Retinopathy of prematurity in Pakistan

Area of Science:

• Ophthalmology
• Neonatology
• Public Health

Background:

• Current retinopathy of prematurity (ROP) screening guidelines, established by the American Academy of Pediatrics and the American Association for Pediatric Ophthalmology and Strabismus, focus on infants with a birth weight of ≤1500 g and/or a gestational age of 32 weeks or less.
• However, ROP has been observed in older and heavier infants in developing and middle-income countries, suggesting current guidelines may not be universally applicable.

Purpose of the Study:

• To investigate the occurrence of retinopathy of prematurity (ROP) in a cohort of infants in a developing country who fall outside the standard screening criteria.
• To determine if ROP affects premature infants who are older and/or heavier than typically recommended for screening.

Main Methods:

• A prospective study was conducted over 16 months involving 172 infants.
• Infants included had a gestational age of 36 weeks or younger and/or a birth weight of ≤3000 g.
• Ophthalmic examinations were performed to identify ROP.

Main Results:

• Retinopathy of prematurity (ROP) was identified in 4 infants older than 32 weeks' gestational age.
• One infant diagnosed with ROP had a birth weight of 2000 g.
• These findings indicate ROP was diagnosed in premature infants heavier than typically considered by international screening standards.

Conclusions:

• Standard ROP screening guidelines may be insufficient for identifying all affected infants, particularly in developing regions.
• There is a need to reconsider and potentially broaden ROP screening criteria to include older and heavier premature infants in resource-limited settings.
• Further research is warranted to establish optimal screening protocols for retinopathy of prematurity in diverse populations.