Profile of asymmetrical retinopathy of prematurity in twins

BACKGROUND: In twin births, both babies have the same gestational age and pre-natal conditions. However, twins may develop a varied retinopathy of prematurity (ROP) course depending on birth weight and other systemic factors. OBJECTIVE: To study the profile of asymmetric ROP in twins DESIGN: Retrospective study SETTING: Tertiary ROP referral eye hospital. MATERIALS AND METHODS: The profile of 56 pairs of twins with ROP were studied and analyzed for differences in zone or need for treatment, while studying possible causes for the varied outcome. RESULTS: In 45 pairs of twins (80%) the disease progressed identically in both eyes, while in 11 pairs (20%) the ROP showed differences in zone or need for treatment. Four of these pairs were discordant. In 3 of these 4 pairs, the heavier birth weight twin had a more severe ROP course. CONCLUSIONS: Twins can present with asymmetric ROP course, and it is therefore essential to examine both twins as per screening protocols.