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[Screening for retinopathy of prematurity-the most important changes in the new German guidelines 2020]
Jeany Q Li1, Ulrich Kellner2, Birgit Lorenz3,4
1Universität zu Köln, Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Insights
Updated German retinopathy of prematurity (ROP) screening guidelines now include earlier gestational age limits and revised oxygen exposure criteria. These changes aim for reliable ROP risk identification and timely treatment to prevent infant blindness.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
Background:
- Neonatal care advancements and new retinopathy of prematurity (ROP) treatments necessitate updated screening guidelines.
- The German ROP screening guideline, last updated in 2008, has been revised in 2020 based on recent study findings.
Purpose of the Study:
- To summarize the key modifications introduced in the updated German ROP screening guideline.
- To highlight changes in screening criteria, treatment protocols, and follow-up recommendations for ROP.
Main Methods:
- Review and analysis of the 2020 updated German guideline for retinopathy of prematurity (ROP) screening.
- Comparison of the new guideline's recommendations with previous versions and relevant research.
Main Results:
- Screening inclusion age lowered to <31 weeks gestational age for infants without additional risk factors.
- Minimum oxygen supplementation duration for screening increased to >5 days.
- Treatment for ROP in zone II is now indicated at any stage 3 with plus disease, irrespective of clock hours affected.
- Defined criteria for follow-up examination frequency and duration post-anti-vascular endothelial growth factor (VEGF) treatment.
Conclusions:
- The revised guideline facilitates accurate identification of infants requiring ROP screening.
- Timely detection of advanced ROP stages is enabled, allowing prompt treatment initiation.
- Implementation of the guideline aims to prevent blindness caused by retinopathy of prematurity.
Background:
Due to improvements in neonatal care of premature infants and the development of novel treatment options for retinopathy of prematurity (ROP), the requirements for screening for ROP have changed since publication of the last version of the German ROP screening guideline in 2008. Based on results of recent studies, the guideline has been extensively revised in 2020 and published in an updated version.
Objective:
This article summarizes the most important changes in the new guideline.
Results:
The age limit for screening inclusion was lowered to a gestational age of below 31 weeks for infants without additional risk factors. The minimum duration of oxygen supplementation necessitating screening inclusion in preterm infants was increased to more than 5 days. Treatment for ROP in zone II can now be given at any stage 3 with plus disease, regardless of the number of clock hours affected. Criteria for the frequency and duration have been defined for follow-up examinations after anti-vascular endothelial growth factor (VEGF) treatment. The binding document for these and other new recommendations is the guideline itself.
Conclusion:
The guideline recommendations enable a reliable identification of infants at risk for ROP for screening inclusion and a timely detection of advanced disease stages for treatment initiation, thus preventing blindness from ROP.
