Dear Sir,
The article titled “Analysis of prenatal and postnatal risk factors of retinopathy of prematurity. In a tertiary care hospital in South India”, made an interesting read.[1]
The criteria for selecting pre term infants with birth weight between 1500-2000g and gestational age >32 weeks have not been clearly delineated and needs more clarification. This is pertinent because different inclusion criteria can have different sensitivities in identifying cases of Retinopathy of prematurity (ROP) as demonstrated by Dogra et al.[2] Therefore, any inference regarding the incidence of ROP and by extension the risk factors would be deemed incomplete unless qualified by clear inclusion criteria. The current criteria for screening pre term/low birth weight infants for ROP have been well defined by Jalali et al.[3]
The authors have also reported that their criteria for LASER therapy comprised of Threshold ROP, Stage 4 ROP and Stage 5 ROP. The Early Treatment for Retinopathy of Prematurity cooperative group has recommended treatment for Pre threshold type 1 ROP.[4] The findings of that study had found reduction in both unfavorable visual outcomes from 19.5 to 14.5% (P 0.01) and unfavorable structural outcomes from 15.6% to 9.1% (P < 0.001) by resorting to early treatment as opposed to observation till the onset of Threshold ROP.
References
- 1.Rao KA, Purkayastha J, Hazarika M, Chaitra R, Adith KM. Analysis of prenatal and postnatal risk factors of retinopathy of prematurity in a tertiary care hospital in South India. Indian J Ophthalmol. 2013;61:640–4. doi: 10.4103/0301-4738.119347. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Vinekar A, Dogra MR, Sangtam T, Narang A, Gupta A. Retinopathy of prematurity in Asian Indian babies weighing greater than 1250 grams at birth: Ten year data from a tertiary care center in a developing country. Indian J Ophthalmol. 2007;55:331–6. doi: 10.4103/0301-4738.33817. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Jalali S, Anand R, Kumar H, Dogra MR, Azad R, Gopal L. Programme planning and screening strategy in retinopathy of prematurity. Indian J Ophthalmol. 2003;51:89–99. [PubMed] [Google Scholar]
- 4.Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: Results of the early treatment for retinopathy of prematurity randomized trial. Arc Ophthalmol. 2003;121:1684–94. doi: 10.1001/archopht.121.12.1684. [DOI] [PubMed] [Google Scholar]