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Adopting Western Retinopathy of Prematurity Screening Programs in Eastern Countries, are we Screening Properly?
Almutez Gharaibeh1, Mohammed Khassawneh, Wadah Khriesat
1Department of Special Surgery-Division of Ophthalmology, The University of Jordan, Amman, Jordan.
Insights
Retinopathy of prematurity (ROP) affects Jordanian preterm infants, even those with higher birth weights and gestational ages. Current screening guidelines may need adjustment based on these findings, considering consanguinity
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Western screening guidelines are widely adopted but may not be universally applicable.
Purpose of the Study:
- To characterize ROP prevalence in Jordanian preterm infants.
- To assess the effectiveness of current Western screening guidelines for this population.
Main Methods:
- Retrospective, descriptive hospital-based study of preterm infants screened for ROP.
- Followed American Academy of Pediatrics guidelines, with additional screening for at-risk neonates.
- ROP defined as stage 1 or higher in either eye.
Main Results:
- ROP occurred in 28.6% of 91 Jordanian preterm infants.
- ROP was observed in infants with birth weight >1500 gm (20%) and gestational age ≥32 weeks (9.4%).
- Consanguinity was significantly higher in infants with ROP (19.2%) compared to those without (1.9%).
Conclusions:
- ROP affects Jordanian preterms with higher birth weights and gestational ages than previously thought.
- Existing screening guidelines may require modification for the Jordanian population.
- Consanguinity may be a risk factor for ROP, warranting further genetic investigation.
Purpose:
To describe retinopathy of prematurity (ROP) among Jordanian preterm infants and evaluate the efficacy of applying current Western screening guidelines for Jordanian preterms.
Materials And Methods:
In this retrospective, descriptive hospital-based study, we collected data on preterm infants who were referred by their neonatologist for ROP screening at King Abdullah University Hospital between July 2006 and June 2007. Guidelines suggested by the American Academy of Pediatrics were followed. Additionally, older preterms considered at risk for ROP by the neonatal intensive care unit were screened. Any neonate with stage 1 ROP or higher in either eye was considered a positive case of ROP.
Results:
Ninety-one preterms were included in the study. The median birth weight was 1390 gm (range,730-1980 gms) and the gestational age ranged from 26 to 35 weeks with 64.8% of preterms ≤ 32 weeks. ROP occurred in 28.6% of all patients, in 20% of infants with birth weight greater than 1500 gms and in 9.4% of preterms with gestational age ≥ 32 weeks. Six patients (6.6%) required laser treatment, two with low birth weight greater than 1250 gm and one was 33 weeks of age. Consanguinity was identified in 19.2% of infants with ROP while consanguinity in infants who did not develop ROP was 1.9%. This difference was statistically significant (P<0.05).
Conclusion:
ROP occurs in premature infants in Jordan with gestational age above 32 weeks and birth weight above 1250 gm. Future guidelines for screening should incorporate the current study outcomes. A prospective, population-based is required to set national guidelines for ROP screening in the Jordanian population and similarly for different populations worldwide. Consanguinity may play a role in ROP development and further genetic studies may aid in elucidating the pathogenesis of ROP.
