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Retinopathy of prematurity: an optimum screening strategy
Shu Fen Ho1, M R K Mathew, W Wykes
1Department of Ophthalmology, Southern General Hospital, Glasgow, United Kingdom. sho2@yahoo.com
Insights
A birth weight under 1251 g and gestational age under 30 weeks effectively screen for sight-threatening retinopathy of prematurity (ROP). This approach safely identifies infants needing treatment while reducing unnecessary screenings.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature infants.
- Effective screening protocols are crucial for timely intervention and prevention of vision loss.
Purpose of the Study:
- To evaluate the efficacy and safety of using a birth weight threshold of less than 1251 g and gestational age of less than 30 weeks for screening treatable retinopathy of prematurity (ROP).
Main Methods:
- A retrospective analysis of infants screened for ROP over an 8-year period.
- Inclusion criteria for screening were birth weight <1500 g or gestational age <32 weeks.
- Data on ROP incidence, stage, and severity were collected.
Main Results:
- ROP incidence was 19.3% (36/187) with stable rates over time.
- All infants with threshold ROP had a birth weight <1100 g and gestational age ≤28 weeks.
- Applying the proposed criteria (BW <1251 g, GA <30 weeks) would have reduced screened infants by 56% and avoided 31% of examinations.
Conclusions:
- A birth weight of less than 1251 g and gestational age of less than 30 weeks serve as safe and efficient screening criteria for sight-threatening ROP.
- These criteria can help optimize resource allocation in ROP screening programs.
- No cases of sight-threatening ROP were missed with these stricter screening parameters.
Objective:
We sought to find out whether birth weight of less than 1251 g or gestational age less than 30 weeks could provide a safe and efficient screening criteria of detecting treatable retinopathy of prematurity (ROP).
Methods:
Infants either with a birth weight less than 1500 g or gestational age less than 32 weeks were screened for ROP during an 8-year period.
Results:
In our study, the incidence of ROP was 36 of 187 (19.3%) infants. Although there was a slight increase in the number of infants screened over the years, the incidence of ROP of any stage remained stable. The maximum stage of ROP reached was stage 1 in 10 of 187 (5.3%), stage 2 in 8 of 187 (4.3%), and stage 3 in 18 of 187 (9.6%) infants. Among those with stage 3 disease, threshold ROP was present in 16 of 18 (88.9%). All infants with threshold ROP had a BW less than 1100 g and gestational age less than or equal to 28 weeks. Significantly fewer babies (105/187, or 56%) would have been examined had inclusion criteria of a birth weight of less than 1251 g and gestational age less than 30 weeks been applied. In addition, 31% (134/437) of screening examinations could have been avoided.
Conclusions:
Our study suggests that a birth weight of less than 1251 g and gestational age less than 30 weeks can be safely and efficiently used to screen infants without missing a diagnosis of sight-threatening ROP in our catchment population.
