Outcomes and associated factors of retinopathy of prematurity treatment at Muhimbili national hospital Dar es salaam, Tanzania.

Abstract

ABSTRACT Background: Retinopathy of prematurity (ROP) is a potentially blinding disease caused by abnormal growth of retinal blood vessels in premature infants, leading to scarring, retinal detachment, and vision loss . It accounts for about 10% of childhood blindness worldwide. Despite the advancements in medical interventions, treatment outcomes for ROP remain highly variable with some infants responding well to treatment while others continue to experience disease progression, complications such as vitreous hemorrhage, or tractional retinal detachment, ultimately leading to blindness. Additionally, visual development may still be impaired despite treatment. The inconsistency in the treatment results and the lack of conclusive data on contributing factors underscore the need for this investigation, which seeks to provide evidence that may guide clinical decision-making and enhance care for premature infants at risk of blindness. Aim: To assess outcomes and associated factors of ROP treatment at Muhimbili National Hospital. Methodology: A hospital-based analytical cross-sectional study that consecutively recruited 40 children who had ROP and had received treatment from 2019 to 2022 was conducted. The study was conducted for a period of six months, from August 2022 to January 2023. Participants were assessed for structural findings, visual status, and refractive errors. Data were analyzed using SPSS version 24. Frequencies and percentages were used to show the structural, visual status and refraction status. while Fisher’s Exact Test was used to show relationship between type of treatment with presenting visual acuity and refraction status. Multiple linear regression analysis was used to show association between factors and presenting visual acuity. Univariate and multivariate logistic regression was used to show association between factors and refractive error. A p-value less than 0.05 considered to be statistically significant. Results: Seventy-nine eyes of 40 patients were analyzed. Majority of the study participants were females (65.0%), and the mean age was 11.50 (±5.60SD) months. The majority of eyes (71.3%) had stage 3 ROP. ROP regression was seen in all eyes. Normal vision was observed in 79.7% of eyes. Most (65.3%) of eyes had refractive error and of them, majority had myopia. Birth vi weight, gestational age (GA), PMA at treatment, and disease severity showed no association with structural outcome, visual and refractive status. Conclusion: All eyes showed ROP regression. Normal vision was observed in majority of eyes. Majority of eyes had refractive error and myopia was the common. PMA at treatment, birth weight, and disease stage showed no association with treatment outcomes. Recommendations: Efforts to screen, detect and treat children with ROP at MNH must continue in order to maintain a good outcome. Children who had undergone ROP treatment should be closely followed up to early identify, correct refractive error on time, and improve their quality of life. To encourage scaling up of ROP screening and treatment throughout the country.