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Retinopathy of prematurity: an evaluation of existing screening criteria in Pakistan
Tanveer Anjum Chaudhry1, Farzeen Khalid Hashmi, Muhammad Sohail Salat
1Section of Ophthalmology, Department of Surgery, Aga Khan University, Karachi, Pakistan.
Insights
Broadening screening for retinopathy of prematurity (ROP) did not identify new cases. Infants with gestational age over 32 weeks or birth weight over 1500g did not develop ROP, suggesting current criteria are adequate.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current screening criteria aim to identify infants at high risk for ROP.
Purpose of the Study:
- To assess the impact of broadening ROP screening criteria to include infants with gestational age ≥32 weeks and/or birth weight ≥1500 g.
- To determine if infants outside current screening guidelines develop ROP.
Main Methods:
- Prospective cohort study conducted at Aga Khan University Hospital, Karachi, Pakistan.
- Screening of infants with gestational age ≤35 weeks or birth weight ≤2000 g for ROP.
- Analysis of ROP incidence in infants within and outside current screening criteria using multivariate logistic regression.
Main Results:
- 27 out of 301 infants (9%) developed ROP, with 19 having stage 3 or worse.
- No ROP cases were observed in infants outside the current screening criteria.
- Gestational age was the only independent predictor of ROP development (aRR 0.774, 95% CI 0.603 to 0.994).
Conclusions:
- ROP was not observed in infants with gestational age >32 weeks and/or birth weight >1500 g in this population.
- Broadening screening criteria to include these infants did not yield additional ROP diagnoses.
- Current screening guidelines appear appropriate for this demographic.
Aim:
To evaluate if broadening the criteria for retinopathy of prematurity (ROP) screening to include babies with gestational age ≥32 weeks and/or birth weight ≥1500 g, would have an impact on the number of babies diagnosed as having ROP.
Methods:
A prospective cohort study was carried out at the Aga Khan University Hospital, Karachi, Pakistan. Infants with gestational age ≤35 weeks or birth weight ≤2000 g born in this hospital from May 2010 to December 2012 were screened for the presence of ROP 4-6 weeks after birth. Subsequent examinations were performed at intervals based on the findings of initial eye examinations. Infants diagnosed as having ROP were treated with argon laser therapy. Neonatal risk factors were also assessed. Cumulative incidence of ROP was calculated for babies falling within and outside current screening criteria. Multivariate logistic regression analysis was performed to examine the predictors of ROP.
Results:
A total of 301 infants were screened: 27 (9%) babies developed ROP, of which 19 had stage 3 ROP or worse. None of the babies falling outside the current screening criteria developed ROP. The incidence of ROP in the infants meeting the current screening criteria was 11.5%. Multivariate logistic regression analysis showed that only gestational age (adjusted relative risk 0.774, 95% CI 0.603 to 0.994) was independently associated with the development of ROP.
Conclusions:
In our population ROP was not seen to occur in infants older than 32 weeks gestational age and/or weighing more than 1500 g.
