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Screening for retinopathy of prematurity: evaluation and modification of guidelines
1Department of Ophthalmology, University Hospital, Uppsala, Sweden.
Insights
Current retinopathy of prematurity (ROP) screening guidelines for premature infants may be too broad. Lowering the gestational age threshold to 31 weeks could maintain screening effectiveness while improving efficiency.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
- Public Health Screening
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current screening guidelines aim to detect ROP early, but their optimal gestational age threshold is debated.
Purpose of the Study:
- To evaluate the effectiveness of existing ROP screening guidelines.
- To determine if current screening criteria for ROP can be modified to improve outcomes and resource allocation.
Main Methods:
- Retrospective analysis of ROP screening in infants born with a gestational age of ≤32 weeks in Stockholm County.
- Study period: August 1998 to July 2000.
- Effectiveness assessed by ROP incidence and severity in relation to gestational age.
Main Results:
- ROP incidence was 25.5% among infants born at ≤32 weeks gestational age.
- No infants born after 31 weeks gestational age developed severe ROP (stages 3-5).
- No infants born after 29 weeks gestational age required ROP treatment.
Conclusions:
- Current ROP screening criteria (≤32 weeks gestational age) effectively screened 80% of the studied population.
- Lowering the screening gestational age threshold to ≤31 weeks is recommended.
- This modification would ensure no severe ROP cases are missed while potentially optimizing screening resources.
Aims:
To evaluate current screening guidelines for ROP (retinopathy of prematurity) and to determine whether they can be modified.
Methods:
In accordance with the authors' present criterion, infants born in Stockholm County, Sweden, from 1 August 1998 to 31 July 2000, with a gestational age of < or =32 weeks, were screened for ROP. The effectiveness of screening was studied.
Results:
The incidence of ROP was 25.5% in this study. A dropout group comprising almost 20% of the population studied (< or =32 weeks), was never referred, were lost to follow up, or died before screening was completed. No infant with a gestational age of >31 weeks at birth developed severe ROP (stages 3-5) and no infant with a gestational age of >29 weeks was treated for ROP.
Conclusion:
80% of infants in this population with a gestational age at birth of < or =32 weeks, the current screening criterion, were effectively screened for ROP. The authors recommend that the screening criterion be lowered to