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[Optimum timing of initial examination for retinopathy of prematurity]
Mariko Kiyota1, Miina Hiraoka, Toyoko Watanabe
1Department of Neonatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. m4429jp@yahoo.co.jp
Insights
The optimal time for retinopathy of prematurity (ROP) screening is 29-30 weeks postmenstrual age for premature infants born before 27 weeks gestational age (GA). For infants born at 27 weeks GA or later, screening at 3 weeks chronologic age is recommended.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatology
Context:
- Retinopathy of prematurity (ROP) is a significant cause of vision loss in premature infants.
- Early detection and treatment of ROP are crucial to prevent severe visual impairment.
- Determining the optimal timing for initial ROP screening is essential for timely intervention.
Purpose:
- To establish the ideal gestational age (GA) and postmenstrual age (PMA) for initiating ROP examinations.
- To investigate the relationship between GA, PMA, and the onset of ROP.
- To assess fundus visibility at different stages of infant development for ROP screening.
Summary:
- This study retrospectively analyzed 663 infants with birth weights under 1,500g.
- For infants with GA < 27 weeks, ROP onset was observed as early as 29 weeks PMA, with treatment initiated at 30 weeks PMA.
- Optimal screening times were identified as 29-30 weeks PMA for GA < 27 weeks, and 3 weeks chronologic age (CA) for GA ≥ 27 weeks.
Impact:
- Provides evidence-based guidelines for ROP screening protocols.
- Aims to improve visual outcomes for premature infants by ensuring timely ROP detection.
- Contributes to the understanding of ROP progression in relation to gestational and postmenstrual age.
Objective:
To determine when to begin examination for retinopathy of prematurity (ROP).
Methods:
We retrospectively reviewed the medical records of 663 infants with birth weights of less than 1,500 g in Tokyo Metropolitan Bokutoh Hospital between June 1999 and March 2009, and investigated the timing of onset and initial treatment. In addition, we investigated visibility of fundus for infants of less than 27 weeks gestational age (GA).
Results:
The mean GA was 28.7 weeks and the mean birth weight was 1,032.6 g. For infants of less than 27 weeks GA, the earliest onset was 29 weeks postmenstrual age (PMA) and the earliest initial treatment was performed at 30 weeks 0 days PMA. Regarding the visibility of the fundus, zone I could be seen for 50.8% of those infants receiving examination during the latter half of 29 weeks PMA and 71.7% of those infants receiving examination during the former half of 30 weeks. For the infants of a GA of 27 weeks or more, the earliest onset was 2 weeks chronologic age (CA) and the earliest initial treatment was performed at 3 weeks 3 days CA.
Conclusions:
The optimum timing of initial examination for ROP proved to be between the latter half of 29 weeks and 30 weeks 0 days PMA for infants of a GA of less than 27 weeks; and 3 weeks CA for the infants of a GA of 27 weeks or more.
