An Observational Study to Assess the Relationship between Retinopathy of Prematurity and Thrombocytopenia

Abstract

Objective: This study aimed to evaluate the relationship between thrombocytopenia (platelet count <150,000/μL) and the severity of Retinopathy of Prematurity (ROP) in preterm infants, focusing on disease progression and clinical outcomes.

Methods: A prospective observational study was conducted at SMS Medical College, Jaipur, involving 70 preterm infants (≤30 weeks gestation, birth weight ≤1500 g) stratified into thrombocytopenic (n=35) and non-thrombocytopenic (n=35) groups. ROP screening was performed using indirect ophthalmoscopy at baseline and follow-up visits (weeks 3, 6, 9, 12). ROP was classified per ET-ROP criteria (Type 1: treatment-required; Type 2: observation). Data on gestational age, birth weight, oxygen therapy, platelet counts, ROP stage/zone and plus disease were collected and analyzed statistically.

Results: Thrombocytopenic infants had significantly lower mean platelet counts (0.93 ± 0.35 vs. 2.34 ± 0.65 lakh/mm³, p<0.001). Type 1 ROP was more prevalent in thrombocytopenic infants (14.29% vs. 0% at week 3, p=0.01), with earlier treatment requirements (14.29% vs. 0% by week 3, p=0.08). Thrombocytopenic infants exhibited rapid ROP progression, with Stage 1 peaking at week 6 (40%) and resolving by week 12 (p<0.0001). Zone 3 involvement increased significantly in thrombocytopenic infants by week 12 (85.71% vs. 34.29% at baseline, p<0.0001). Plus disease was transient and more frequent in thrombocytopenic infants (5.71% vs. 0% at week 3, p=0.53).

Conclusion: Thrombocytopenia is associated with more severe and rapidly progressive ROP, necessitating earlier interventions. These findings highlight the potential role of platelet counts in risk stratification and optimizing screening protocols for preterm infants. Further research is needed to elucidate the underlying mechanisms and refine clinical management strategies.