A Prospective Study on the Incidence, Risk Factors, and Clinical Outcomes of Retinopathy of Prematurity in Preterm Neonates Admitted to A Tertiary Care Centre Neonatal Intensive Care Unit at Esic Medical College, Kalaburagi

Background: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disorder affecting the immature retina of preterm infants. With improved neonatal survival rates, ROP has emerged as a significant cause of preventable childhood blindness, particularly in developing countries. Early identification of risk factors and timely intervention are essential for reducing visual morbidity associated with the disease.

Objectives: To determine the incidence of Retinopathy of Prematurity among preterm infants admitted to the Neonatal Intensive Care Unit (NICU) of ESIC Medical College and Hospital, Kalaburagi, to identify associated risk factors, and to evaluate clinical outcomes of affected infants.

Materials and Methods: This prospective observational study was conducted in the NICU of ESIC Medical College and Hospital, Kalaburagi, over a period of 12 months from May 2025 to May 2026. A total of 120 preterm infants fulfilling the inclusion criteria were enrolled. Retinal screening was performed by indirect ophthalmoscopy according to the National Neonatology Forum (NNF) India and All India Ophthalmological Society (AIOS) 2022 guidelines. ROP was classified based on ICROP3. Treatment decisions were based on ETROP (Early Treatment for Retinopathy of Prematurity) criteria. Statistical analysis was performed using IBM SPSS Statistics version 26.0, and confidence intervals (95% CI) were calculated. A p-value <0.05 was considered statistically significant.

Results: Among the 120 preterm infants studied, 32 developed Retinopathy of Prematurity, yielding an incidence of 26.7% (95% CI: 18.9%–35.4%). The majority of affected infants belonged to the gestational age group below 32 weeks and had birth weights below 1500 g. Significant associations were observed between ROP and lower gestational age (p<0.001), lower birth weight (p=0.002), prolonged oxygen therapy with fluctuating SpO₂ (p=0.003), and neonatal sepsis (p=0.002). Stage 1 ROP was the most common presentation (37.5%), followed by Stage 2 (31.3%) and Stage 3 disease (25.0%). Two cases of Aggressive Posterior ROP (APROP) were identified. Spontaneous regression occurred in 62.5% of affected infants, while 25.0% required laser photocoagulation and 6.3% required intravitreal anti-VEGF treatment (bevacizumab/ranibizumab) for Zone I or APROP.

Conclusion: The incidence of ROP in the present study was 26.7%. Lower gestational age, lower birth weight, uncontrolled oxygen therapy, and neonatal sepsis were significant risk factors. Adherence to NNF–AIOS 2022 screening guidelines, oxygen saturation targeting (SpO₂ 90–95%), and timely ETROP-based intervention are essential to prevent disease progression and reduce the burden of childhood blindness