The Relationship of Common Biomarkers with the Risk of Development and Progression of Retinopathy of Prematurity

Background: Retinopathy of prematurity (ROP) is a potentially blinding vasoproliferative retinal disorder affecting preterm infants. Although prematurity and low birth weight are established risk factors, increasing evidence suggests that hematological biomarkers may influence the development and progression of ROP. Data from Bangladesh regarding this association are scarce. Objective: To evaluate the relationship of common blood biomarkers—hemoglobin (Hb), platelet count, lymphocyte count, neutrophil count, and HbA1c—with the risk of development and progression of ROP. Methods: This prospective observational study was conducted at the National Institute of Ophthalmology & Hospital, Dhaka, from July 2022 to June 2023. Preterm infants meeting ROP screening criteria were enrolled. Ophthalmoscopic examinations were performed at the first visit (4th postnatal week) and during follow-up until 42 weeks postmenstrual age. Blood biomarkers were measured at the 4th week of life. Associations between biomarkers and ROP development and progression were analyzed using independent sample t-tests. Results: Of the 59 infants analyzed, 22 (37.3%) developed ROP. Infants with ROP had significantly lower hemoglobin levels (10.7 ± 2.3 vs 12.1 ± 1.9 g/dL; p = 0.016) and higher lymphocyte counts (4260.6 ± 1789.9 vs 3388.2 ± 1161.7 cells/cmm; p = 0.027) compared to non-ROP infants. No significant association was found between ROP development and platelet count, neutrophil count, or HbA1c. Among infants with ROP, disease progression occurred in 50%, but none of the biomarkers showed a significant association with progression (p > 0.05). Conclusion: Low hemoglobin levels and elevated lymphocyte counts are significantly associated with the development of ROP. These readily available biomarkers may help identify preterm infants at higher risk of ROP in resource-limited settings. J.Natl.Inst.Ophthalmol.2025;8(1): 32-35