Exploring Retinopathy of Prematurity: Insights from the First USAID-Funded Screening Program in KPK, Pakistan.

Objective: To investigate incidence, demographics and risk factor associated with Retinopathy of prematurity.

Methods: It was multi-centered prospective cross sectional study. Department of Ophthalmology at Khyber Teaching Hospital conducted this study, from February 2022 to September 2023 in collaboration with three teaching hospitals based in Peshawar. It was funded by United States Agency for International Development (USAID) with Grant No. CBP051. Infants born at ≤ 35 weeks, or birth weight ≤ 2kg, or admitted to Neonatal Intensive Care Unit (NICU) for ≥ three days were included. Screening was conducted at ≥3-4 weeks after birth or 31 completed weeks post-conception, whichever came first. Endpoint for follow-up was complete vascularization of temporal retina.

Results: It included 622 of 840 screened infants, with 98(15.8%) ROP cases. Among diagnosed, 56.1% were males, 66.3% born between 26-30 weeks, and 63.3% with birth weight between 0.6-1.5 kg. 62.2% were at 1-4 months of age, 98.9% had screening weight range 1-3 kg, 99% received postnatal oxygen therapy, and 24.5% had neonatal diseases. In multivariate analysis, risk factors including gestational age (AOR 0.793, 95% CI 0.69-0.90), postnatal oxygen therapy (AOR 40, 95% CI 1.9-817), duration of postnatal oxygen therapy (AOR 1.05, 95% CI 1.02-1.07), birth weight (AOR 0.3, 95% CI 0.125-0.725), blood transfusion (AOR 349, 95% CI 17.7-9601), and neonatal diseases (AOR 2.4, 95% CI 1.2-4.8) were found significant.

Conclusions: Gestational age, postnatal oxygen therapy and neonatal disease are significant factors associated with ROP.