Refining evidence-based retinopathy of prematurity screening guidelines: The SCREENROP study

Area of Science:

• Neonatal ophthalmology
• Perinatal medicine
• Public health

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
• Current screening protocols identify many infants who do not require treatment, leading to unnecessary resource utilization.

Purpose of the Study:

• To assess and validate predictors for identifying clinically significant ROP (type 2 or worse) and ROP requiring treatment.
• To refine screening criteria for ROP in premature infants.

Main Methods:

• Nationwide retrospective cohort study of infants born between January 2014 and June 2016 in Canadian level 3 NICUs.
• Analysis of 32 potential predictors using multivariable logistic regression on derivation and validation cohorts.
• Screening threshold set at ≥1% risk for clinically significant ROP or ROP requiring treatment.

Main Results:

• Screening infants with birth weight (BW) <1,300 g or gestational age (GA) <30 weeks captured those at ≥1% risk for clinically significant ROP.
• Screening infants with BW <1,200 g or GA <29 weeks captured those at ≥1% risk for ROP requiring treatment.

Conclusions:

• Canadian ROP screening criteria can be optimized by focusing on infants with BW <1,200 g or GA <30 weeks.
• These refined criteria would identify infants requiring treatment and decrease the number of infants screened unnecessarily.