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Retinopathy of prematurity: Recommendations for screening
Insights
New guidelines recommend screening premature infants for retinopathy of prematurity (ROP) based on gestational age and birth weight. Early detection and treatment of ROP are crucial for preventing vision loss in preterm babies.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) affects premature infants' developing retinal blood vessels.
- Recent years have seen updated recommendations for ROP screening and treatment.
Purpose of the Study:
- To outline current evidence-based recommendations for screening and treating retinopathy of prematurity (ROP) in preterm infants.
- To emphasize the importance of standardized screening protocols and communication.
Main Methods:
- Screening infants with gestational ages of 30 6/7 weeks or less, or birth weights of 1250 g or less.
- Initial screening by an ophthalmologist at 31 weeks' postmenstrual age for earliest gestations, or 4 weeks' chronological age for later gestations.
- Follow-up examinations based on ophthalmologist recommendations.
Main Results:
- Screening based on gestational age (≤30 6/7 weeks) and birth weight (≤1250 g) has a very low likelihood of missing treatable ROP.
- Centers may extend birth weight criteria to 1500 g.
- Infants with high-risk ROP are referred for retinal ablative therapy.
Conclusions:
- Adherence to updated screening guidelines minimizes the risk of undetected treatable retinopathy of prematurity.
- Establishing robust processes for ROP screening, documentation, and communication is vital for nurseries caring for preterm infants.
- Prompt referral for retinal ablative therapy is indicated for high-risk ROP cases.
Abstract:
Retinopathy of prematurity (ROP) is a disorder of the developing retinal blood vessels of the preterm infant. New recommendations for screening and treatment of ROP have been published in the past few years. Current evidence suggests that screening infants with gestational ages of 30 6/7 weeks or less (regardless of birth weight) and birth weights of 1250 g or less is a strategy with a very small likelihood that an unscreened baby would have treatable ROP. Individual centres may choose to extend birth weight screening criteria to 1500 g. Initial screening should be performed at 31 weeks' postmenstrual age in infants with gestational ages of 26 6/7 weeks or less at birth, and at four weeks' chronological age in infants with gestational ages of 27 weeks or more at birth by an ophthalmologist skilled in the detection of ROP. Follow-up examinations are conducted according to the ophthalmologist's recommendation. Infants with high-risk prethreshold ROP and threshold ROP are referred for retinal ablative therapy. Developing processes for ROP screening, documenting results and communicating results to parents as well as health professionals involved in the infant's care are important responsibilities for all nurseries providing care for preterm infants.
