Abstract
Background: Retinopathy of prematurity (ROP) is one of the primary causes of infant blindness worldwide. This study aimed to estimate the incidence of ROP among neonates admitted to a neonatal intensive care unit (NICU) and analyze the clinical characteristics, therapeutic outcomes, and associated factors.
Methods: This single-center retrospective cohort study included 1,551 premature babies admitted to the NICU and screened for ROP at a tertiary hospital in Central Saudi Arabia from January to August 2021. Clinical charts were reviewed to collect data on gestational age (GA) at birth, birth weight, GA at diagnosis, age at diagnosis, sex, ROP laterality, severity assessment (stage, zone, and plus), treatment procedures and number of sessions, and outcomes (regression or stationary).
Results: The ROP incidence was 8.7% (male ratio, 0.85). The monthly incidence showed a small peak in spring and a higher peak in summer. Among all patients with ROP, 10.8% required treatment. Anti-vascular endothelial growth factor injection was administered in 85% of the pooled treatment and retreatment sessions, yielding a 66.7% success rate, while laser therapy, which was administered in the remaining 15% of the sessions, resulted in a 100% success rate. The treatment efficacy was relatively lower in more severe cases, although this trend showed no statistical significance.
Conclusion: Nationwide studies should be conducted to understand the incidence and risk factors of ROP which are essential to design evidence-based screening criteria specific to the local population and to implement evidence-based guidelines for the management of ROP, notably for the selection of the best therapeutic approach.

Key words: Retinopathy of prematurity, incidence, clinical presentation, management, outcome, Saudi Arabia