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Updated: Aug 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Surveillance for retinopathy of prematurity in practice: experience from one neonatal intensive care unit
1Neonatal Unit, Hammersmith Hospital, London.
Insights
This study suggests that infants born at 31 weeks or more gestational age do not require Retinopathy of Prematurity (ROP) screening. This focused approach can improve the detection of clinically significant ROP cases.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of Prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current surveillance programs aim to detect sight-threatening ROP early.
Purpose of the Study:
- To evaluate the effectiveness of a modified ROP surveillance program.
- To determine optimal gestational age criteria for ROP screening.
- To assess an atraumatic eye examination technique for ROP detection.
Main Methods:
- A six-year review of ROP surveillance program data.
- Analysis of ROP incidence and severity based on gestational age.
- Evaluation of an examination technique without speculum or scleral indentation.
Main Results:
- 137 infants (44.8%) showed signs of ROP; 35 (10.8%) reached stage 3.
- All stage 3 ROP cases occurred in infants born at 25 weeks or less gestational age.
- No infants born at 30 weeks or later developed stage 3 ROP.
Conclusions:
- Excluding infants born at 31 weeks or more from ROP surveillance is safe and effective.
- This revised protocol enhances the yield of clinically significant ROP.
- An atraumatic examination technique reliably identifies stage 3 ROP requiring intervention.
Abstract:
We have reviewed the results of a six year surveillance programme for acute Retinopathy of Prematurity (ROP) in order to see how the yield of cases reaching clinically significant stage 3 can safely be maximised, and to assess the effectiveness of an examination technique which does not require a speculum or scleral indentation. An overall 137 (44.8%) developed some signs of ROP and 35 (10.8%) reached stage 3. Seventeen of these were born at 25 weeks or less gestational age, and included four with rush-type disease. None of those born at or over 30 weeks developed stage 3. It is concluded that infants born at 31 weeks or more do not need to be included in a surveillance program, and this protocol will increase the yield of significant disease. In addition, cases of stage 3 which may require cryosurgery will not be missed using an atraumatic examination technique.
