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Screening for retinopathy of prematurity
L Andruscavage1, D J Weissgold
1Department of Pediatrics, College of Medicine, University of Vermont, Burlington, VT, USA.
Insights
Restrictive screening criteria for retinopathy of prematurity (ROP) may lead to missed diagnoses in premature infants. Current methods might not identify all infants needing ophthalmoscopic examination for ROP.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early detection through ophthalmoscopic screening is crucial for timely intervention and prevention of vision loss.
Observation:
- A cross-sectional study evaluated screening criteria for ROP in 438 premature infants over six years.
- Infants with birth weights <=1500g had a 91.7% screening rate, while those between 1501-2500g had a 52.3% rate.
- ROP, including sight-threatening stage 3, was detected in infants with larger birth weights, indicating potential under-screening.
Findings:
- Commonly used criteria for ROP screening may be too restrictive.
- A notable percentage of infants, particularly those with birth weights between 1501-2500g, were not screened despite developing ROP.
- Two infants with larger birth weights progressed to threshold ROP requiring treatment, highlighting the risk of missed diagnoses.
Implications:
- Current ROP screening guidelines may need revision to include a broader range of premature infants.
- Optimizing screening criteria can improve early detection rates and reduce the incidence of severe visual impairment due to ROP.
- Further research is warranted to refine eligibility criteria for ROP screening to ensure comprehensive care for all at-risk premature infants.
Aim:
A cross sectional (prevalence) study was performed to assess the usefulness and sensitivity of commonly employed criteria to identify infants for routine ophthalmoscopic screening for retinopathy of prematurity (ROP).
Methods:
At a tertiary care centre between 1 January 1992 and 30 June 1998, experienced vitreoretinal specialists screened 438 premature infants for ROP. Retinal maturity and the presence of ROP were determined by indirect ophthalmoscopic examinations.
Results:
Of the eligible infants surviving 28 days, 276 (91.7%) of 301 infants with birth weights
Conclusions:
Relatively restrictive criteria to identify premature infants eligible for routine ophthalmoscopic screening for ROP may be the cause for some infants going unexamined and their ROP undetected.
