Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan

Abstract Background The principal objective of our study is to evaluate the characteristics of babies with type 1 ROP, screening practices and treatment trends in a tertiary care centre in Pakistan. Methods This prospective study at Mayo Hospital, Lahore (July 2022–July 2024), included 89 preterm in...

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Main Authors: Muhammad Moin, Aisha Azam, Lubna Siddiq Mian, Ashal Pal, Rutaab Kareem, Noor Us Sehar
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03865-8
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author Muhammad Moin
Aisha Azam
Lubna Siddiq Mian
Ashal Pal
Rutaab Kareem
Noor Us Sehar
author_facet Muhammad Moin
Aisha Azam
Lubna Siddiq Mian
Ashal Pal
Rutaab Kareem
Noor Us Sehar
author_sort Muhammad Moin
collection DOAJ
description Abstract Background The principal objective of our study is to evaluate the characteristics of babies with type 1 ROP, screening practices and treatment trends in a tertiary care centre in Pakistan. Methods This prospective study at Mayo Hospital, Lahore (July 2022–July 2024), included 89 preterm infants with type 1 ROP, selected using non-probability sampling. Infants were categorized based on international (GA < 32weeks or BW < 1500 g) and local screening criteria (GA < 35 weeks or BW < 2000 g), and treatment outcomes were evaluated across three groups: Anti-VEGF, combination therapy (Anti-VEGF followed by laser), and laser therapy. Statistical analysis was performed using SPSS version 27.0, significance was set at p < 0.05. Results Out of 355 infants screened, 89 (25.1%) met the inclusion criteria for type 1 ROP. The cohort included 55 males (61.8%) and 34 females (38.2%), with a mean gestational age of 31.31 weeks and a mean birth weight of 1602.25 g. Zone 1 ROP was found in 36% of cases, associated with lower birth weight (P = 0.029) and earlier gestational age (P = 0.037), while Zone 2 ROP, found in 64%, was linked to higher birth weight and later gestational age. Zone 1 infants were more likely to receive anti-VEGF or combination therapy, whereas Zone 2 infants predominantly received laser therapy (p < 0.000). Preterm infants (born before 32 weeks) mostly received Anti-VEGF or combination therapy, while those with higher birth weights primarily received laser therapy (p < 0.010). Among the treated babies, 63 (70.8%) met international screening criteria and were more likely to have Zone 1 ROP and receive Anti-VEGF or combination therapy. Conversely, 26 (29.2%) did not meet these criteria, had predominantly Zone 2 ROP and were more likely to receive laser therapy (p = 0.007). Conclusion International screening criteria effectively identify severe type 1 ROP cases, particularly Zone 1, which often require Anti-VEGF therapy. Local criteria capture additional cases, predominantly Zone 2, which are more likely to need laser treatment. These findings highlight the need for tailored screening and treatment approaches to improve ROP management and outcomes for preterm infants.
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spelling doaj-art-95c090cb2fe4447e81e2476844fc287d2025-01-26T12:21:00ZengBMCBMC Ophthalmology1471-24152025-01-012511710.1186/s12886-025-03865-8Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, PakistanMuhammad Moin0Aisha Azam1Lubna Siddiq Mian2Ashal Pal3Rutaab Kareem4Noor Us Sehar5 Institute of Ophthalmolohy, King Edward Medical University Institute of Ophthalmolohy, King Edward Medical University Institute of Ophthalmolohy, King Edward Medical University Institute of Ophthalmolohy, King Edward Medical University Institute of Ophthalmolohy, King Edward Medical University Institute of Ophthalmolohy, King Edward Medical UniversityAbstract Background The principal objective of our study is to evaluate the characteristics of babies with type 1 ROP, screening practices and treatment trends in a tertiary care centre in Pakistan. Methods This prospective study at Mayo Hospital, Lahore (July 2022–July 2024), included 89 preterm infants with type 1 ROP, selected using non-probability sampling. Infants were categorized based on international (GA < 32weeks or BW < 1500 g) and local screening criteria (GA < 35 weeks or BW < 2000 g), and treatment outcomes were evaluated across three groups: Anti-VEGF, combination therapy (Anti-VEGF followed by laser), and laser therapy. Statistical analysis was performed using SPSS version 27.0, significance was set at p < 0.05. Results Out of 355 infants screened, 89 (25.1%) met the inclusion criteria for type 1 ROP. The cohort included 55 males (61.8%) and 34 females (38.2%), with a mean gestational age of 31.31 weeks and a mean birth weight of 1602.25 g. Zone 1 ROP was found in 36% of cases, associated with lower birth weight (P = 0.029) and earlier gestational age (P = 0.037), while Zone 2 ROP, found in 64%, was linked to higher birth weight and later gestational age. Zone 1 infants were more likely to receive anti-VEGF or combination therapy, whereas Zone 2 infants predominantly received laser therapy (p < 0.000). Preterm infants (born before 32 weeks) mostly received Anti-VEGF or combination therapy, while those with higher birth weights primarily received laser therapy (p < 0.010). Among the treated babies, 63 (70.8%) met international screening criteria and were more likely to have Zone 1 ROP and receive Anti-VEGF or combination therapy. Conversely, 26 (29.2%) did not meet these criteria, had predominantly Zone 2 ROP and were more likely to receive laser therapy (p = 0.007). Conclusion International screening criteria effectively identify severe type 1 ROP cases, particularly Zone 1, which often require Anti-VEGF therapy. Local criteria capture additional cases, predominantly Zone 2, which are more likely to need laser treatment. These findings highlight the need for tailored screening and treatment approaches to improve ROP management and outcomes for preterm infants.https://doi.org/10.1186/s12886-025-03865-8ROPType 1 ROPAnti-VEGF therapyLaser therapy
spellingShingle Muhammad Moin
Aisha Azam
Lubna Siddiq Mian
Ashal Pal
Rutaab Kareem
Noor Us Sehar
Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan
BMC Ophthalmology
ROP
Type 1 ROP
Anti-VEGF therapy
Laser therapy
title Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan
title_full Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan
title_fullStr Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan
title_full_unstemmed Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan
title_short Improving ROP management: insights from a comparative analysis of screening and treatment modalities in a tertiary hospital, Pakistan
title_sort improving rop management insights from a comparative analysis of screening and treatment modalities in a tertiary hospital pakistan
topic ROP
Type 1 ROP
Anti-VEGF therapy
Laser therapy
url https://doi.org/10.1186/s12886-025-03865-8
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