implications for primary, secondary, and tertiary prevention. J AAPOS 2019;23(5):264.e1-264.e4.

Nahar N, Badmus SA, Das SK, Malek MIA, Rahman M, Khan MAM. Retinopathy of prematurity in Bangladesh: an overview. Community Eye Health 2018;31(101):S25–6.

Šarenac-Vulović T, Srećković S, Petrović N, Janićijević-Petrović M, Jovanović S, Todorović D. Modern approach to the retinopathy of prematurity treatment. Medicinski časopis 2017;51(4):131–5.

Kim J, Kim SJ, Chang YS, Park WS. Combined intravitreal bevacizumab injection and zone I sparing laser photocoagulation in patients with zone I retinopathy of prematurity. Retina 2014;34(1):77–82.

Lee JY, Chae JB, Yang SJ, Yoon YH, Kim JG. Effects of intravitreal bevacizumab and laser in retinopathy of prematurity therapy on the development of peripheral retinal vessels. Graefes Arch Clin Exp Ophthalmol 2010;248(9):1257–62.

Mintz-Hittner HA, Kennedy KA, Chuang AZ, BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med 2011;364(7):603–15.

Stahl A, Lepore D, Fielder A, Fleck B, Reynolds JD, Chiang MF, et al. Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomised controlled trial. Lancet 2019;394(10208):1551–9.

McCahon H, Chen V, Paz EF, Steger R, Alexander J, Williams K, et al. Improving follow-up rates by optimizing patient educational materials in retinopathy of prematurity. Journal of American Association for Pediatric Ophthalmology and Strabismus 2023;27(3):134.e1-134.e5.

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.

Vinekar A. Timing of laser following intravitreal anti-vascular endothelial growth factor injections for aggressive posterior zone 1 retinopathy of prematurity. Indian J Ophthalmol 2021;69(8):1988–9.

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Published

2025-09-17

How to Cite

1.
Reza Ali T, Choudhury N, Akhter Jolly F, Sultana N, Bushra T. Follow-Up Compliance in Retinopathy of Prematurity Care: A Bangladeshi Perspective. J Neonatal Surg [Internet]. 2025Sep.17 [cited 2025Sep.21];13(1):1205-11. Available from: https://jneonatalsurg.com/index.php/jns/article/view/8974

Issue

Vol. 13 (2024): Journal of Neonatal Surgery

Section

Original Article

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