Refractive Status of Stage III and IV Retinopathy of Prematurity in Bangladesh: A Cross-Sectional Study

Open Access

Abstract

Background: Retinopathy of prematurity (ROP) is a significant cause of childhood visual impairment among premature infants. Advanced stages of the disease are often associated with long-term ocular complications, including refractive errors that may affect visual development. Understanding the pattern of refractive status in children with severe ROP is important for early detection and appropriate visual rehabilitation. This study aimed to evaluate the refractive status among children with Stage III and Stage IV ROP. Methods & Materials: This cross-sectional study was conducted in the Department of Ophthalmology and Community Ophthalmology at Bangladesh Medical University and Bangladesh Eye Hospital, Malibagh from January 2025 to December 2025. A total of 50 children previously diagnosed with Stage III and Stage IV ROP were included using purposive sampling. Results: Among the 50 participants, 31 (62.0%) had Stage III ROP and 19 (38.0%) had Stage IV ROP. Myopia was the most common refractive error, observed in 23 (46.0%) cases, followed by hyperopia in 11 (22.0%), astigmatism in 9 (18.0%) and emmetropia in 7 (14.0%). In Stage III patients, myopia was present in 13 (41.9%) cases, while in Stage IV it was seen in 10 (52.6%) cases. The association between stage of ROP and type of refractive error was not statistically significant (p = 0.81). Among the myopic children, mild myopia was most common (39.1%). Conclusion: Refractive errors, particularly myopia, are common among children with advanced ROP. Regular ophthalmic follow-up and early refractive correction are essential to ensure optimal visual development in these high-risk children.