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Evaluation of new guidelines for ROP screening in Sweden using SWEDROP - a national quality register
Gerd Holmström1, Ann Hellström, Peter Jakobsson
1Department of Neuroscience/Ophthalmology, University Hospital, Uppsala, Sweden.
Insights
Swedish Retinopathy of Prematurity (ROP) screening guidelines for infants born before 31 weeks gestational age (GA) remain effective. A new cohort showed similar ROP incidence and treatment rates to a previous one, supporting current screening protocols.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of Prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Swedish guidelines recommend ROP screening for infants with a gestational age (GA) at birth of less than 31 weeks.
Purpose of the Study:
- To evaluate the applicability of current Swedish ROP screening guidelines in a recent national cohort.
- To compare ROP incidence, treatment, and screening practices between two national cohorts.
Main Methods:
- Utilized data from the Swedish national ROP register (SWEDROP) for infants born between 2010-2011.
- Compared findings with a previously published cohort (2008-2009).
- Analyzed gestational age, birth weight, screening timing, examination frequency, ROP severity, and treatment rates.
Main Results:
- 1744 infants were screened; mean GA was 28.4 weeks.
- Mild and severe ROP occurred in 15.4% and 8.7% of infants, respectively.
- Treatment was administered to 4.2% of infants, with no treatment needed for those born at 30 weeks GA or later.
Conclusions:
- Current Swedish ROP screening guidelines are applicable to the new national cohort.
- ROP incidence, treatment frequency/timing, and screening coverage remained consistent with the previous cohort.
- Findings support continued discussion on potentially adjusting the upper screening limit for ROP.
Purpose:
To investigate whether recent Swedish guidelines for Retinopathy of Prematurity (ROP) screening, that is, a gestational age (GA) at birth of <31 weeks (w), are applicable in a new national cohort of prematurely born infants.
Methods:
SWEDROP is a national register for ROP, initiated in 2006. The present paper reports on data from the register on various aspects of screening for ROP in infants born between 2010 and 2011 and compares the results with those for a previously published cohort born between 2008 and 2009.
Results:
During the study period, 1744 infants were screened for ROP. Mean GA was 28.4 w (22-31), and mean birth weight was 1239 g (382-2615). Screening started at postnatal age (PNA) 5.4 w (0.4-13.3) and postmenstrual age (PMA) 33.8 w (24.9-50.1) Mean number of examinations was 5.4 per infant (1-38). Mild (stages 1-2) and severe (≥ stage 3) ROP was found in 15.4% and 8.7%, respectively. Treatment was performed in 4.2% (73/1744) of the infants, but in none with a GA of 30 weeks or more. The first treatment was performed at a mean PNA and PMA of 12.7 w (7.7-25.4) and 37.4 w (32.1-51.4), respectively.
Conclusions:
Recently introduced new guidelines for ROP screening in Sweden remain applicable. Reassuringly, in infants born between 2010 and 2011, incidence of ROP, frequency and timing of treatment, frequency and timing of examinations and national coverage of ROP screening remained almost identical to those for a previous cohort from 2008 to 2009. The two SWEDROP cohorts provide a basis for discussion among Swedish ophthalmologists and neonatologists on the question of further lowering the upper screening limit with 1 week.
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